Letters: Let's charge for services
It would be most unlikely that taking ventilator rentals into the CMS bidding process would meet the goals of the program ("Next in line: Vents and manual wheelchairs?" page 4). Rates have remained, relative to other medical costs, rather stable over the past 12 years despite the technological advances (and with that, added significant provider costs). Additionally, the vast majority of Medicare beneficiaries on ventilators generally have their co-payment paid for by Medicaid, so the "reduces the out-of-pocket expenditures" argument should not carry much weight. Of all the in-home equipment rentals Medicare provides for, undoubtedly ventilation is the most complex, hands-on service provided. What I believe we should all strongly support is a separate professional component, a fee for service, for the patient evaluation prior to hospital discharge, the training of the caregivers, and the on-going monitoring, biomedical certifications, specialized disposables, etc., that play a significant role in the patient remaining at home.
-James Roache, president and CEO, Advanced Pharmacy