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NHIA Responds to Congressional Committees’ Requests for Information (RFIs)

October 18, 2023

NHIA recently submitted comments to 2 Congressional committees seeking more information on health care-related issues, sharing its recommendations to modernize and personalize the health care system, support innovation, and increase patient access to quality and affordable care. The U.S. House Budget Committee’s Health Care Task Force issued a request for information (RFI) on improving health outcomes while reducing spending and the House Ways and Means Committee issued an RFI on improving access to health care in rural and underserved areas. In both responses, NHIA pointed out that unlike other stakeholders—including health systems, drug manufacturers, epidemiologists, pharmacists, nurses, and more—the federal government has failed to take full advantage of capacity and efficiencies provided by home infusion.

In addition, NHIA described the faulty design and resulting poor uptake of the current Medicare Home Infusion Therapy benefit and recommended that Congress provide for the coverage of home infusion services and supplies regardless of whether the medication they need requires a pump to administer — including treatments that are covered under Medicare Part D. Under this model, patients would have access to home infusion for a wide variety of therapies whether or not they require a mechanical pump. “This model has been overwhelmingly effective in commercial plan coverage at providing access to patients in rural and underserved communities while also shortening hospital stays and avoiding long-term care admissions,” said NHIA.

In its response to the Health Care Task Force, the association presented data from payor studies, medical literature, and the Government Accountability Office (GAO) to support the relative cost savings of home infusion compared to other sites of care in addition to patient preference. NHIA also noted the difficulty in obtaining Congressional Budget Office (CBO) scores, which are essential to the legislative process and can inadvertently become an obstacle to the advancement of otherwise well-vetted policies. The association asked the task force to consider providing additional resources to CBO to increase the number of analysts working on health care legislation. “Given the size of the nation’s federal health programs and the magnitude of savings from health care policies that may not otherwise be properly vetted, such a modest investment could result in meaningful long-term savings through reforms that create efficiencies and improve patient care,” said NHIA.

In its response to the House Ways and Means Committee, NHIA shared research from the National Home Infusion Foundation (NHIF) concluding that most home infusion providers serve rural patients and the percentage of rural patients increased year-over-year from 2018 to 2020. Utilizing the particularly conservative rural designation defined by the Centers for Medicare and Medicaid Services (CMS) DMEPOS Competitive Bidding Program, the study found that 13.1% of patients served by home infusion providers lived in rural areas, alleviating patient travel barriers and making treatments more accessible to patients with limited health care options due to lack of proximity to urban centers. “Without home infusion, patients in rural areas would have to travel great distances to receive these medications. In addition to the quality-of-life benefits to patients, home infusion therapy benefits families and the whole health system by providing an alternative to the long-distance burdens associated with receiving care in rural settings,” said NHIA.

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