ALEXANDRIA, Va.--The American Association for Homecare's HME/Respiratory Therapy Advisory Council is collecting data about what kind of oxygen systems patients use to help draw a better picture of home oxygen utilization nationwide.

According to Council Chairman Jeff Wills of Oklahoma City-based CV Solutions, the association's "ultimate goal is to be able to prove the utilization of products and services to CMS and other bodies."

In recent months, a debate over access to portable oxygen systems has grown in respiratory circles. The National Association for Medical Direction of Respiratory Care has questioned Medicare's current modality-neutral reimbursement--that is, reimbursement that does not differentiate liquid oxygen from other systems--and has circulated a draft position paper on the subject among its board. Some have said modality-specific reimbursement, which would separate liquid oxygen, could be a more appropriate reimbursement model.

Earlier this year, AAHomecare announced that, as one of its priorities for 2005, it would work to preserve Medicare's current payment methodology. But NAMDRC has contended the reimbursement model may hinder access to portable liquid systems, which it says generally bring less provider profits than bulkier systems.

Other stakeholders, though, say the present method has not created any access problems--particularly considering the increasing sales of home oxygen filling systems, which allow users to fill portable units themselves.

"If the reimbursement for an E cylinder is the same amount as for a $2,000 to $3,000 widget, it's not hard to understand [why] some patients [have] E cylinders instead of $2,000 widgets that might be more medically appropriate," said NAMDRC Executive Director Phil Porte. "It's understandable that [a provider] would invest hundreds of dollars rather than thousands of dollars to get the same amount of money. That's capitalism."

Porte added, however, that "there are certainly complex issues involved with modality-specific [reimbursements]. How do you stop the pendulum from going to solely and singularly the $2,000 and $3,000 widgets?"

In other words, some observers say, modality-specific reimbursement could spawn over-utilization of more expensive liquid systems.

Wills explained that AAHomecare's effort to collect data on oxygen use is "not specifically being gathered for [NAMDRC]," but for use by regulatory bodies and various industry and clinical groups. "We saw the need from an HME and respiratory therapy standpoint to begin to collect data to show what the accessibility for portable oxygen really is," Wills said, "and we're in the process right now of doing just that."

He added the association hopes to partner with industry buying groups this summer to gather data from non-association members as well, and to have "a good sampling of data" by the fall.