The Wall Street Journal reports that a gap in Medicare coverage makes the hospital-to-home care swap more difficult.
Under “home-infusion therapy,” patients can receive cost-effective care in their own homes and forgo lengthy hospital stays. But Medicare doesn’t fully cover home-infusion therapy. For instance, the list of intravenous drugs has grown, and patients can get these treatments at home. Home drug administering costs between $150 and $200 a day, as opposed to $1,500 to $2,500 a day in hospitals.
Insurance companies know a cost-effective program when they see one, and many fully cover home-infusion care. Medicare Part D, however, covers only the cost of intravenous drugs. It does not cover pharmacy and nursing services, supplies, and other features that account for about half the cost of home-infusion therapy.
Part D is a drug program, so it makes sense on some level that non-drug supplies and services won’t be covered. But Russell Bodoff, president of the National Home Infusion Association, says Medicare could save money by paying for more services under home-infusion therapy.
The association commissioned a study that estimated the cost of legislation requiring Medicare Part D to cover home-infusion services: $1.5 billion over 10 years, offset by a savings of $7.4 billion, if 10 percent of infusion therapy patients receive care at home.
