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 A Bipartisan Fix for America’s Looming Homecare Crisis

By Tom Ryan

Within the next 40 years, the number of people over the age of 65 in this country will increase by about 70%.

Many older Americans — three in four, according to an AARP survey — want to live out their golden years at home. They won’t be able to, absent action to shore up our nation’s homecare infrastructure.

Fortunately, Congress is beginning to recognize as much. In February, a bipartisan coalition in the House introduced legislation that would raise pay for the homecare providers who furnish seniors and Americans in need with oxygen, wheelchairs, ventilators, and other medical equipment that enables them to safely receive care at home.

This pay hike not only will ensure that seniors have access to homecare in the years to come. It will also generate savings and reduce pressure on other parts of the healthcare system.

Long-standing demand for critical homecare has surged during the pandemic.

Aging Americans want to avoid group facilities where the risk of contracting COVID-19 is high. Hospitals are turning to home care for follow-up services that might previously have required a return trip to the clinic.

This surge in demand has collided with severe shortages of everything from hospital beds to walkers. Before the pandemic, the average wait for delivery of new stock was a few days. Now, wheelchairs are on months-long back orders. Sleep apnea machines and oxygen tanks are in short supply.

When items are available, costs have soared. Home medical equipment providers have reported price increases of more than 30%. On top of that, they’re paying shipping and handling surcharges.

Then there are pandemic-related expenditures for personal protective equipment for staff, which can total $15,000 a year per location.

Operating under these conditions would be challenging for any industry. But homecare providers cannot pass these higher costs along. That’s because they’re paid according to a reimbursement schedule set by Medicare back in 2015 that’s been locked in ever since.

Many home medical equipment providers have found the strain too much to bear. More than one-third have gone out of business or stopped accepting Medicare patients.

The need to act is urgent.

Medicare has twice failed to hold a new bidding round that would bring rates into alignment with market reality. Instead, Medicare has offered a 5% increase, citing the overall inflation rate. That’s hardly adequate.

Preserving America’s homecare infrastructure will benefit not just the patients who count on it but the rest of our healthcare system.

High-quality, home-based care reduces overall healthcare costs by keeping patients out of high-cost environments like hospitals and nursing homes. That can help preserve scarce medical resources for more acute cases.

In an era of intense polarization, it’s rare to find an idea that commands the support of Republicans and Democrats. But both parties can support Americans who wish to age in place, in the comfort of their own homes.

Lawmakers can translate that support into action by advancing H.R. 6641, the DMEPOS Relief Act of 2022. This bill would raise pay and ensure that Medicare reimbursement for homecare providers keeps up with rising equipment and operational costs.

The COVID-19 pandemic has brought our nation’s ability to provide care outside of hospitals and nursing facilities into focus. Our nation’s growing population of seniors adds even more urgency to the need to invest in home-based care. Passing The DMEPOS Relief Act of 2022 is an important step in that direction.

Tom Ryan is president and CEO of the American Association for Homecare ( This piece originally ran in the Detroit News.

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