An easy state fix on home medical equipment

I ran a respiratory and home medical equipment company out of Farmingdale for 25 years. I delivered oxygen concentrators, hospital beds and patient lifts to homes across Nassau and Suffolk. Long Island is where I built my company, and watched house by house what home medical equipment actually means to the people who depend on it.

For a homebound senior with COPD, an oxygen concentrator is the difference between staying in the house she's owned for 40 years and moving to a nursing facility. For a father recovering from a stroke, a hospital bed and a patient lift are what let his wife care for him at home rather than sending him somewhere else. This equipment is the infrastructure of independence, and it's getting harder to get from suppliers on Long Island and across New York as networks narrow and suppliers close.

Here's why. New York allocates hundreds of millions of dollars a year to Medicaid-managed care plans specifically to cover this equipment for their members, and the state pays those plans in full. Yet by the time that money reaches the companies that actually deliver, fit and service the equipment, a significant share of it has vanished along the way. Suppliers across the state report getting 60-70 cents of every dollar New York allocated for their patients' care, on a Medicaid base rate that's barely moved since 1987. New York has lost roughly 24% of its durable medical equipment suppliers since 2013.

I have spent the last decade as the president and CEO of a national trade association, testifying in Albany and Washington about exactly this. But I saw it first in Farmingdale, Amityville and Babylon. A company that served a patient for 20 years starts turning away new referrals because the reimbursement no longer covers the cost of the visit. When that happens enough times, the patient down the block from you loses access to the oxygen equipment that keeps her out of the hospital.

This is the difference between a Long Island family caring for a loved one at home and that same family being told there's no supplier left who can serve them.

There is good news. A fix already has bipartisan support in Albany, and it doesn't cost the state a dime more. The State Legislature passed a bill this year, with a 60-0 vote in the Senate, requiring Medicaid-managed care plans to pass through the entire amount laid out in the existing Medicaid fee schedule to the suppliers who provide this equipment. This will ensure that money New York has already budgeted for this equipment reaches the people who provide it, instead of being absorbed by a health plan along the way.

This bill needs Gov. Kathy Hochul's signature.

I've spent my career on Long Island watching this industry as an owner, as a local official, as a neighbor. I know what happens in the towns I've served when a supplier closes its doors. Families lose the equipment that keeps a parent or a child at home instead of in an institution, and they lose it quietly, one household at a time, long before anyone in Albany notices.

This guest essay reflects the views of Thomas Ryan, of Farmingdale, the president and CEO of the American Association for Homecare, and a former president and CEO of Homecare Concepts Inc. in Farmingdale.