For homecare equipment providers, every dollar counts

Aug 14, 2023

Bill Mixon

Flat or declining reimbursement rates — particularly from Medicaid — make it harder for homecare providers to serve an aging population.

More than three-fourths of people over 50 say they prefer to age in place rather than move elsewhere for care. Home may be the safest place to receive regular care for people with serious chronic conditions or limited mobility. However, many people rely on Medicaid, the public health program for low-income and disabled Americans, to pay for their healthcare services.

But patients may soon lose access to high-quality homecare if state officials do not prioritize ensuring their Medicaid programs are paying enough to keep homecare accessible for the vulnerable people who depend on them.

Rates to homecare providers are stuck in the past. Some states are even directly cutting Medicaid funding for home medical equipment. Between 2017 and 2019, these cuts amounted to $5.3 million.

Utah has gone so far as to adopt formal annual rebasing to ensure that the state isn't increasing payments for homecare equipment compared to the previous year.

These stagnant rates — or cuts — don't make sense. Home medical equipment companies represent a tiny part of each state's Medicaid budget. In fact, providing appropriate home medical equipment can prevent spending on things like hospital stays, saving the state Medicaid program money.

Home medical equipment companies serve the medical needs of Americans who require diabetes management supplies, oxygen systems, wheelchairs, medical supplies, and other medical equipment and services in their homes.

Complex rehab technology (CRT) for individuals with complex disabilities or medical conditions enables them to deal with their daily physical, functional and cognitive challenges and play a critical role in addressing the complex medical needs of children and adults. Home medical equipment products and services not only improve independence and function but also keep the overall cost of healthcare down by reducing additional medical complications and caregiving requirements.

So, when states fail to address low reimbursement rates, they disregard business realities for providers facing inflation, supply shortages and other challenges.

Homecare providers have struggled to keep qualified workers in stock, too. Low reimbursements from Medicaid and other insurers make it difficult for homecare providers to pay enough to attract and retain talent — particularly in today's tight labor market. Over the past two years, labor costs have risen more than 16% for technicians and more than 15% for customer service representatives.

Episode 12: The mother of two boyish men joins Karen in the studio for this special Mother's Day preview to share sage advice with other mothers (and fathers) about parenting. "Motherhood is amazing, wonderful and overwhelmingly beautiful. But at the same time it is the most horrifying, frustrating, exhausting and terrifying thing," Allison Thomas says. "Being a mom is so very hard," Karen says. "No one can fully prepare you for it." Still, both women offer candid insights and real world suggestions about the most important job in the world. "You want to do it right," Allison says. "So buckle up buttercup and let's go," Karen says.

More broadly, 95% of manufacturers cite raw material prices as a top source of inflation.

Add up all these challenges, and it is no wonder homecare providers are scaling back or closing shop entirely. Nearly 40% of counties nationwide still need a traditional home medical equipment supplier. One in five has access to only one supplier within their county, making patient choice difficult. That number is even smaller for CRT providers.

Low Medicaid reimbursement rates exacerbate these challenges.

Our healthcare system cannot afford to have homecare providers disappear. High-quality, home-based care is more efficient and cost-effective than alternatives. That's partly because people who receive care at home need to visit the emergency room or hospital less.

Equipping a home to be more accessible is one-third the cost of an average stay in the hospital after a fall ($10,000 vs. $30,000). Preventing falls is critically important to keeping patients out of the hospital, and the incidence of additional falls and injuries after the first fall increases significantly.

There are also mental health benefits that come with receiving care at home. Families can stay together, and patients can exercise more independence than they might be able to in a clinical setting.

No one should have to become immobile in their own home — or be unnecessarily driven from it into an institutional setting. It's time to place dignity and quality of life first, especially for our most vulnerable citizens, by ensuring Medicaid reimbursement rates keep pace with market realities for home medical equipment providers.

Bill Mixon is a board member and former CEO of National Seating & Mobility. He wrote this for InsideSources.com. The opinions are the writer's.

Get local news delivered to your inbox!

"Remember, all of this stays between you and me," the accused reportedly told the boy after the massage.

Cleveland-Cliffs plans to reline a blast furnace at its Burns Harbor Works steel mill in 2025.

Denver Johnson was charged Wednesday with reckless homicide and involuntary manslaughter, both Level 5 felonies; pointing a firearm, a Level 6…

"Witnesses said the two had been swimming in the river and were last seen being carried downstream by the current and then going under the sur…

"(The administrator) inquired as to why Edmari (Sanders) had not told him it was there to which he advised he was afraid of the trouble he wou…