In a political era where both major parties essentially agree on the virtues of big government programs (give or take a few billion dollars), the only argument left is how best to save the money we have and will have. And while that amount of money is vast, not much is currently allocated for home care. According to statistics provided by Ann Howard, director of federal policy for AAHomecare (see Howard’s article "Home Oxygen Threatened Again"), home care represents about 5.4% of Medicare expenditures (1.8% for HME and 3.6% for home health), yet it constitutes nearly 20% of the Administration’s recommended fiscal year 2008 cuts. If it feels like you’re getting picked on, you’re right.

Last month I said that home care issues seemed to strike a uniquely bipartisan tone. Perhaps I spoke too soon. In light of the President’s reintroduction of the 13-month cap on oxygen rental, it would appear the message is not getting through. Editorial advisory board (EAB) member Joel Mills agrees. “The President’s budget again reflects the lack of understanding about home care and its important place in the US health care system,” says Mills, CEO of Advanced Homecare, Greensboro, NC. “The 13-month purchase of oxygen concentrators, the 13-month purchase of PMD, and the 5-year freeze/negative market basket adjustment for home health shows that our industry has a lot of work to do to gain respect in Washington.”

Vernon R. Pertelle

Speaking from his position as an executive with the Tri-City Hospital District, San Diego, Vernon R. Pertelle, MBA, RRT, is equally frustrated. “I don’t understand the science or economic methodology behind this proposal because home health care is the solution to reducing expenses associated with high-cost acute care,” says Pertelle, an HME Today EAB member and industry activist. “The proposed 5-year freeze (from 2008 to 2012) for home health agencies, and the reduction of 0.65% for each year thereafter is simply shortsighted.”

What are the odds the 13-month oxygen cap will become reality? One industry luminary who declined to be named estimated the chances at 50-50.

If it does happen, the ripple effects beyond mere oxygen could be huge. After all, respiratory is often the backbone that supports other less profitable niches such as CPAP and more.

The good news is that the Home Oxygen Patient Protection Act is back, and providers can unite with a clear mission. With consumer groups joining with AAHomecare, the industry seems truly ready for battle.

Greg Thompson