A new study published in Scientific Reports is shining a light on how durable medical equipment (DME) use impacts patients’ electric bills.
The study — “The electricity cost burden of durable medical equipment in the United States” — was published in the December 2024 edition of the journal, which is part of the National Library of Medicine.
“Those who rely on durable medical equipment for their health are more likely to be energy insecure and face higher energy burdens than those who do not,” the study’s authors said. “In this article, we evaluate the costs of electricity to run DMEs.”
Large variations in costs from state to state
Study authors pointed out that actual costs vary widely based on the type of DME used, how often the DME is used, how much power is needed to run the DME, and the cost of electricity in local markets.
For example, researchers noted that electricity rates in California, Hawaii and Massachusetts are “elevated” compared to rates in other states.
“We find that the average cost across the most common types of high-frequency DMEs — including oxygen concentrators, continuous positive airway pressure machines, and peritoneal kidney dialysis machines — is between $120 and $333 per year, depending on device size and usage frequency,” the study said. “Some DMEs can cost more than $700 per year to operate, which is an increase of over 40% above the average household bill, and well over that in states with higher electricity prices.
“For those households that are energy insecure and already face difficulty in paying their energy bills, the use of DMEs has the potential to exacerbate this insecurity. Several studies have found that an important correlate of energy insecurity and utility shut-offs is when a member of the household relies on an electronic medical device.”
Researchers added that energy insecurity, also known as energy poverty, “is considered an overlooked social determinant of health.”
From oxygen concentrators to hospital beds
Study authors examined the most common types of DME “that use electricity either through plugging into a wall outlet or rechargeable battery packs.” Those product categories were oxygen concentrators, peritoneal home dialysis systems, ventilators, continuous positive airway pressure (CPAP) systems, bilevel positive airway pressure (BiPAP) systems, nebulizers, scooters, hospital beds, feeding pumps, infusion pumps, and suction machines.
Researchers referenced information such as equipment cost, wattage, and average hourly use “from various sources including brochures and manuals, company websites like Philips, Resmed, Baxter, Pride Mobility, and Covidien, and phone calls to manufacturing companies.” Study authors also “informally” cross referenced the information from those sources with information from “a group of practicing medical professionals.”
On the lower end of the costs survey were suction machines “at about $1.75 to $17.95 in electricity costs per year.” IV pumps and nebulizers would also add “only close to tens of dollars” per year to power bills.
Higher-wattage peritoneal kidney dialysis machines were on the higher end of survey, with authors estimating “$39.89 to $837.63” in electricity costs per year.
While the estimated costs did vary widely, the study said, “Several of the devices have the potential to add more than $50 to one’s monthly electricity bill over the course of a year.”
When power bills are too high to pay
The study acknowledged that insurance providers, even if they cover the cost of the DME itself, do not cover electricity costs, “which might lead to situations where expensive and potentially life-saving devices, accessed for free or very low cost, may go unused because of the cost of electricity.”
It’s a topic, researchers said, that deserves discussion.
“Such outcomes should be understood and addressed by policymakers,” the study said. “Yet, this has not historically been an area where policy discussions can occur since, to date, there have been no credible estimates of the energy needs associated with a range of medical devices. This analysis has sought to address this need by providing such estimates that can help inform policy discussions. It is essential to recognize and document the challenge households face in paying for the electricity needed to operate DMEs and thus access full medical care.”
The study did not examine the costs of electricity versus the overall value of the DME — for example, how optimally used DME at home can prevent medical conditions from escalating and can reduce the need for much more costly hospitalizations, residential care facilities, or medical interventions.
But it did suggest several ways to help DME patients with high energy bills, including strengthening utility disconnection protection policies.
“While all but five states offer disconnection protections for those with medical conditions, few specify any requirements pertaining to reliance on DMEs,” the study said. “Moreover, many of those existing serious illness protections do not adequately protect those using DMEs. For example, many of them can only be invoked or renewed for limited periods of time, require a doctor to certify that the underlying medical condition is life-threatening (which may not be true for many with DME), still require partial or deferred payments from the customer, or require burdensome proof of low-income status.
“States could more explicitly protect those with DMEs by removing existing barriers to asserting protection against termination.”
And in suggesting that insurance providers could help cover electricity costs, the study noted that when patients do not use DME as often as recommended by their clinicians, the result is “a lost opportunity to improve health.”
“A careful cost-benefit approach to covering DME electricity costs under insurance programs would take into account the potential improved health, the reduced mental strain from financial worries, as well as potential increases in Medicare spending if patients are elastic in their demand for DME with respect to the operation costs (electricity) of the DME,” the study said.
