In a bizarre editorial this morning, the Wall Street Journal cites Medicare payments for medical oxygen therapy as Exhibit A in an editorial about controlling costs, repeating a misleading article about White House budget director Peter Orszag. The reality, not mentioned by the Journal, is that reimbursement rates for oxygen have been reduced by 27 percent in 2009 alone. There are more cuts on the table. Oxygen was cut in the Medicare Modernization Act of 2003, in the Deficit Reduction Act of 2005, and in the Medicare Improvements for Patients and Providers Act of 2008, which delayed the competitive bidding program to make a few essential improvements (contrary to what the Journal opines, it was not "blown up" by any stretch of the imagination). The delay to that program came along with a 9.5 percent cut to all bid-upon home medical equipment items to pay for the savings that the bid program was projected to save. Meanwhile, the bid program begins again this fall. See editorial at http://online.wsj.com/article/SB10001424052970203517304574303014243807246.html.
The home medical equipment and service (durable medical equipment) sector is one of the slowest growing spending areas in Medicare (0.75 percent per year per 2007 National Health Expenditures data) and it represents about 1.6 percent of Medicare spending. Good home-based care helps prevent rehospitalizations. Ironically, the Wall Street Journal has a front-page story about that topic. Quoting the Journal’s news article about reducing readmissions, "The breakdown was occurring not in the hospital, but in the transition to home." http://online.wsj.com/article/SB124873545269485081.html.
Homecare is not the problem -- it's part of the solution. But you wouldn't know that reading this editorial.