WASHINGTON—The American Association for Homecare (AAHomecare) launched two portals to collect end-user and family caregiver stories about the real-world impact of policy changes for non-invasive ventilators (NIV) and continuous glucose monitors (CGM). These stories will be used in advocacy efforts to educate payers and governmental agencies on the access issues and proposed solutions.
AAHomecare said suppliers can direct customers to the following pages to upload their stories, either written or via video:
• CGM access issues: aahomecare.org/access-issues-upload-form-cgm
• NIV access issues: aahomecare.org/access-issues-upload-form-niv
The web pages provide a high-level overview of the issue, suggested talking points and a portal to easily submit a story. AAHomecare said leveraging these voices in advocacy efforts is critical to helping payers, legislators and governmental bodies understand the devastating impact this has on individuals who rely on these devices to manage their medical needs at home.
"As we advocate for access to medically necessary equipment in the home, it is important for payers and government officials to understand how restrictive policies impact patients directly," said David Chandler, AAHomecare vice president of payer relations. "By sharing these experiences, we can all gain greater insight into the challenges end users face accessing HME and work together to reduce barriers to care."
NIV Access Issues
As reported in its June 12 Insider, AAHomecare, allied patient and clinician groups, and Members of Congress have weighed in with concerns about Medicare Advantage Plans employing coverage criteria for NIV that is more restrictive than Medicare NCD guidelines. Individuals with ALS or COPD with chronic respiratory failure are being denied access to life-sustaining NIV and are often caught up in a lengthy and cumbersome appeals process or forced into the “tried and failed” step therapy to get the needed NIV.
“Running an HME business can be challenging, but there is no greater satisfaction than ensuring a patient and their family have the equipment and support they need at home for a better quality of life," said Roxanne Venard, owner of Ascent Respiratory Care. "When payer policies disrupt access to care, it’s important that we give patients a voice in sharing about how this affects them.”
AAHomecare said suppliers can share this letter with their customers inviting them to submit their story to the portal.
CGM Access Issues
Advocacy efforts are also underway to address how some Medicare Advantage plans and Medicaid programs are shifting coverage of CGM devices and related supplies to Part D benefits, with some restricting access through suppliers and going to a pharmacy only channel. The Diabetes Council is working on this issue, as covered in AAHomecare's July 24 Insider.
“Patients’ stories provide insight into the obstacles they may experience in obtaining their CGM therapy through their pharmacy channel," said Linda Langiotti, senior vice president, strategic channels for CCS Medical. "The payer community needs to understand these challenges and recognize the services the DME community provides to support diabetes therapies for our patients.”
Suppliers can share this letter with their diabetic customers inviting them to submit their story to the portal.
For additional information on these issues or opportunities for your company to assist, contact Ashley Plauché, AAHomecare’s senior director of brand marketing, at ashleyp@aahomecare.org.
