CQRC Statement on the NY Times Article on Medicare's Home Oxygen Benefit
The story inappropriately treats home oxygen therapy as though it is nothing more than the rental of inert equipment, when in fact home oxygen is a prescribed therapy, that when properly administered, requires both medical devices and myriad patient services. Oxygen providers deliver critical services that help this oft-overlooked beneficiary segment manage their chronic disease and therapy between physician visits, which in turn helps to avoid costly hospital admissions, serious complications, and sometimes even death. Home oxygen providers are often the physician's eyes and ears in the patient's home setting.
Home Oxygen Therapy is an important and cost-effective treatment for COPD. Every year, millions of Medicare beneficiaries are treated for the effects of chronic obstructive pulmonary disease, or COPD. COPD is a progressive, non-curable disease that causes irreversible loss of lung function and threatens the ability of patients to perform even routine, daily tasks. COPD is the fourth largest killer in the United States. The average home oxygen patient is a 73-year old, frail female who lives alone, does not drive and takes multiple medications for multiple disease conditions. The sickest COPD patients need oxygen therapy to breathe and remain stable at home. Oxygen therapy providers are often the first line of care for these patients -- helping to maintain proper patient compliance with their prescribed oxygen therapy, thereby helping to slow lung degeneration and avoid hospitalizations.
These points were reinforced in a separate article reported in the Thursday, November 29th New York Times story by Denise Grady on COPD which states:
"Although incurable, it is treatable, but many patients, and some doctors, mistakenly think little can be done for it. As a result, patients miss out on therapies that could help them feel better and possibly live longer. The therapies vary, but may include drugs, exercise programs, oxygen and lung surgery. Incorrectly treated, many fall needlessly into a cycle of worsening illness and disability, and wind up in the emergency room over and over again with pneumonia and other exacerbations -- breathing crises like the one that put Ms. Rommes in the hospital -- that might have been averted."
Medicare's home oxygen benefit helps keep beneficiaries out of expensive health care settings. The home oxygen benefit is vital to restraining Medicare's costs, and any immediate budget savings resulting from reducing reimbursement will come at a far greater cost to Medicare and its beneficiaries. Respiratory therapy in the hospital can cost Medicare over $4,600 per day. In 2002, there were 673,000 hospitalizations for COPD with an average length of stay of 5.2 days. A government study by the Agency for Healthcare Research and Quality and other multiple clinical studies conclude that once a patient goes on home oxygen therapy, he or she has 10 fewer days in the hospital per year, saving $46,000 per year in hospital costs alone. Few would argue it makes sense to spend $2,400 to save more than $40,000.
Recent Medicare cuts to home oxygen have yet to be realized. Over the past decade, beginning with the 1997 Balanced Budget Act, Congress cut Medicare funding for oxygen therapy multiple times -- resulting in a 39 percent reduction in payments, according to the New York Times. What the story does not lay out is that the biggest cuts haven't even taken effect. In 2009, this Medicare benefit will be cut by nearly 20 percent without any further Congressional action. If new cuts being propos
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