No Magic Bullets

There are no magic bullets in the battle for good health care policy in Washington. I've learned that from my six years in the prosthetics/orthotics sector — and from my two short months in the DME sector.

But there are reliable bullets.

When home care takes an issue to Congress or CMS, we want to have ammunition of two distinct types: political support and data support.

Political support for the issue means some combination of grassroots backing in the district and support from key members of Congress. Data support is just as important. We need research and quantifiable evidence that demonstrates why our position makes sense in terms of accuracy, fairness and unfettered access to home care.

Of course, political support and data support are not mutually exclusive. We want to generate support for policies that make abundant good sense for patients, politicians and taxpayers alike.

As federal budget pressures inevitably translate — dramatically at times — into attempts to ratchet down home care payments further and further, good home care research takes on greater and greater significance. In recent years, AAHomecare has collected some of the numerous medical studies in JAMA, the New England Journal of Medicine and other journals that document the cost-effectiveness of home care.

During my brief tenure with the association, I've seen data and research move to the top of the agenda in efforts to prevent further erosion of the home oxygen benefit and in efforts to retract the power mobility fee schedule cut that is slated to occur this month. Specifically:

• A study of oxygen costs by Morrison Informatics released in June showed that only 28 percent of the cost of providing oxygen therapy in Medicare relates to equipment, while 72 percent is related to services. This is an essential point in rebutting congressional arguments that reduce the issue of oxygen reimbursement to a question of paying for a piece of equipment.

• Morrison also prepared a rebuttal to the September Office of Inspector General report on the cost and payment issues associated with oxygen equipment. The Morrison analysis demonstrated that the OIG report is too narrow and contains too many methodological flaws to offer reliable guidance for Medicare home oxygen pricing policy.