Health cuts could prove disastrous

From: My San Antonio

Kathleen Weir Vale

As a lifelong provider of home medical equipment and services in the San  Antonio area, I recently shared some of my concerns about Medicare  with Marjorie  McColl Petty, regional director of the Department of Health and Human  Services (HHS).  Here are the points I made:

For three generations, since 1941, Hope Medical has been serving Texans. Our  patients, mostly the elderly, use Medicare, Medicaid, and private insurance. We  employ 49 people in San Antonio and Corpus Christi.

Our healthcare sector, called “durable” or home medical equipment and  services (HME), is largely composed of small, independent facilities throughout  the country that deliver wheelchairs, walkers, oxygen and other items to  patients discharging from the hospital or coming home from a  doctor’s visit.

The HME sector arose from the need to shorten expensive hospital stays and  get patients back home to recover. Did you know that one day in the hospital  costs Medicare more than an entire year of equipment rental for home oxygen  therapy? My company and others like it are a low-cost means of preventing far  more expensive institutional care by reducing visits to the emergency room and  the hospital.

HME is not the culprit behind ballooning healthcare spending. HME spending as  a proportion of total healthcare spending has decreased over time.

We understand that the government needs to cut spending in order to reduce  the deficit, but HME has already been cut. In the last 5 years alone Medicare  has cut HME reimbursement by 27 percent overall. Reimbursement for home oxygen  therapy has been cut by roughly two thirds. And, Medicare no longer pays for the  equipment needed for home oxygen therapy after three years, even if the patient  still needs it.

For months, I have been working on preparing my company’s bid for Round 2 of  Medicare’s badly designed “competitive” bidding program, which is now underway  in the San Antonio metropolitan area. Hundreds of economists have warned  Congress that, as currently designed, this bidding system will fail to live up  to its promises.

In fact, it will decimate our sector, dramatically reduce Medicare  beneficiaries’ access to care, and cost at least 100,000 jobs. Many small  businesses have already closed as a result of Round 1 of the bidding program in  nine other areas around the U.S. A vast expansion of the program will  be devastating.

We work hard to get patients covered when physicians order wheelchairs,  walkers, hospital beds, oxygen, prosthetics, orthotics, and other equipment.  These are much needed home healthcare items, and if reimbursement for HME  continues to be cut and the HME sector fails, how are patients going to be  discharged to their homes? How are they going to stay out of  the hospital?

We are asking HHS to take further cuts to HME off the table. We are already  struggling with reduced reimbursement. If Medicare’s bidding program continues,  estimated job loss is huge. Worse, access to cost-effective care for seniors and  people with disabilities is on the line.

Kathleen  Weir Vale, CEO, Hope Medical