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Home Care NetWorkHot TopicsIndependence at Home Act Health-care reform is in the headlines on a daily basis and, while the ultimate outcome is unknown, it seems certain that changes to the current system are inevitable. An important piece of legistation has recently been reintroduced in Congress. The Independence at Home Act (S 1131, HR 2560) has important implications for health-care providers involved in caring for patients who are chronically ill, particularly providers involved in home care. The Independence at Home (IAH) Act targets the 10% of Medicare beneficiaries that consume more than 60% of Medicaire costs and have poor outcomes. The IAH Act uses physician- and nurse practioner-directed home calls in an effort to reduce health-care costs and improve outcomes. The IAH Act proposes a 3-year pilot program in the 13 states where Medicare expenditures for the chronically ill are highest and in 13 other states identified as having the greatest needs. The IAH Act proposes to use long-standing, successful home call programs. Unique features of the IAH Act are that it is paid for by the money it saves through coordinating the care of this high risk population. Providers in the program are held accountable to provide at least 5% savings to Medicare, improve outcomes, and improve patient satisfaction. The IAH Act is receiving broad bipartisan support. Further details of the legislation can be obtained from the American Academy of Home Care Physicians Web site.
Changes to the Use of Respiratory Equipment on Airlines New regulations for the Air Carriers Access Act, 49 USC §41705 (2009), became effective on May 13, 2009. These regulations should help patients who require supplemental oxygen, CPAP, or noninvasive ventilation while flying, but there may be some growing pains as equipment manufacturers and airlines respond to the changes. As described in the summer 2009 issue of "Ventilator-Assisted Living," airlines are now required to allow individuals with disabilities to use portable oxygen concentrators, ventilators, or CPAP machines. However, the devices need to meet Federal Aviation Administration (FAA) guidelines and need to have a label from the manufacturer indicating that it meets FAA guidelines. Unfortunately, these regulations have gone into effect before manufacturers have been able to obtain the correct labeling. As such, a carrier can refuse to allow a passenger to use a device that does not have the correct FAA-approved label. Additionally, carriers may require 48 hours notice from passengers who plan to use an approved device or who may require early check-in.
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