HME stands out as solution amid pandemic

YARMOUTH, Maine - HME providers are the “pressure release valve” for acute care facilities that are expected to strain from the number of patients who have COVID-19 and need care.

The respiratory virus, which can be deadly for older people and those with underlying conditions, has created a spike in demand for ventilators, oxygen concentrators and BiPAP devices, equipment that HME providers are well positioned to provide in the home.

“The home is the pressure release valve for the acute care facilities,” said Dan Starck, CEO of Apria Healthcare and chairman of the Council for Quality Respiratory Care. “We can more than satisfy the overflow from acute care facilities, if we have a model or payment structure that's reflective of how we're putting folks and equipment into homes and taking the mild COVID-19 cases out of those facilities.”

At press time, there were more than 10,442 cases of COVID-19 in the U.S., with cases in all 50 states, plus Washington, D.C., Puerto Rico, Guam and the U.S. Virgin Islands. The virus has resulted in 150 deaths so far.

Capacity

Despite a Medicare competitive bidding program that has constricted their numbers by almost 40%, HME providers say they represent a sizable network, with the ability to serve most of the country.

“We have as much capacity to deal with this crisis as possible,” said Luke McGee, CEO of AdaptHealth, a member of the CQRC. “We can get patients out of acute and sub-acute care facilities and into the home, where it's safer to provide care and less expensive, but we need help and recognition from the government and payers.”

HME providers, collectively, are spending an estimated tens of millions of dollars to buy the equipment needed to help treat patients with the virus in their homes, knowing that even when COVID-19 cases wane in the next few months they may resurface in the fall, or another virus will infiltrate the population.

“This crisis isn't going away,” McGee said.

Recognition

While CMS has made numerous concessions to healthcare providers in the wake of the coronavirus outbreak, few are directly related to HME, an oversight that's hampering the very industry that's at the heart of the response to COVID-19, HME providers say.

“(The government and other payers) need to give us the support to go out there and aggressively set up patients to keep them out of healthcare institutions,” said Stephen Griggs, CEO of AeroCare, a member of the CQRC.

Providers, led by industry groups like VGM and AAHomecare, have been quick to make recommendations to CMS and other payers, including waiving the chronic respiratory disease coverage requirements for respiratory equipment, medications and supplies when a patient is diagnosed with COVID-19 or has other acute respiratory conditions during the pandemic; delaying Round 2021 for another year; and extending the blended reimbursement rates in rural areas.

“Providers have the capacity today, but what we're hearing from some providers, especially those rural providers, is that they're only holding on with the 50/50 rates,” said Tom Ryan, president and CEO of AAHomecare. “We need continued relief to keep the infrastructure of the DMEPOS world intact.”

Next steps

CMS and other payers need to do right the right thing, clearing the way for HME providers to do what needs to be done under challenging conditions, they say.

“There's this amazing ability (to provide care) out there in the home,” said Clint Geffert, president of VGM & Associates. “It's just a matter of it being more of an option.”

Big picture, the U.S. has a long way to go to recognize the importance and value of post-acute care, HME providers say.

“Lincare, as part of Linde, is a muti-national homecare business and we're learning from our European businesses, which are much farther along than the U.S.,” said Crispin Teufel, CEO of Lincare, a member of the CQRC. “I can tell you that in most European countries, home care plays a critical role to free up hospitals. Post-acute care is recognized as a vital part of the solution.”