Analysis: NHIA’s changes could save billion-plus
By HME News Staff
Updated 10:12 AM CST, Thu December 5, 2024
WASHINGTON – An independent analysis by Magnolia Market Access estimates that changes proposed by NHIA to the Preserving Patient Access to Home Infusion Act to expand Medicare Part B home infusion therapy services coverage to anti-infectives and to bundle payments for disposable supplies with the services payment would generate significant savings for Medicare. On the IV anti-infective policy, Magnolia provides two savings estimates based on the magnitude of patients that would migrate from hospitals to home infusion under this coverage expansion: $500 million over 10 years if 25% of patients shift to home infusion, and $1 billion over 10 years if 50% of patients shift to home infusion. On the bundling policy, Magnolia provides a savings estimate that is consistent with the Congressional Budget Office of approximately $400 million over 10 years. Introduced in 2023 in both the Senate and the House of Representatives, “The Preserving Patient Access to Home Infusion Act” would include pharmacy services as part of the home infusion therapy benefit under Medicare, covering everything from assessments to drug preparation and compounding to care coordination and documentation. The bills, S. 1976 and H.R. 4104, would also direct CMS to pay 50% of the nursing rate on days when home infusion is provided, even when a nurse is not present.
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