With so much attention focused on a heated presidential race over the last several months, you may have missed a serious problem facing a major component of the healthcare infrastructure that serves rural communities nationwide. But home medical equipment companies in these areas, and the millions of seniors, people with disabilities and other individuals who depend on their products, are all-too-aware of the growing crisis facing them.
Across the country people are reeling over new policies that are costing jobs, lowering quality of care for seniors on Medicare and making medical equipment supplies less accessible to those in need. Earlier this year, the Centers for Medicare and Medicaid Services (CMS) implemented a new reimbursement rate procedure that is driving rural medical equipment providers out of business. This new policy was enacted at the beginning of this year without proper evaluation to ensure the stated objectives would be met and that unintended consequences were not created. Unfortunately, both of these results have come to pass.
Recommended Stories
CMS has adopted new medical equipment reimbursement policies that apply prices set by a bidding program taking place in the country’s largest metropolitan areas to rural communities and other less-densely populated areas. The controversial bidding program in these big cities has caused major problems for home medical equipment companies and the patients they serve. The University of California Health System recently expressed their frustrations in comments to CMS on the program, saying that since the program has been implemented, hospital discharge planners “are no longer able to select DME suppliers based on what is in the patient’s best interest, but must use suppliers that, in their view, provide sub-standard customer service and often cannot meet the patient’s needs-ultimately compromising care outcomes.”
The problems with the program are magnified even further when these rates from this program are applied to rural communities, which has seen Medicare reimbursement cuts of 50 percent or more in many categories, including home oxygen, wheelchairs and specialized beds. Large-scale medical equipment providers in urban areas can at least capitalize on increased market share and economies of scale and leverage efficiencies from serving patients over a smaller geographic area.
For seniors, people with disabilities, and other individuals with chronic conditions on Medicare who live in rural communities, the potential for diminished quality of care is evident.
While many medical equipment providers are making tough decisions such as cutting staff, reducing product offerings or no longer accepting new Medicare patients, others are making even more difficult choices to close their stores. As a result, seniors on Medicare have fewer places to find the products they need to stay home and comfortable. In many cases, store closures force seniors to drive farther to stores in neighboring communities 30 miles or more away. This may not seem like a big difference, but to a senior in need of oxygen therapy or a wheelchair these trips can require Herculean effort, not to mention support from family and friends.
If these unintended consequences were not enough, it is just plain unfair and bad policy. Your ZIP code should not dictate the quality of Medicare you receive or the level of access available to you under Medicare.
With your help, we can solve this problem. I urge you to contact your federal representatives in the U.S. House and Senate. Both chambers recognize the importance of fixing this problem, and passed differing versions of legislation to roll back part of these cuts to give policymakers time to assess the potential impacts of applying these deep reductions to rural areas. However, they need to pass a final bill that can be sent to the White House. People who depend on home medical equipment, their caregivers, and anyone else who is concerned with maintaining this essential part of our healthcare infrastructure in rural communities need to contact their legislators, and let them know we are paying attention and want action now—before it is too late.
Thomas H. Ryan is the president of the American Association for Homecare (AAHomecare). AAHomecare represents durable medical equipment providers, manufacturers, and others in the homecare community. Visit www.AAHomeCare.org. Thinking of submitting an op-ed to the Washington Examiner? Be sure to read our guidelines on submissions.
