Medicare Must Raise Reimbursement Rates | Opinion

Inflation has reached its highest level in four decades. Gas is about 40% more expensive than a year ago. Groceries are up about 10%.

Yet there is one sector of the economy where prices are rising much more slowly: health care. And ironically, this creates problems for patients who rely on home medical equipment such as electric wheelchairs, ventilators, and home oxygen equipment.

Providers they rely on for home care are penalized by rising labor, transportation and material costs. But unlike other companies, they can’t just raise prices to compensate. Their prices are actually set by Medicare. These reimbursement rates are based on a seven-year-old formula that barely covered provider costs before inflation took off.

Unless Congress steps in soon to increase reimbursement rates, many home care providers could go bankrupt. Millions of Americans could no longer get the care they need at home. At best, they should move to nursing homes or other clinical facilities. At worst, some could do without it altogether.

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The double whammy of inflation and supply chain issues has hit homecare companies hard. Key supplies – like spare parts for electric wheelchairs and tubing for home oxygen machines – have been hard to come by. When the equipment that patients and home care providers need is available, the cost of shipping and transportation is almost prohibitive. Labor costs are also soaring.

Add all of these factors up and some home care businesses struggle to keep their doors open.

This is a potential disaster for the elderly and people with chronic illnesses or disabilities who rely on home medical equipment.

Imagine an elderly person with chronic obstructive pulmonary disease, or COPD, who is dependent on home oxygen. If her home care provider is reducing services in her community or leaving Medicare entirely due to stagnant payment rates and rising costs, she may need to seek care more frequently in expensive clinical settings — or end up in the emergency room.

Or consider someone who relies on a wheelchair to live independently. If the home care provider they rely on to maintain their wheelchair disappears, possible consequences include reduced mobility at home, the need to hire a part-time or full-time carer, or even a transition to an assisted living facility.

Scenarios like these are already happening. And the problems will multiply if reimbursement rates for home medical equipment remain unchanged even in the face of inflationary spikes.

Fortunately, a bipartisan group of House lawmakers introduced legislation that would help address this looming crisis. The DMEPOS Relief Act would increase payments for many home medical equipment providers by an average of 9%. It would provide a lifeline to local suppliers of home medical equipment burdened by inflation – and, more importantly, to the patients who rely on them for their care.

It’s also inexpensive, relative to the Medicare budget. Home medical equipment accounts for less than 2% of Medicare spending. More importantly, home care can keep people away from more expensive settings like hospitals and nursing homes.

The current inflationary spiral is a national crisis. Home care providers and the patients they serve are finding this out the hard way. It’s time for Congress to make sure these patients can get the care they need — by updating Medicare reimbursement rates.

Thomas Ryan is president and CEO of the American Association for Homecare. This piece was originally published in Medical Economics.

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