Remembering Former First Lady Barbara Bush: The Importance of Access to Comfort Care for All

Posted on in HME Government Issues, Membership, Legislation, Government and Advocacy

There are only a few certainties in life and one of them is the certainty of aging and death. The recent passing of former First Lady, Barbara Bush, demonstrates that no matter one’s outstanding achievements in life, we are all equally vulnerable as we enter our later years. The First Lady suffered from congestive heart failure as well as chronic obstructive pulmonary disease (COPD), and sadly passed away last week.

In her final days, Mrs. Bush was simply seeking what all would like to do, live our final days in the comfort of our own home. As she was once quoted, “To us, family means putting your arms around each other and being there.” Her decision to remain at home in her final days reflects the importance of loved ones and togetherness to the former First Family.

Comfort Care has been the phrase revolving around the First Lady’s decision to forego additional hospitalizations, or entering a skilled nursing facility. Having the ability to age, regardless of what illness one may face, while living peacefully and comfortably at home is something that must be the first option for those who choose that path.

Unfortunately, it is becoming increasingly difficult for seniors to access the equipment that they need to remain independent and in the place they want to be, at home. Since 2013, there has been a reduction in the number of home medical equipment supplier locations by 42%. Accessing crucial supplies such as oxygen, a hospital bed, and other assistive equipment allows those approaching the final, natural stages of life to do so quietly and comfortably.

Equipment most critical to comfort care at home, such as semi-electric beds, mattresses and oxygen are in some cases not even available to patients without cash payment. In the last ten years there has also been a significant reduction in utilization of this type of equipment and it is not due to decrease in patient population. In fact as baby boomers age, patient population is most definitely increasing. The drop in monthly claims is due to a decrease in access to quality care at home, especially in rural areas.

Monthly Equipment Claim Decline

Source: CMS

This significant reduction stems from a federal program called competitive bidding, which is conducted by Medicare. Competitive bidding awards contracts to providers for common types of medical equipment. While the intent was to provide equipment to Medicare beneficiaries at a competitive price, the actual results of the program allow suppliers from 500 miles away to service patients in urban America called competitive bid areas, excluding independent providers right in the backyard of a patient in need. Patients are forced to wait days and sometimes weeks for equipment because of such narrow local provider choices.

The problem was exacerbated in 2016 when competitive bidding areas began setting the prices for delivery costs in rural America, where suppliers often travel over 100 miles in one direction for a single patient. With reimbursement reductions of approximately 50%, suppliers have been unable to maintain a high quality of service that they once were able to provide, and many have been forced to close their doors.

Healthcare is a high-touch service requiring a significant amount of time and attention for a single patient to age comfortably, as well as those with common health challenges. It is vital that short term relief reaches providers by way of a pending interim final rule (IFR) at the Office of Management and Budget. This short term solution must be followed by long-term reforms to the competitive bidding program in order to establish reimbursement levels which account for increasing costs to do business and navigate red tape.

What can you do to help? Urge Congress to Support H.R. 4229 - Protecting Access to Home Oxygen & Medical Equipment Act: Legislation has been introduced to provide substantial relief to struggling suppliers and to reduce patient access issues to medical equipment. This legislation would return non-CBA rates back to January 1, 2016 levels from January 1, 2017 until December 31, 2018, a retroactive two year extension. Additionally, this would remove the artificial “double dip” for oxygen which is lowering reimbursements by an additional 10-14 percent. The bill is being spearheaded in the House of Representatives by Reps. McMorris Rodgers and Dave Loebsack (D-Iowa).

We need your member of Congress to be on this legislation as a cosponsor! Contact them today by  sending a message or calling them using our call script. Let us know how your call went by using the reporting tool to after selecting your member of Congress.

As the late Barbara Bush once said, “At the end of your life, you will never regret not having passed one more test, not winning one more verdict or not closing one more deal. You will regret time not spent with a husband, a friend, a child, or a parent.” Access to quality care and the necessary medical equipment at home is crucial for every American that chooses to spend his or her last moments with loved ones in the comfort of wherever home may be.