Mount Vernon Most people who read about the superbug that killed six people last year at the National Institutes of Health (NIH) probably reacted with fear and horror. My reaction was anger.
You see, the day before the NIH story appeared in The Washington Post, my father arrived back at his Mt. Vernon home after being discharged from George Washington University Hospital. His recent surgery required him to receive antibiotics via IV for several weeks.
But when nurses realized my 60-year-old Dad was on Medicare due to disability, he was informed that he had to get the infusion treatments at Mt. Vernon Hospital. We were told that Medicare covers only the drugs administered intravenously, but not the supplies, equipment and pharmacy-related services that account for more than half the cost of home-infusion therapy. Like most Medicare patients, my Dad could not afford to pay for the therapy out of pocket, so getting the treatments at Mt. Vernon was his only option.
Mt. Vernon is an excellent hospital, but the fact is that patients at hospitals are at a significantly higher risk of getting infections. The Centers for Disease Control and Prevention (CDC) estimates that two million Americans get hospital-acquired infections every year, and almost 100,000 of them die as a result.
So now every day my Dad, already suffering from a compromised immune system, has to travel to the hospital for treatment. Not only is he at risk for a new infection, but the trip is an additional burden on my Mom, his longtime caregiver. At least he only needs the antibiotic infusion once a day. Some patients who need infusion treatments twice daily must do a return trip every day.
Risk of infection is not the only issue. The difference in price
between hospital treatment and home infusion is substantial. The cost of hospital treatment is more expensive than the at-home option.
So why doesn’t The Centers for Medicare and Medicaid Services (CMS), the federal agency that oversees Medicare, fix the problem? It claims it does not have the jurisdiction. CMS maintains Congress needs to correct this glitch in Medicare. Meanwhile, Congress does nothing, leaving taxpayers to foot the bill.
What’s even more outrageous is that while the Medicare program continues to place people like my Dad at risk for new infection, every national private insurance company provides coverage for infusion therapies in the home.
As long as CMS indicates it does not have the authority to correct this problem and Congress is unwilling to act, elderly and disabled patients like my Dad will continued to be placed in harm’s way. There’s no doubt some of these patients will get infections and some will die due to this inaction.
That makes me mad.
Jennifer Waugh is manager of office services at National Home Infusion Association.