National Home Infusion Association Recommends Demonstration Project to Reaffirm New GAO Report Supporting Need for Comprehensive Medicare Coverage of Home Infusion Therapy

GAO Report Outlines Potential Medicare Cost Savings, Value to Patients

WASHINGTON, June 14 /PRNewswire-USNewswire/ -- In response to a new Government Accountability Office (GAO) study that outlines the potential Medicare cost savings and value to patients associated with home infusion therapy, the National Home Infusion Association (NHIA) is recommending that a demonstration project be conducted to confirm the benefit of home infusion therapy to patients and to support Medicare's cost-containment efforts.

The recommendation for the demonstration project follows today's release of a GAO study commissioned by Representative Frank Pallone, Jr. (D-NJ), Chairman of the House Energy and Commerce Committee's Subcommittee on Health, and Representative Eliot Engel (D-NY), that compared home infusion policies and practices under traditional Medicare fee-for-service and those policies adopted by private plans, including Medicare Advantage plans.  

Among its findings, private payers report that infusion therapy provided at home generally costs less than treatment in other settings, including hospitals and nursing homes.  Hospital inpatient care was recognized as the most costly setting, with therapy costing up to three times as much as the same therapy in the home.  In a review of quality management practices, GAO found that private payers use provider networks, accreditation and complaint monitoring to ensure the delivery of high quality home infusion therapy.  According to the study, the current range of coverage offered under Medicare FFS was limited compared to the more comprehensive coverage for home infusion therapy that is available through commercial health plans. As a result, the GAO has recommended a Department of Health and Human Services (HHS) study of home infusion therapy to inform Congress of the potential program costs and savings associated with establishing a comprehensive benefit under Medicare.  

"NHIA and its members thank the GAO staff for their work in this important area and commend the leadership of Chairman Pallone and Representative Engel for their commitment to supporting the delivery of high quality care and access to home infusion therapy for all Medicare beneficiaries," said NHIA Chair Lynn Giglione.  "We are pleased that GAO's conclusions confirm what physicians, patients and health care providers have known all along -- that home infusion therapy offers high quality care at home that is cost-effective and results in better patient outcomes.  We believe that the most useful and constructive way HHS can carry out GAO's recommendation is by conducting a demonstration project," added Giglione.

"Providing these therapies at home where patients are most comfortable may improve their recovery and prove to be more cost-effective," said Chairman Pallone. "Determining the potential benefits home infusion therapy coverage under Medicare would be in the best interest of both patients and the program."

"Medicare is the only major payor that does not cover all the essential components of home infusion therapy.  All patients, including older and disabled Americans needing intravenous medications, should be allowed to undergo treatment in the comfort of their own homes," said Representative Engel.  "A study in the form of a demonstration would bring to light real-world applications of home infusion therapy and confirm the benefits of comprehensive access toward achieving Medicare savings and improving the quality of care to patients."

"A plain and simple proven fact remains clear—home infusion makes sense for the patient and our country's effort to better manage its health care costs.  We support Representative Engel's recommendation for a demonstration project and urge Congress and HHS to act expeditiously to support a change in Medicare policy that will allow Medicare beneficiaries access to high quality home infusion therapy that non-Medicare patients have enjoyed for years," said NHIA President Russell Bodoff.

For a full text of the GAO report – go to http://engel.house.gov/uploads/Home%20Infusion%20Therapy%20-%20Differences%20Between%20Medicare%20and%20Private%20Insurers%27%20Coverage.pdf

NHIA, based in Alexandria, Virginia, represents and advances the interests of organizations that provide infusion and specialized pharmacy products and services to the entire spectrum of home-based patients. It is the leading voice in representing the interests of older and disabled Medicare patients denied home infusion coverage.  For more information, visit www.nhia.org.

SOURCE National Home Infusion Association