Swapping growth for change

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08/29/2018

This probably says it all: In this year’s State of the Industry Report, for our data on Medicare utilization for 2017, we decided to change the name of the column “2017 Growth” to “2017 Change.” Why? Because for several years now, the allowed charges for the majority of codes have been decreasing year over year, not increasing.

Take CPAP devices. There is an increasing, not decreasing, number of people who are being diagnosed and treated for obstructive sleep apnea, right, with awareness efforts at what I’d guess are all-time highs (thanks to everyone from the CPAP manufacturers to John Goodman’s character on Roseanne)?

Well, the allowed charges for E601 decreased about 15% in 2017 to $136.4 million.

  • Oxygen concentrators (E1390): down about 31%
  • Power wheelchair, Group 2 standard, Captain’s chair (K0823): down about 27%
  • Hospital bed, semi-electric with mattress (E0260): down about 28% (although, without mattress: up about 53%)


So what are those products that saw “growth” in 2017?

Portable oxygen concentrators, for one. The allowed charges for E1392 increased about 5% in 2017 to about $35.3 million.

Outside of POCs, supplies, in general, seem to be a product category that’s seeing growth year over year.

  • Disposable canister for pump (A7000): up about 7%
  • Tubing used with suction pump (A7002): up about 4%
  • Replacement nasal cushion (A7032): up about 3%
  • Replacement nasal pillows (A7033): up about 5.5%
  • Cushioned headrest (E0955): up about 16%
  • Tubing with heating element (A4604): up about 25%


There are a few other codes that, like cushioned headrests and tubing, saw double-digit “growth” in 2017, including:

  • EF blenderized foods (B4149): up about 24%
  • Custom fabricated wheelchair back cushion (E2617): up about 20%
  • Power wheelchair, Group 3 standard, Captain’s chair (K0849): up about 20%
  • Ultralight wheelchair (K0005): up about 24%
  • Dry pressure mattress (E0184): up about 44%


You’d think with the aging baby boomers that we’d see some more consistent, marginal increases in utilization across the board starting right about now. Actually, with the oldest baby boomers starting to turn 65 back in 2011, we should be in the thick of it.

See these numbers and more in December, when we publish the State of the Industry Report online.