Three-quarters of voters polled in a recent survey believe home care is part of the solution to the problem of rapidly increasing Medicare spending — and it’s a preferred healthcare option by most as well.

Attempting to catch hold of the presidential primary/election year dialogue and debating opportunity in the U.S., the American Association for Homecare (AAH; Arlington, Virginia) commissioned the poll in order to draw attention to the need for increased funding.

“As an association representing the industry of providers and manufacturers in the homecare sector, we face a constant challenge on Capital Hill,” Tyler Wilson, president of the AAH, told Medical Device Daily. “We sense an under-appreciation for the value of home care among legislators.”

The AAH represents providers of durable medical equipment (DME) and related services and supplies, and DME manufacturers.

The telephone survey of 1,000 American adults, conducted by Harris Interactive, found that strong majorities of both Democrats (85%) and Republicans (71%) support home care-friendly candidates. One of the rather unsurprising results from the survey was that Americans age 55 and older say they are more likely to favor candidates who support home care (83%), compared to the 18-to-54 age group (76%). Around 69 million Americans are 55 or older.

“A lot of interest groups are looking at the Medicare pie and trying to prevent their reimbursements from declining,” Wilson said. “There’s a lot of competition for those Medicare dollars. We’re out there against hospitals, nursing homes and hospitals who are all striving to get their messages heard.”

The AARP has dubbed the 2008 election as “the 50-plus election,” estimating that voters age 50-plus will turn out in even greater numbers than the 52% reported by exit polls during the 2006 elections.

Wilson said his organization has not been able to identify whether or not any presidential candidates have taken specific positions on homecare issues. “It doesn’t show up in the big platform papers,” he said, adding that John McCain has made some positive comments about home care recently as did Bill Richardson (recently dropped out of the primary tussle).

“But I can’t claim we’ve gotten anything from the Democrats yet,” he said. “We’re working to get our message heard. We have an annual legislative conference coming up in March to lobby on Capital Hill and at the same time we hope to hear from the candidates.”

The AAH predicts that some members of Congress are likely to again propose deep cuts in Medicare DME reimbursement rates for the 2009 budget year, on top of previous cuts and other reductions that have yet to take effect. “Broad bipartisan voter sentiment calling for better policy may elevate home care as an issue in the congressional and presidential elections this year,” Wilson said.

More than four out of five Americans (82%) surveyed expressed a preference for home care over institutional care, agreeing with the statement, “If I required medical services, I would prefer to receive it in my home, if possible, rather than in a hospital or nursing home.”

Three out of four (74%) Americans agree with the statement, “Homecare is part of the solution to the problem of rapidly increasing Medicare spending for America’s seniors.”

While most folks may prefer to receive care at home, if possible, how exactly is it more cost effective than institutional care?

Wilson offered this example:

“Home oxygen therapy for a patient suffering from chronic obstructive pulmonary disease is about $7 to $8 a day, on average, when you price out the equipment and services around that Medicare benefit,” he said. “In the hospital, if [patients] receive that service, it’s many thousands of dollars. It’s much more affordable to receive that therapy at home. Plus, we’ve learned that it prevents rehospitalization and visits to the emergency room. A good home care delivery system keeps patients at home.”

Wilson pointed out that homecare-related industries across the board are facing a big threat in 2008 because of the new Centers for Medicare & Medicaid competitive bidding initiative.

This year the competitive bidding program will operate in bidding areas within 10 of the largest Metropolitan Statistical Areas (MSAs), excluding, for logistical reasons, CMS says, the New York, Los Angeles and Chicago MSAs. The program will apply to 10 of the top DME, prosthetics, orthotics and supplies product categories outlined in the final rule.

The program is to be expanded into 70 additional MSAs in 2009, and after 2009 CMS will expand the program to additional areas and product areas (Medical Device Daily, April 4, 2007).

The competitive bidding program was mandated to replace current payment amounts for items being bid under Medicare’s top DME, prosthetics, orthotics and supplies fee schedule, with payment rates derived from the bidding process.

“Providers must bid in order to price equipment,” Wilson said. “It’s likely to cause a big fallout in the industry and jeopardize a lot of companies.

He also emphasized the service component of providing medical products, not often understood by rule-makers.

“Our biggest challenge is to convince [CMS] that we’re more than just equipment providers. There’s a whole regimen of service that surround equipment. You don’t just plunk down the equipment and leave the patient. There’s a lot of service that goes into preparing the equipment and patient, and it’s under-appreciated.”

The association will hold a teleconference titled “The Internet — Friend or Foe of the HME Industry” on Feb. 7. Its 2008 Washington Legislative Conference will be held March 6-8, in Washington at the L’Enfant Plaza Hotel.