Although I agree that the current Medicare policy for home oxygen, which is
I think it is important to remember that in the short history of home oxygen, problems associated with the previous modality specific system contributed to the implementation of the modality neutral payment model.
I think that some of the drivers toward a modality specific model may be based on opinions and assumptions that aren’t objectively validated, in particular the concern that fewer home oxygen patients have ambulatory devices and that declining reimbursement will limit patient access to newer, more ambulatory technologies.
Data from the SADMERC supports that of the approximately 834,000 Medicare patients with a stationary home oxygen system, nearly 75% have some type of portable oxygen system prescribed. To date, external market pressures, along with the improved clinical and operational benefits associated with many of the newer, higher technology oxygen systems has proven to be a very effective sales tool, creating a contradictory argument. Sales of the newer, high technology systems are growing dramatically despite facing some of the most severe oxygen payment reductions since the inception of the program.
In my market, the provision of modern and lightweight ambulatory oxygen systems is the norm. As a provider, if you don’t offer these, you will see your referrals and patient populations decline.
In my opinion, we can do more for patient care and the standard of care if we focused our energies on recognizing and paying for the clinical and operational services delivered as part of the modality neutral payment system.
Technology will continue to change, as will the modalities, so I think remodeling the payment system around the modality alone is shortsighted and misses the long term clinical objectives that are the foundation of LTOT in the home.
- Joe Lewarski is Inogen’s vice president of clinical and government affairs.