Walgreens wants Medicare to fund home therapy program
It was once a big deal to receive nutrition or medication intravenously.
Often it meant long stays in a hospital or nursing facility where experts could make sure the access points to a patient’s veins wouldn’t become infected.
The problem? Part of the cost of home infusion therapy isn’t covered under any section of Medicare, which often leaves patients footing weekly supply and service bills. And those costs range anywhere from $200 to $800 a week.
The concern is enough to have caught the attention of U.S. Rep. Peter Roskam, R-6th District, of Wood Dale. Roskam recently toured a Walgreens Home Care clinic in Elmhurst.
Walgreens officials invited Roskam to the facility to explain the need for legislation to provide funding in Part B of Medicare for supply and service costs unique to home infusion therapy.
Although Part D of Medicare covers most infusion therapy medications, other costs fall on the consumer, said Bryan Schneider, director of governmental affairs for Walgreens.
“(Home infusion therapy) is a very service-intensive therapy, a very supply-, equipment-intensive therapy and what’s missing from a reimbursement perspective is any payment for that,” he said. “They’re getting coverage for the drug, but not for the high-touch clinical supplies and service.”
Since acquiring OptionCare Inc., a Buffalo Grove-based specialty pharmacy and home infusion services provider, Walgreens is quickly becoming a leader in home infusion therapy, Schneider said.
Walgreens hopes to continue that trend by making home infusion therapy cheaper for patients. They’re encouraging federal lawmakers to support House Resolution 2567, which would provide money for infusion therapy equipment in Part B of Medicare.
Since in-home treatment is much cheaper than a hospital stay, the government ultimately would save more money in Part A than it would be putting into Part B, said Tom Rout, director of clinical operations for Walgreens.
“What we do at home costs insurance companies so much less than what have to spend at the hospital,” he said. “It’s more economically favorable and helps hospitals get patients out sooner. And they’re glad to have an alternative place to discharge patients, too.”
As recently as 25 years ago, home infusion therapy was not possible. Since then, medical experts have invented peripherally inserted central catheters, which can be installed by nurses in homes. In addition, medical companies have invented better pumps, Rout said.
“Those two, plus the economic incentives, and our understanding that patients do better at home. ... It’s a win-win situation for everybody,” he said of home infusion therapy.
The Elmhurst facility, 665 Grand Ave., is capable of serving up to 300 patients in a 50- to 70-mile radius, Rout said.
Roskam said he would seriously consider H.R. 2567.
“This is important work that you’re doing, and I can see how it would be a great blessing to people,” he told Walgreens officials. “This would take a big burden off them, I would imagine, and off the system.”
The bill could be a big boost to seniors, Roskam said.
“If you think about the challenges that seniors face, anything we can do to help them stay in home and be around loved ones makes all the sense in the world,” he said.