Study: Not Investing in HME Costs CMS ‘Significantly’ More

Leitten Medicare Cost Shift study details how repeated cuts to DMEPOS reimbursement are sending patients back to the hospital and costing Medicare Part A as a result.

As providers and industry advocates work to lobby lawmakers while they are back in their districts for the August congressional recess, they have some convincing data to help them make their case: The Leitten Medicare Cost Shift study.

The study, conducted by Leitten Consulting and sponsored by VGM, shows how reduced access to home medical equipment and related products is actually costing Medicare Part A more money in the long run. To make the case, the study examined three areas where costs get shifted to Part A: fall injuries, COPD exacerbations, and untreated sleep apnea.

“VGM will be using this study in meetings with legislators to help underline the need to fix this area,” a statement from VGM Government Relations read. “We encourage suppliers to use these numbers while meeting with policymakers during the August of Action.”

Leitten tabulated the cost to treat each injury or condition, and calculated by how much they exceed the cost of the HME items that would have obviated or mitigated the issue. Some key costs:

  • The failure to provide mobility equipment to patients needing such devices winds up costing Medicare between $4,705 and $5,029 due to injuries incurred in events such as falls.
  • COPD-related exacerbations resulting from Medicare impeding patients’ access to the right oxygen equipment cost Part A approximately $14,350.
  • Sleep apnea complications due to patients not receiving CPAP equipment cost Medicare $1,631.

“In sum, Medicare ends up paying significantly more to treat the medical complications that result from its failure to adequately invest in DME,” Leitten notes in the survey. “By shifting both the cost and the focus of CMS to provide needed treatment for patients up front, the government can dramatically reduce overall healthcare costs and improve the care provided to its Medicare beneficiaries.”

To read the full Leitten study, visit bit.ly/2M9PN4Q.

About the Author

David Kopf is the Executive Editor of HME Business and DME Pharmacy magazine. Follow him on Twitter at @postacutenews.

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