Medicare saves with HME, study says

Thursday, June 12, 2014

WATERLOO, Iowa – Medicare sees significant cost savings when it preserves spending on home medical equipment, according to a new study unveiled at The VGM Group’s Heartland Conference this week.

The study, conducted by Brian Leitten of Leitten Consulting, found, for example, that for every $1 that Medicare pays for mobility equipment, it saves $16.78 in treatment for avoided falls.

“The message is clear: HME does save Medicare money and helps beneficiaries live where they want to be—at home,” said John Gallagher, vice president of government relations for VGM, in a press release.

Other examples from the study: For every $1 Medicare spends on supplemental oxygen therapy, it saves $9.62 in treatment for COPD-caused medical complications; and for every $1 Medicare spends on CPAP therapy, it saves $6.73 for the treatment of OSA-related complications.

The study is an update to a similar study in 2011.


I'm happy to see a new study that quantifies our proposition that the therapies we provide are a bargain. We have known this for decades.   This study shows clearly that CMS, in their zeal to defund DME services,  would prefer to pay exponentially higher costs to other sectors rather than compensate DME providers fairly for our economical services.

First, rentals were capped, then then CMS allowed maintanence payments every six months.  Then they stopped maintenance payments.  Next came cessation of reimbursement for services such as O2, for 40% of the duration of service.  Then CMS's relentless harrassment of DME with imposition of unreasonable documentation requirements, punishing audits, wanton lack of accountability themselves when they impose new regulations retroactively and delay response FOR YEARS in the audit process, all demonstrate clearly that they are on a campaign to eliminate the DME benefit from healthcare in the US. 

We all know that provision of DME services before Competitive Bidding was marginally profitable at best, what with the onerous regulatory requirements that slowly began mounting in the 1990s.  Now Competitive Bidding is killing hundreds of US businesses.

Organizations such as the Scoorter Store that get away with over 20 years of abuse through overutililzation of one or two codes are the cause of bitter frustration by the govenrment because there is no identifiable responsible party.  These companiess have phalanxes of intermediaires to protect them fron the regulators, a situation that is very depressing to heads of compliant companies who have fought the good fight for so long in full compliance with all federal, state, and local laws and regulations,

We are unique in that the credentialling of the DME "person-in-charge" is nonexistant. Every other healthcare sector protects itself by restricting practice(provision) of the service to highly credentialled "professionals". Orthotists, Prosthetists, Pharmacists, Pedorthists, RRTs, CRTs, RNs, RCPs, PTS, OTs, Polysomnographers, etc. This list goes on. In DME there is no BS or BA required, and certainly no MBA (Healthcare or otherwise).

The DME Industry has foolishly resisted licensing of its members.  I now wonder if credentialling of the person-in-charge, be it an owner, a pharmacist, an Rt, an RN, a degreed person (BS or BA), an individual with a certain time period as head of an orperation, would be something to consider pursuing.