New England Journal of Medicine Underscores Relevance of Homecare

An October 20 article in the New England Journal of Medicine states that, “ultimately, health care organizations that do not adapt to the home care imperative risk becoming irrelevant. It seems inevitable that health care is going home.”

The article describes the demographic, clinical, economic, and technological forces that are making home-based care an “imperative” for healthcare. The article, by Steven H. Landers, M.D., of the Cleveland Clinic, cites oxygen as an example of advances in portable medical technology, and cites parenteral nutrition and infusion as examples of care that are both cheaper than and as equally effective as institutional care.

Landers notes that in 20 years, there may be more than 70 million Americans age 65 and older. “Many of these older adults will have limitations on their activities, including difficulty walking and transferring from bed to chair, that make leaving their homes difficult. Bringing care to the home improves access for such people, especially those living in older homes with hard-to-negotiate entryways and those with limited resources for transportation. Older adults are particularly prone to complications of confinement in hospitals, such as delirium, skin conditions, and falls. Treating people at home may be one way to avoid such complications.”

CMS Misses Deadlines for Bid Program and Providers and Patients Get Little Information

Missed deadlines for the “competitive” bidding program will needlessly complicate care for the millions of Americans who depend on home medical equipment and services. During the September 15, 2010 House Energy and Commerce Committee hearing on the HME bidding program, Laurence Wilson from CMS reassured the committee that the program was moving forward without any difficulties. He said that he was confident that all the contacts in the Round One areas would be signed and CMS would release information regarding bid winners sometime in September.

It is now mid-October and CMS has failed to release any information on the bid process or winning contracts. If CMS still plans to begin implementation of the bid rates in Round One areas at the beginning of next year, it will leave little time for HME referral sources, discharge planners, providers, and patients to prepare for such a drastic change in the delivery of HME – placing beneficiaries’ safety at risk.

“In an Administration that touts transparency and open government, CMS has once again failed to provide basic information about the bidding process,” said Tyler Wilson, AAHomecare president. “Without this important information, it is impossible to analyze whether or not Medicare patients will receive the proper equipment and services they need.”

To address the fatal flaws in HME competitive bidding, AAHomecare is urging Congress to immediately stop the implementation of this bidding program and work with the HME community to ensure accurate pricing, while at the same time ensuring access to quality care for Medicare beneficiaries.