Is POC use going up or down?

Did anyone else raise an eyebrow when the Government Accountability Office stated in a recent report that use of portable oxygen concentrators has gone down while use of stationary concentrators has gone up from 2001 to 2008?

Shouldn't it be the other way around?

The GAO theorizes that the way Medicare pays for oxygen therapy—its rental payment for stationary concentrators includes payment for portable oxygen refills even though, one-third of the time, they're not provided—discourages the provision of POCs. What the GAO's really saying: That HME providers prefer to provide stationary concentrators because they often get paid for products and services they never furnish.

Tsk tsk.

First of all, says Joe Priest, president and COO of AirSep, POCs are just starting to gain momentum and, therefore, comparing POC and stationary concentrator use from 2001 to 2008 is kind of a moot point.

"POCs as part of the Medicare model have just started to occur over the past couple of years and (their use) is ramping up," he said.

Second of all, stationary concentrator use may still be increasing, but it's not because HME providers discourage POC use, says Joe Lewarski, vice president of clinical affairs for Invacare.

"While there is no objective data, it is highly likely the growth in the stationary-only users is the result of earlier diagnosis and treatment of patients with COPD, which includes the identification of nocturnal hypoxemia," he said. "Patients who qualify for oxygen only during sleep only qualify for a stationary device."

There are other cracks in the GAO's theory. For example: A patient may buy a POC direct from an Internet provider, bypassing Medicare and the GAO's eyes completely.

At the end of the day, growth from HME providers and patients buying POCs is steady, says Ron Richard, vice president and general manager, respiratory, for Chart SeQual Technologies.

"The trend over the last three years reflects 15% compounding growth rates," he said.

Liz Beaulieu