Much needed home respiratory oxygen restricted as Medicare rates decline


While there is a rising number of Americans over the ago of 65 who live with Chronic Obstructive Pulmonary Disease (COPD), Medicare claims for the much needed home respiratory therapy have severely gone down over the years, according to a report published Friday by The Hill.

COPD, a condition suffered by an estimated eleven million Americans, is a disease with no cure, but it is treatable with a combination of prevention, infection control, and the addition of supplemental oxygen therapy.  The best course of action for the patients with COPD is to give them the best care available so they don’t have to go on the oxygen. Once they are prescribed supplemental oxygen the patient will remain permanently on it.

There are alarming numbers coming in according to data from the Centers for Medicare & Medicaid Services (DMS).  They report that Medicare patients receiving home oxygen between 2008 and 2014 has declined by 42 percent at the same time patients on Medicare grew by 19 percent. Of that 19 percent, those with a COPD diagnosis blossomed by 59 percent.

The findings are that the declining numbers of people getting the home oxygen services for their COPD are due to cuts in Medicare payments, which have reduced access to the equipment.

Many of the suppliers have reduced or stopped providing services in the most rural areas across 24 states, the report states.  In some cases, patients are being kept in hospitals longer due to the hospital being unable to find an oxygen supplier.  It is especially difficult if the patient is on Medicare.

The Centers for Medicare and Medicaid Services (CMS) oversee the nation’s Medicare program had reported there has not been access to care issues.

The report was published by Tim Pigg, the President and CEO of Rotech and a board member of the Council for Quality Respiratory Care.

Pigg expresses great concern that the number Medicare patients who need home oxygen is increasing, but flaws in Medicare’s competitive bidding program and reimbursement cuts have resulted in fewer people receiving the needed service.

Some supplies, especially those in rural areas, have simply stopped providing the service.  Patients who go without the oxygen service are then at risk for other respiratory illnesses, and even hospitalizations. The expense of a one day in the hospital is 100 times more than the monthly cost allowed for oxygen therapy, Pigg notes.

Pigg further reports:

“Nationally, the number of home oxygen suppliers is on the decline. Smaller suppliers are leaving the business, large regional and national companies are leaving states, and closures and consolidations are resulting in thousands of layoffs. For example, one national home respiratory supplier has closed 87 locations in non-competitive bidding areas (CBAs), 44 locations in CBAs, and has laid-off 3,000 employees since the implementation of Medicare’s Modified Fee Schedule. Another large supplier has closed nearly 200 locations in non CBAs, and at least one national supplier has reduced or stopped providing services in rural areas across 24 states.  

“The unfortunate result, of course, is that there will be a growing numbers of Medicare beneficiaries who will not be able to get the care they need, or can’t get it in a timely fashion. In the most drastic cases, delayed oxygen therapy is keeping patients hospitalized longer. In one rural area, the local hospital couldn’t find an oxygen supplier willing to take on new Medicare patients at the reduced reimbursement rate, delaying patient discharge by several days.”

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