Survey: ‘This is putting us in the red’

WASHINGTON – The expired 75/25 Medicare blended reimbursement rates in non-bid, non-rural areas is affecting business operations and the ability to serve patients and communities, according to a national survey from AAHomecare. 

The association is still analyzing survey results, but it shared some of the open-ended responses in a recent bulletin: 

• Reimbursements are so low now that it is hard to keep up with expenses and payroll. We may have to close. Medicare Advantage plan reimbursements are based on the extremely decreased Medicare rates. We have been in business for 24 years and have never had this type of terrible treatment. 

• The rate cuts have cost our company an average of $55,000 per month and going up as more and more payers are using the new rates, both rural and non-rural patients. This is putting us into the red instead of being slightly profitable.  

• Reduced staff, reduced coverage area, reduced revenue. We have been in business for over 23 years and it seems like the durable medical equipment business cannot get a win; Medicare Advantage plans and commercial plans go by the Medicare allowable so when they reduce rates everyone reduces rates. We cannot sustain at the current rates. 

• Because of the loss in revenue and increased product cost and labor cost, our business has been forced to lay off employees, turn away high usage oxygen patients and stop providing options on masks for patients to choose from. We are now looking into the cheapest products in the market just to keep the margins from being negative. We are to the point if reimbursement doesn't increase soon we will be shutting our doors and leaving 15,000 patients without a provider. 

 AAHomecare will use survey results to help develop new advocacy materials to share with Congress and CMS in support of restoring the 75/25 blended rates, which expired on Jan. 1.