A segment aired on CNN July 20, 2009 titled, “One wheelchair—one lesson of problems in health care reform,” presented a distorted, inaccurate view of the home medical equipment benefit in Medicare. The American Association for Homecare provided ample information to CNN about the costs of providing equipment and services to Medicare beneficiaries in their homes. The Association also presented information about the controversial competitive bidding program that Medicare implemented last year. However, CNN used a combination of incorrect figures and cherry-picked facts to paint a false picture of both topics.
The CNN producers and correspondent reported incorrect and inflated numbers related to the cost of the wheelchair to taxpayers, and the segment highlighted an unusually long rental situation in which the user elected to continue renting instead of allowing Medicare to purchase the chair for her, resulting in a higher cost to taxpayers. Apria Healthcare has responded to CNN about the numerous specific errors in its report.
However, the CNN reporter and producers perpetuated two myths that harm the public’s understanding of home medical equipment benefit in Medicare.
Myth Perpetuated by CNN: Medicare overpays for durable medical equipment because the same items can be purchased more inexpensively over the Internet. CNN failed to report that the value of medically required services and medical equipment (such as a wheelchair) provided to frail seniors or people with disabilities in their home in compliance with Medicare and other federal and state regulations cannot be equated with the value of the purchasing the wheelchair alone via the Internet or via a simple cash transaction at a store. Yet CNN made this myth premise of its entire segment, using incorrect and overstated figures for the cost of the chair to taxpayers. The costs of providing home medical equipment and services to Medicare patients include delivery, often within hours of discharge from a hospital, set-up, patient education, compliance, and 24-hour on-call service. It is the consumer who values the local provider as demonstrated by data that an extraordinarily small number of consumers purchase these products over the Internet and instead actively choose their local provider.
Myth Perpetuated by CNN: Home medical equipment providers escaped the price reductions that competitive bidding would have imposed. The CNN producers and reporter know that the competitive bidding program was not, in fact, “stopped after two weeks.” It was delayed in order to fix serious flaws in the program. In a far more serious omission, CNN reporter failed to report the fact, which he knew, that taxpayers benefited fully in the billion-dollar savings that last year’s competitive bidding program was projected to have produced: Providers of home medical equipment were subjected to a 9.5 percent reduction in the reimbursement rates, beginning in January 2009, for items subject to competitive bidding, as mandated by the Medicare Improvements for Patients and Providers Act of 2008. This reduction was imposed by Congress as a condition for delaying the bidding program so the program could be fixed and re-implemented. CNN had this information but failed to mention it. Instead, CNN left its viewers with the impression that providers of medical equipment escaped any negative impact because of intervention by Congress. The stark reality is that hundreds of providers of home medical equipment are struggling and in some cases failing as a result the 9.5 percent cut, and a 27 percent total cut for oxygen therapy in 2009, and even deeper cuts in reimbursement for power wheelchairs in recent years. Nor did CNN explain that the competitive bidding system is designed to reduce the number of competitors by as many as 80 percent, by arbitrarily excluding providers from Medicare, even if they agree to lower bid prices.
The net effect of this extraordinarily misleading segment is a false impression about the nature of the home medical benefit in Medicare and completely inaccurate picture of the competitive bidding issue.
To view the CNN piece, visit http://www.cnn.com/video/#/video/politics/2009/07/20/griffin.wheelchair.medicare.cnn?iref=videosearch.