In Washington, D.C. it is critically important to have credible studies and good data to substantiate our policy objectives. This year, as Congress potentially looks to all providers and payors to help fund the SCHIP (state children’s health insurance program) or Medicare payment changes to physicians, it is even more critical that we tell our story with hard facts.
In July, a new study was released demonstrating that impending cuts to Medicare’s home oxygen benefit are much deeper than anticipated – cuts totaling $710 million in 2009 and $855 million in 2010. The reductions in funding – which amount to an 18.8 percent reduction in the reimbursement rate – are the result of changes brought by the Deficit Reduction Act (DRA) of 2005 and will affect a significant portion of the more than one Medicare beneficiaries with chronic lung disease who rely on home oxygen for health and independence.
When you consider these cuts along with other cuts that have been legislated since the Balanced Budget Act of 1997, the severity is particularly significant. In essence, it means that the average Medicare home oxygen payment by 2010 will be almost half what it was in 1997. The Medicare Modernization Act was responsible for the competitive bidding program, and the Deficit Reduction Act imposed the 36-month cap on Medicare payments for home oxygen therapy. According to data from the government, at least 22 percent of the 1.4 million Medicare beneficiaries who require home oxygen use it for more than 36 months.
Another recently released government study found that patients who use home oxygen therapy are less likely to go to the hospital. Further, another study published in the June 2007 issue of the medical journal Medical Care links lung disease patients’ access barriers to home oxygen care with increased hospitalization. Home oxygen costs the Medicare program $7.62 per day vs. as much as $4,600 per day in the hospital. In 2002, there were 673,000 hospitalizations for Chronic Obstructive Pulmonary Disease (COPD) with an average length of stay of 5.2 days. Further, the June issue of the medical journal Medical Care links elderly COPD patient access obstacles to oxygen care with increased patient hospitalizations.
These are credible and respected reports that we need to use to educate members of Congress about home oxygen therapy consumers, and the home oxygen benefit. Policy makers also need to know that home oxygen therapy is an essential therapy for Americans who suffer from COPD or other degenerative diseases of the lung. Nationwide, as many as 15 million Americans have been diagnosed with COPD – a slowly progressive, incurable disease causing irreversible loss of lung function. COPD is the fourth leading cause of death in the United States, and will soon reach number three in the near future. Although existing medications have not proven beneficial in reversing its effects, home oxygen therapy, when properly prescribed and maintained, can slow lung degeneration. Today, over one million Medicare patients depend on the Medicare oxygen benefit for quality of care and quality of life in the home environment.– by Cara Bachenheimer, vice president, government affairs, Invacare Corp.