VieMed works to elevate NIV

LAFAYETTE, La. - As a relatively new technology, there's a lack of hard data showing the effectiveness of non-invasive ventilators in treating patients, says Dr. William Frazier, chief medical officer for VieMed.

That's why VieMed recently released the results of a study,  “CRF/COPD 4-year CMS Data Comparison of Mortality & Cost, (2013-2016),” conducted by KPMG that analyzed data from CMS and the provider to compare the costs and benefits of commonly prescribed respiratory assist devices in relation to mortality, hospital readmissions and total cost of care.

“In the field, taking care of 6,000 patients, we have a real understanding of the real value of NIV,” he said. “But that's different than having a more objective stance, so we stuck our flag in this area of research.”

NIV has had a tough go of it, including a revamp of the vent product category in 2016. CMS made coding changes after a spike in utilization for an old code, E0464, that it says was the result of providers billing for pressure support vents that also function and are used as PAP devices for the treatment of OSA, rather than respiratory failure.

VieMed and others vouch for the clinical efficacy of NIV and the study backs them up: KPMG found patients who receive high-touch NIV therapy fared better across the board, says Frazier.

“In our data, COPD and CRF patients on NIV are less likely to return to the hospital over the next six months, total healthcare costs go down and they live longer,” he said. “It's a win-win-win for patients, providers and payers.”

What VieMed would like to happen next: to hold meetings with CMS and other stakeholders, and to have them develop best practice metrics and clear guidance on who should qualify for NIV therapy—something that has been sorely lacking as utilization rates for the therapy increase.

“We need to take the gray out,” Frazier said. “We need to have consensus on what the qualifying rules are. We never have arguments about who qualifies for oxygen—we know those rules.”

VieMed recently launched a second study to analyze 2017 data, which, thanks to an increase in vent patients, will be a “much-enriched” data set, Frazier says.

Allowed charges for the new code, E0466, were nearly $350 million in 2017, an increase of 25% from $281 million in 2016, according to the HME Databank.