AAHomecare and the American Thoracic Society held a briefing in the U.S. Capitol building on HME patient access issues attended by more than fifty House and Senate staffers who handle healthcare-related issues. The briefing centered around presentations from the authors of two studies that show credible evidence that patients are experiencing significant access problems in today’s regulatory and reimbursement climate for HME.
Al Dobson, president of Dobson DaVanzo & Associates and study lead on Analysis on the Impact of Competitive Bidding on Medicare Beneficiary Access to Durable Medical Equipment, detailed survey results that show the expansion of competitive bidding nationwide has significantly impacted patients, hospital case managers, and HME suppliers. Dobson’s presentation included findings that 77% of case managers have experienced difficulties with the ease and timeliness of the discharge process for HME patients in the previous year. 52% of all HME patients surveyed experienced difficulties accessing equipment and services, with a subgroup of oxygen patients reporting a higher level of difficulty at 59%.
Susan S. Jacobs, RN, MS, a Pulmonary Nurse Specialist at Stanford University’s School of Medicine, and lead author for Patient Perceptions of the Adequacy of Supplemental Oxygen Therapy, echoed frustrations with HME access for oxygen patients. Jacobs' peer-reviewed study, published in the Annals of the American Thoracic Society in October 2017, found that 51% of patients nationwide experienced problems with their oxygen service, a stark contrast to CMS’ assertion that they receive a handful of complaints regarding supplemental oxygen each month.
Mike Calcaterra (at podium), Northern Zone Vice President for NORCO Inc. and Montana State Chair for the Big Sky Association of Medical Equipment Suppliers, provided a supplier’s perspective. Calcaterra noted that Montana has lost 20% of its HME companies since 2013, and Idaho has seen a 37% reduction in its ranks of suppliers, and detailed how drastic Medicare reimbursement cuts of 57% for stationary oxygen since 2016 make it impossible for rural providers to meet their costs.
AAHomecare’s Tom Ryan concluded the meeting with a warning that both HME suppliers and patients, especially those in rural communities, will face even more severe impacts without near-term relief for rural and non-bid areas. Ryan asked for further help from Congress in releasing the HME-related Interim Final Rule currently at OMB and to support longer-term reforms for the bidding program going forward.