New abstract highlights ‘hidden’ costs of DME 

YARMOUTH, Maine – A careful cost-benefit approach to covering DME electricity costs under insurance programs should consider the potential improved health and the reduced mental strain from financial worries, as well as potential increases in Medicare spending, according to a new abstract published in Nature. 

As there is an increase in the consumption of these devices, more careful consideration should be devoted to possible insurance policy coverage of these “hidden” out-of-pocket costs of DME, the abstract says. 

“We find that the average cost across the most common types of high-frequency DME – including oxygen concentrators, continuous positive airway pressure machines, and peritoneal kidney dialysis machines – is between $120 and $333 per year, depending on device size and usage frequency,” it says. “Some DME can cost more than $700 per year to operate, which is an increase of over 40% above the average household bill, and well over that in in states with higher electricity prices.” 

The abstract offers several policy changes to address the issue, including utility disconnection protections. While all but five states offer disconnection protections for those with medical conditions, few specify any requirements pertaining to reliance on DME, the abstract says. Moreover, many of those existing serious illness protections do not adequately protect those using DME, it says. For example, many of them can only be invoked or renewed for limited periods of time, require a doctor to certify that the underlying medical condition is life-threatening (which may not be true for many with DME), still require partial or deferred payments from the customer, or require burdensome proof of low-income status. States could more explicitly protect those with DME by removing existing barriers to asserting protection against termination. 

The abstract also offers another potential policy change: Helping patients who cannot afford the additional energy burden to defray the cost of running their medical devices. Medicare and Medicaid in several states are beginning to provide more flexibility for covering a greater range of items, the abstract says. For example, some states are allowing Medicaid managed care organizations to cover air conditioners for patients with asthma, medical transport for patients, utility deposit fees, and meals; and the federal government allows Medicare Advantage to offer similar benefits to patients, the abstract says. None of these programs currently cover the electricity costs of DME or of electricity consuming benefits offered through their social determinants of health (SDOH) programs. 

“It is essential to recognize and document the challenge households face in paying for the electricity needed to operate DMEs and thus access full medical care,” the abstract says. “It is also important to design public policy and program solutions that address this challenge directly.”