To guard patient access to care, Medicare must up its reimbursement rates | Opinion


Inflation has soared to the best level in 4 a long time. Gas is roughly 40 percent dearer than it was a 12 months ago. Groceries are up about 10 percent.

Yet there’s one sector of the economy where prices are growing way more slowly — health care. And paradoxically, that’s creating problems for patients who depend on home medical equipment like power wheelchairs, ventilators, and residential oxygen equipment.

The providers they rely on for his or her homecare are getting walloped by rising labor, transportation, and material costs. But unlike other businesses, they’ll’t simply raise prices to compensate. Their prices are effectively set by Medicare. Those reimbursement rates are based on a 7-year-old formula that hardly covered providers’ costs before inflation took off.

Unless Congress intervenes to boost reimbursement rates soon, many homecare providers could go under. Thousands and thousands of Americans would not have the ability to get the care they need at home. At best, they’d need to move into nursing homes or other clinical facilities. At worst, some could go without care altogether.

The double whammy of inflation and provide chain snags has hit homecare firms hard. Key supplies — like alternative parts for power wheelchairs and tubing for home oxygen machines — have been hard to come back by. When the equipment patients and homecare providers need is out there, the value of shipping and transportation is sort of prohibitive. Labor costs are soaring, too.

Add all these aspects up, and a few homecare firms are struggling to maintain their doors open.

That’s a possible disaster for the elderly and people with chronic conditions or disabilities who depend on home medical equipment.

Imagine a senior with chronic obstructive pulmonary disease, or COPD, who relies on home oxygen. If her homecare provider scales back service in her community or exits Medicare entirely due to stagnant payment rates and rising costs, then she could have to hunt care more ceaselessly in expensive clinical settings — or may find yourself within the emergency room.

Or consider someone who relies on a wheelchair to live independently. If the homecare provider they depend on to service their wheelchair disappears, possible consequences include impaired mobility at home, the necessity to bring on a part- or full-time caregiver, or perhaps a transition to an assisted living facility.

Scenarios like these are already happening. And the issues will multiply if home medical equipment reimbursement rates remain unchanged at the same time as inflation spikes.

Thankfully, a bipartisan group of lawmakers within the House have introduced laws that might address this looming crisis. The DMEPOS Relief Act would raise payments for a lot of providers of home medical equipment by a median of 9 percent. This could provide a lifeline to local home medical equipment providers burdened by inflation — and more importantly, the patients who depend on them for care.

It’s also inexpensive, relative to Medicare’s budget. Home medical equipment accounts for lower than 2 percent of Medicare spending. More importantly, home-based care can keep people out of higher-cost environments like hospitals and nursing homes.

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

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


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