The Holidays Highlight the Value of Home-Based Health Care

WASHINGTON, November 23, 2011 ------ Millions of Americans will be able to share Thanksgiving and other holidays with seniors and people with disabilities who are able to live safely and independently in the comfort of their own homes, thanks to home medical equipment, services, and supports.

Homecare also provides tremendous value to more than eight million Americans who require some type of care in the home, says the American Association for Homecare. Home medical equipment and services can be provided and maintained for just dollars a day, which is why homecare is a cost effective alternative to institutional care and is an important part of the solution to our nation’s healthcare financing challenge.

Facts about Homecare

• More than eight million Americans depend on medical equipment and services at home which treats conditions such as multiple sclerosis, Lou Gehrig’s disease, spinal cord injuries, severe lung disease such as chronic obstructive pulmonary disease (COPD), congestive heart failure, sleep apnea, and diabetes. Virtually every type of health care short of surgery can be successfully delivered in the home. Seniors and people with disabilities receive medically prescribed oxygen therapy, wheelchairs, hospital beds, drug infusion therapy, hospice care, walkers, and other medical services, supplies, and equipment at home.
  
  
• Americans would rather receive care at home according to surveys by AARP and other organizations. Moreover, a 2011 Harris Interactive survey about spending priorities for health care found that 79 percent of Americans believe the federal government should strengthen patient access to home medical equipment and services and 61 percent favor investment in community- or home-based care to improve cost-effective health care.
  
  
• Providers of home medical equipment and services help prevent ER visits and hospitalization and enable hospitals to discharge patients on a timely basis to post-acute care at home, which reduces length of hospital stays and lowers spending in the healthcare system. The home is the most cost-effective setting for many types of medical care including long-term care and is part of the solution for lowering health costs. In an October 20, 2010 New England Journal of Medicine article, Steven H. Landers, M.D., cites home oxygen as an example of advancement in portable medical technology and cites parenteral nutrition (tube feeding) and infusion as examples of home-based care that are cheaper than and as equally effective as institutional care.
  
  
• Home medical equipment providers serve as first responders to ensure that people receiving homecare are safe in emergencies such as Hurricane Irene or ice storms where power is lost for days at a time. A power outage can be deadly for a person who requires a ventilator or an oxygen concentrator that treats lung diseases or chronic heart failure. During a power outage or evacuation, having an adequate back-up supply of battery power or oxygen is essential to the health of the device users. In a catastrophic pandemic flu, home-based care will play a large role in treating flu victims since patients will quickly overwhelm hospitals.

The American Association for Homecare celebrates the thousands of dedicated professionals and family caregivers who provide the equipment, services, and supports that enable seniors and people living with disabilities to remain in the care setting that most prefer – their own homes.

The American Association for Homecare represents providers of durable medical equipment and services who meet the healthcare needs of millions of Americans who require oxygen equipment and therapy, wheelchairs and mobility assistive technologies, medical supplies, inhalation drug therapy, and other medical equipment and services in their homes. Members provide homecare in all 50 states.

Contact:
Michael Reinemer, 703-535-1881, michaelr@aahomecare.org
Tilly Gambill, 703-535-1896, tillyg@aahomecare.org

Misleading Medicare Data on Improper Payments for Home Medical Equipment Paints False Picture

The American Association for Homecare expressed dismay today that the Centers for Medicare and Medicaid Services’ (CMS) calculated a 61 percent improper payment rate for the home medical equipment sector for 2011. The 61 percent improper payment rate is significantly higher than the overall Medicare fee-for-service error rate, which is 8.6 percent for 2011.

Even though the improper payment rate is not a calculation of fraud, the rate is misunderstood and it casts an unwarranted cloud over the entire home medical equipment sector.

“The 61 percent error rate is preposterous,” said Tyler Wilson, president of the American Association for Homecare. “More than anything, the improper payment rate for HME reflects badly on Medicare. It highlights the inconsistent guidance provided by CMS and the subjective audit reviews by the Agency’s contractors. Without significant changes to the medical review process, the millions of Medicare beneficiaries who require home medical equipment will not receive what their physicians order. The agency must better educate physicians about documentation requirements and help to improve compliance without placing needless burdens on providers of home medical equipment.”

The Association has worked with CMS to lower the error rate through greater consistency in audit requests, Medicare coverage criteria, and education of both home medical equipment providers and physicians. However, the Association’s recommendations to the agency for reducing the error rate have been ignored.

CMS is required by law to estimate and report the improper payment rate through a random sampling of claims conducted by the Comprehensive Error Rate Testing (CERT) audit contractor. The CERT contractor evaluates claims to determine whether they were properly paid according to Medicare coverage, coding, and billing rules.

The American Association for Homecare represents providers of durable medical equipment. Members serve the medical needs of millions of Americans who require oxygen equipment and therapy, wheelchairs and mobility assistive technologies, medical supplies, inhalation drug therapy, home infusion, and other medical equipment and services in their homes. The Association’s members operate more than 3,000 homecare locations in all 50 states. Visit www.aahomecare.org.

AAHomecare Supports Key Anti-Fraud Bill Introduced in House

The American Association for Homecare (AAHomecare) is pleased that Representative Peter Roskam (R-Ill.) introduced an important bill yesterday designed to reduce fraud and improper payments in Medicare.

The Fighting Fraud and Abuse to Save Taxpayer Dollars Act, or FAST Act, H.R. 3399, would strengthen Medicare by shifting Medicare's "pay-and-chase" payment system to one that is modeled after credit card industry fraud-prevention tactics, utilizing predictive modeling technology to prevent paying fraudulent Medicare claims. The legislation also contains a provision, supported by AAHomecare, which would require an electronic prior authorization process for standard power wheelchairs in Medicare. This provision requires physicians to use a clinical medical necessity template to document the medical need for a power wheelchair. The Association believes that this physician template is a critical tool needed to reduce improper payments due to documentation errors.

AAHomecare has long fought against Medicare fraud. The Association has worked with Congress and the Administration to implement a number of key components of its 13 point anti-fraud plan. Visit www.aahomecare.org/stopfraud to see the plan. Last year, AAHomecare supported H.R. 5546, introduced by Rep. Roskam, which would have improved the tools and resources available to prevent fraud and abuse in Medicare through the use of predictive modeling technologies.

The Association welcomes the opportunity to work with Rep. Roskam on this important bill as it moves through the legislative process.

Meet the Team: Dan Smith, Director of Membership Sales and Marketing

Dan Smith is the director of membership sales and marketing at AAHomecare. Dan joined the team in the summer of 2011.

Dan spends the majority of his time traveling state to state, listening to members, talking to prospects, and promoting the value of AAHomecare. He’s a seasoned veteran of the HME sector, bringing decades of experience to AAHomecare. From 1983 to 1991, he was a Rehabilitation Technology Supplier (RTS) for Advacare Medical, in Kansas City. From 1991 to 1997, he served as Regional Manager at Everest & Jennings. He also worked for The MED Group for twelve years, where he served as vice president of membership from 2002 to 2009.

Dan is a graduate of Kansas University and a huge JayHawk basketball fan.

Fun Facts
• Dan is an amateur herpetologist. He currently owns an 8-foot boa constrictor as a pet, and he has appeared twice on TV.

• Dan has been a national triathlete (swim, bike, run) for 15 years and competed all over the country, including the National Championships at Hilton Head Island, South Carolina, where 2000 national triathletes competed.

• Dan is a self-proclaimed expert on the Mexican/US border and Mexican Drug Cartels. He works out of the AAHomecare Western Regional Office (actually, his house) in Lubbock, Texas.