Here's why CMS keeps cutting HME reimbursement

Police Academy 4: Citizens on Patrol dvdrip I had an interesting conversation with an anesthesiologist at a cookout this past weekend.

It turns out, that like HMEs, Medicare loves to cut reimbursement for anesthesiologists. In fact, Medicare typically pays anesthesiologists 30 cents on the dollar, compared to 80 cents on the dollar for other MD specialists. Not surprisingly, anesthesiologists are unhappy about this situation.

After talking to this guy for 20 minutes or so, I think I've discovered why Medicare has targeted both professions repeatedly for deep reimbursement cuts: More so than most other medical professionals, anesthesiologists and HMEs have raised patient care to a very high level.

Let me explain.

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Anesthesiologists are legendary for developing protocols that eliminate most adverse anesthesia-related outcomes. The American Society of Anesthesiologists was the first medical organization to create a foundation to focus on patient safety—the Anesthesia Patient Safety Foundation, founded in 1985. Their safety record puts most other doctor groups to shame. My cook out companion blamed this, ironically, for Medicare's low opinion of the profession. Because it's so safe, Medicare bureaucrats now think nurses can provide anesthesia (at a much reduced cost), and there is apparently a move afoot to allow that. You can almost hear the CMS pencil pushers: “Heck, anesthesia is so safe, anyone can do it. Let's cut their reimbursement again.”

Likewise, HME has always been a very service-oriented profession with a satisfied customer base. As with anesthesiologists, CMS does not recognize the hard work and dedication (the service component) required of HMEs to provide good patient care.

My anesthesiologist acquaintance used this analogy: Roger Federer makes tennis look easy, but you try returning a 130 mph serve.

It seems to me that we've got a bunch of people calling the shots and designing policy in Washington who don't recognize a good thing when they've got it. That's not a great recipe for success.

— Mike Moran