Ostomy patients and the providers who care for them at home have launched an initiative to educate private and public payers about the needs of those patients. They also hope it will lead to more solid reimbursements.
A new white paper developed by the American Association for Homecare, the Ostomy Association of America and a half dozen other medical groups outlines the products and care that the nearly 1 million Americans living with ostomies require.
“When a person living with a permanent or temporary ostomy does not have access to their prescribed ostomy supplies, the consequences can be severe,” said James Murray, president of the United Ostomy Associations of America. “Inflamed skin, pouch leaks, and emotional stress are just a few of the outcomes that can have devastating effects on a person’s quality of life.”
The white paper underscores the complexities and importance of providing care to patients with bowel and bladder issues requiring ostomy products. Each body and ostomy is unique, so a customized approach is needed to determine the combination of products and brands that work best for an individual’s clinical and personal needs. Home medical and equipment providers work closely with clinicians and patients to educate and deliver the most appropriate and cost effective options for home use.
But the groups say continued reductions in reimbursements for ostomy supplies jeopardize access to needed goods and services, increasing the risk of poor health outcomes and increased costs to payers.
“It is critical that payers understand the distinct needs of this population and what is required to safely and effectively manage their medical conditions,” said Laura Williard, Vice President of Payer Relations at the American Association for Homecare. “By providing sustainable reimbursement, the HME community will have the resources to maximize outcomes while ensuring cost-effective payer management.”
The white paper wants payers to ensure rates for ostomy products and services are no less than current corresponding Medicare fee-for-service rates.
