WASHINGTON—In the United States, hundreds of thousands of individuals face the challenges and risks of malnutrition, necessitating life-sustaining enteral nutrition (EN) to receive necessary nutrition and hydration. Delivered through various methods into the gastrointestinal tract, EN is indispensable for individuals with diverse medical conditions either temporarily or as a lifelong requirement.
Failure to manage EN properly can lead to severe health consequences, including increased vulnerability to falls, delayed wound healing and health care-associated complications like pressure ulcers. Moreover, malnutrition amplifies readmission rates, institutionalization and health care service dependence, especially among medically complex individuals.
A white paper, “Challenges in Enteral Nutrition Access & Management: Safeguarding Life-Sustaining Enteral Nutrition,” was developed by EN stakeholders and provides an overview of EN, market challenges that threaten access to EN, and the integral role of home medical equipment (HME, also known as durable medical equipment or DME) providers in delivering clinically appropriate EN to end users as valued partners in the care continuum. The paper includes findings from a 2023 nationwide study revealing that one in four HME providers of EN are considering or actively planning to stop providing EN/supplies due to cost pressures.
The paper outlines four key actions that payers can take to ensure continued access to life-sustaining EN including:
- Adjust reimbursement to ensure appropriate end-user access
- Expedite Prior Authorization processing for EN formula
- Provide regular review and expeditious product additions to approved product lists/formularies
- Decrease excessively burdensome documentation requirements
“Access to life-sustaining enteral nutrition is a lifeline for countless individuals facing nutritional challenges,” said Ashley Plauché, senior director of brand marketing for the American Association for Homecare (AAHC). “It is essential for the HME community and payers to partner together to assess the growing barriers to care to safeguard the health and well-being of those who rely on EN and critical services.”
“Home Enteral Nutrition (HEN) patients deserve access to the best care and the safest and best medical products available," said Ben Davis, executive director of Global Enteral Device Supplier Association (GEDSA). "Too often this access is unnecessarily challenging, as described in the white paper, and more work needs to be done to remove these barriers against patient care."
The white paper was spearheaded by the American Association for Homecare in partnership with GEDSA and a technical review was provided by Dietitians in Nutrition Support (part of the Academy of Nutrition & Dietetics). The resource will be used in outreach and education to payers, state programs and legislators to preserve access to EN, supplies and services. The HME industry may access the white paper, order flowcharts for oral nutrition and tube feeding/nutrition and survey infographic in outreach efforts; contact AAHC for opportunities to get involved in the Enteral Nutrition Work Group at info@aahomecare.org.
