The American Association for Homecare (AAHomecare), in collaboration with the Global Enteral Device Supplier Association (GEDSA), has introduced a white paper supporting the “life-sustaining” importance of enteral nutrition.
In a Jan. 8 news release, AAHomecare discussed the paper, “Challenges in Enteral Nutrition Access & Management: Safeguarding Life-Sustaining Enteral Nutrition,” which the association said was developed in collaboration with enteral nutrition stakeholders.
“In the United States, hundreds of thousands of individuals face the challenges and risks of malnutrition, necessitating life-sustaining enteral nutrition to receive necessary nutrition and hydration,” AAHomecare said in the announcement. “Delivered through various methods into the gastrointestinal tract, enteral nutrition is indispensable for individuals with diverse medical conditions either temporarily or as a lifelong requirement.
“Failure to manage enteral nutrition properly can lead to severe health consequences, including increased vulnerability to falls, delayed wound healing, and healthcare-associated complications like pressure ulcers. Moreover, malnutrition amplifies readmission rates, institutionalization, and healthcare service dependence, especially among medically complex individuals.”
Threats to Enteral Nutrition Access
The white paper provides an overview of the enteral nutrition market and discusses threats to access and the role that home medical equipment (HME) suppliers play in providing enteral nutrition supplies and equipment to consumers.
But enteral nutrition is also under pressure, AAHomecare added, citing “findings from a 2023 nationwide study revealing that one in four HME providers of enteral nutrition are considering or actively planning to stop providing enteral nutrition and supplies due to cost pressures.”
Those providers, the paper said, cited “significant increases in product, labor, and shipping costs, yet 88 percent have received no reimbursement increase from payers outside of the Medicare FFS CPI-U adjustment to offset the new market realities.”
The paper also mentions billing and coding complexities due to a “wide variety of products, dressing, and adapters within a single miscellaneous non-reimbursable billing code, affiliated costs of safety initiatives including change management and execution, as well as limitations on feeding kit reimbursement.”
The paper provides four recommendations to preserve crucial access to enteral nutrition. Funding sources, the paper says, need to adjust reimbursement to support continued and appropriate access to consumers; expedite prior authorizations for enteral nutrition formula; provide “regular review and expeditious product additions to approved product lists/formularies”; and reduce documentation requirements that are “excessively burdensome.”
HME Suppliers Play Key Roles
The paper covers short-term, long-term, and low-profile G-tube button routes of administration, and syringe tube feedings, gravity tube feedings, and feeding pump usage.
The paper also describes the work that HME suppliers provide to enteral nutrition patients, including coordinating logistics; being experts on billing and the requirements of a range of payers; acting as clinical liaisons to educate prescribers on documentation requirements; educating consumers on enteral nutrition management; maintaining product knowledge and expertise; and acting as care coordinators who handle renewals and order changes from patients’ healthcare teams.
AAHomecare said Dietitians in Nutrition Support — part of the Academy of Nutrition & Dietetics — provided the technical review of the white paper. “The resource,” the association added, “will be used in outreach and education to payers, state programs, and legislators to preserve access to enteral nutrition, supplies, and services.”
Image: istockphoto/Jeniffer Fontan
