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					  Discharging Dual Eligibles Needing Home Infusion Therapy
               Under Part D: National Survey
               of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017



1. What state or US territory do most of your patients reside in? (If many patients in
multiple states, select Multiple States.)

Multiple States                                                      15        6%
Alabama                                                               9        4%
Alaska                                                                0        0%
Arizona                                                               4        2%
Arkansas                                                              1        0%
California                                                           15        6%
Colorado                                                             13        5%
Connecticut                                                           2        1%
Delaware                                                              0        0%
District of Columbia                                                  1        0%
Florida                                                               2        1%
Georgia                                                               7        3%
Hawaii                                                                2        1%
Idaho                                                                 1        0%
Illinois                                                              3        1%
Indiana                                                               3        1%
Iowa                                                                  7        3%
Kansas                                                                3        1%
Kentucky                                                              1        0%
Louisiana                                                             0        0%
Maine                                                                 1        0%
Maryland                                                              2        1%
Massachusetts                                                        17        7%
Michigan                                                              3        1%
Minnesota                                                             1        0%
Mississippi                                                           6        2%
Missouri                                                             21        9%
Montana                                                               0        0%
Nebraska                                                              0        0%
Nevada                                                                6        2%
New Hampshire                                                         0        0%
New Jersey                                                            2        1%
New Mexico                                                            0        0%
New York                                                             10        4%
North Carolina                                                        8        3%
North Dakota                                                          0        0%
Ohio                                                                  7        3%
Oklahoma                                                              3        1%
 Discharging Dual Eligibles Needing Home Infusion Therapy
              Under Part D: National Survey
              of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

Oregon                                                              1        0%
Pennsylvania                                                       26       11%
Puerto Rico                                                         1        0%
Rhode Island                                                        2        1%
South Carolina                                                      0        0%
South Dakota                                                        0        0%
Tennessee                                                           9        4%
Texas                                                              10        4%
Utah                                                                5        2%
Vermont                                                             3        1%
Virginia                                                            4        2%
Washington                                                          4        2%
West Virginia                                                       1        0%
Wisconsin                                                           4        2%
Wyoming                                                             0        0%
Other US Territory                                                  0        0%
Total                                                             246      100%



2. In considering your perspectives on arranging care for Medicare Part D patients
needing home infusion therapy, are you in a position to speak for the experiences
of your entire organization, or from your own experience only?

My own experiences                                                158       64%
Our organization's experience                                      88       36%
Total                                                             246      100%




3. Please choose the single answer that best describes your role in arranging
treatment for patients needing infusion or injectable therapies:



I am in a hospital discharge planning or case
management role and responsible for
referring patients for outpatient treatment
who are being discharged from a hospital
(or, I manage/supervise people in this role)                      246      100%
  Discharging Dual Eligibles Needing Home Infusion Therapy
               Under Part D: National Survey
               of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

I am a physician or work in a physician office
and am responsible for referring patients for
infusion or injectable therapies who are
residing in their homes (or, I
manage/supervise people in this role)                                        0     0%
Other                                                                        0     0%
Total                                                                       246   100%



4. For DUAL ELIGIBLE (Medicare/Medicaid) patients, how does the CURRENT
process for arranging home infusion therapy under Part D compare to before
January 2006 when DUAL ELIGIBLES received drug coverage through the state
Medicaid program?
Much easier                                                                   2     1%
Easier                                                                       12     5%
About the same                                                               63    26%
More difficult                                                               78    32%
Much more difficult                                                          86    36%
Total                                                                       241   100%

                        For DUAL ELIGIBLE (Medicare/Medicaid) patients, how
                       does the CURRENT process for arranging home infusion
                        therapy under Part D compare to before January 2006
                      when DUAL ELIGIBLES received drug coverage through the
                                      state Medicaid program?




                      About the                                More difficult
                       same                                       32%
                        26%                Other               Much more
                                           68%                  difficult
                                                                 36%
                Easier
                 5%
                           Much easier
                              1%
  Discharging Dual Eligibles Needing Home Infusion Therapy
               Under Part D: National Survey
               of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017


5. Are DUAL ELIGIBLE patient discharges from the hospital CURRENTLY being
delayed due to complications related to arranging access to home infusion therapy
under Medicare Part D?

No delay: these patients are being
successfully referred for home infusion                                               36    15%
No delay: these patients are generally being
referred to other care settings rather than to
a home infusion therapy provider                                                       41    17%
Yes, delays are occurring                                                             163    68%
Total                                                                                 240   100%




6. If yes to question #5, how long are DUAL ELIGIBLE patient discharges typically
delayed?

No significant delay                                                                   26    14%
One day                                                                                69    36%
Two days                                                                               67    35%
3 days or more                                                                         29    15%
Total                                                                                 191   100%

                If delays occurring, how long are DUAL ELIGIBLE patient discharges
                                          typically delayed?



                                                                       One day
                                                                        36%




                                                  Significant
                                                    Delays
                           No significant delay      86%
                                                                         Two days
                                  14%                                      35%




                                                                     3 days or more
                                                                          15%




7. If yes to question #5, please estimate CURRENTLY the number of these discharge
delays occurring in the hospital EACH MONTH:
151 Responses - See Tab for Qts #7
 Discharging Dual Eligibles Needing Home Infusion Therapy
              Under Part D: National Survey
              of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES accessing home infusion
therapy under Medicare Part D, please list the top three problems:
169 Responses - See Tab for Qts #8




9. What was the average cost (not charges) in 2005, to the hospital, of each
inpatient day? (your best estimate)

Less than $300 per day                                               2           1%
$301 - $400 per day                                                  3           2%
$401 - $500 per day                                                  7           4%
$501 - $600 per day                                                 11           6%
$601 - $700 per day                                                  7           4%
$701 - $800 per day                                                 15           8%
$801 - $900 per day                                                 17           9%
$901 - $1000 per day                                                19          10%
$1001 - $1100 per day                                               29          15%
$1101 - $1200 per day                                               10           5%
$1201 - $1300 per day                                                6           3%
$1301 - $1400 per day                                                1           1%
$1401 - $1500 per day                                                5           3%
$1501 - $1600 per day                                                8           4%
$1601 - $1700 per day                                                4           2%
$1701 - $1800 per day                                                3           2%
$1801 - $1900 per day                                                2           1%
$1901 - $2000 per day                                                1           1%
$2001 - $2100 per day                                                4           2%
$2101 - $2200 per day                                                2           1%
$2201 - $2300 per day                                                1           1%
$2301 - $2400 per day                                                1           1%
$2401 - $2500 per day                                                4           2%
Over $2500 per day                                                   5           3%
Don't know                                                          31          16%
Total                                                              198         100%




10. For question #9, is your response based on:
 Discharging Dual Eligibles Needing Home Infusion Therapy
              Under Part D: National Survey
              of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

The estimated daily cost for an inpatient
receiving infusion and other basic services                        68       37%
The estimated daily cost for all inpatients                        97       53%
Other, please explain:                                             18       10%
Total                                                             183      100%



11. Are you CURRENTLY placing more DUAL ELIGIBLE patients in nursing homes
or in hospital outpatient settings due to problems in accessing home infusion under
Medicare Part D than you were before January 2006?

Yes                                                               144       63%
No                                                                 85       37%
Total                                                             229      100%



12. Considering your answers above, please enter comments you may have on
arranging for home infusion therapy for DUAL ELIGIBLE patients:
120 Responses - See Tab Qts #12

13. (LAST QUESTION) Are you CURRENTLY experiencing complications in
arranging access to home infusion for Part D patients who are NOT DUAL
ELIGIBLES? (Please explain how this may differ from your experiences with DUAL
ELIGIBLE patients)
Yes                                                              152      67%
No                                                                75      33%
Total                                                            227     100%
130 Responses - See Tab Qts #13
Discharging Dual Eligibles Needing Home Infusion Therapy
             Under Part D: National Survey
             of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

7. If yes to question #5, please estimate CURRENTLY the number of these discharge
delays occurring in the hospital EACH MONTH:
#                                  Response
1            15
2            20
3             1-2
4            3
5            5
6            5
8            2
9            more than 10
10           My floor in hospital has about 4 a year

11        my division is 1 every 2mths; i also cover weekend
12        3
13        not sure for whole hospital , on my floor 3-4
14         2-3
15         2-5
16        ?
17        varies
18        on a single unit of 25 patients approx 3 - 5
19        unknown
20        1
21         5-10
22        20
24        5 to 8
25         3-5
26        7
27         5-6
28        12
29        10
30        25
31        1 for myself
32        5
33        unable to speak towards entire hospital
34        5
35        1 or 2 from my own case laod
36        at least 2-4
37        I have few cases, but approx. 1x/month
38        10-May
Discharging Dual Eligibles Needing Home Infusion Therapy
             Under Part D: National Survey
             of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

39           5-Feb
7. If yes to question #5, please estimate CURRENTLY the number of these discharge
             not sure
delays occurring in the hospital EACH MONTH:
40
41           10-Jun
42           ?
43           7-Jun
44           6-May
45           UNSURE OF #
46           difficult to choose a specific number
48           they are set up as series patients
49           unknown
50           10
51           60 + per month, and some times many more.
52           approx 20
53           un certain
54           6
55           3
56           5
57            12-15
58           15 to 30 days
59           5
60           10
61            4-5
62           not sure
63           1 or 2
64           4-6 on the floor I cover
65           1
66           5
67           not sure
68           25+
69           1
70           5
71           10
72           No IV infsion is arranged for discharge
73           3
74            1-3
75            3-4
76           1
77           2 to 3
78            1-2
79           2
Discharging Dual Eligibles Needing Home Infusion Therapy
             Under Part D: National Survey
             of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

80           5
7. If yes to question #5, please estimate CURRENTLY the number of these discharge
              3-5
delays occurring in the hospital EACH MONTH:
81
82            3-5
83           unknown
84            2-3
85            5-6
86           uncertain
87           2
88            2-3
89            3-5
90           10
91           Varies - 10-20
92           seven to ten
93            4-6
94           2
95            2-3
96           Hard to say ??? ten
97           2
98            2-3
99           5
100           10-20
101          5
102          10 to 12
103          10
104          1
105          unknown
106          only 1 or 2
107          1
108          one so far
109          8
110          unknown
111          8
112          My patients, 8-10 per month
113          7
114          35-50
115          at least 15-20
116          two
117           10-15
118           2-4
119          2
Discharging Dual Eligibles Needing Home Infusion Therapy
             Under Part D: National Survey
             of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

120          2
7. If yes to question #5, please estimate CURRENTLY the number of these discharge
             50
delays occurring in the hospital EACH MONTH:
121
122          2
123          2
124          75% of discharges
125          2
126          2
127          unknown
128          20
129          5
130          3
131          2
132          3
133           2-3
134          3
135          3
136          10
137           6-8
139          0-2
140          unsure
141          >100
142          10
143           10-20
144          10
145          10
146          20-25
147          2
148          4 to 5
149          Varies monthly. Typically 5-10
150           4-5
151          one or two
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
under Medicare Part D, please list the top three problems:
#                                       Response
            #1
            no coverage for the medication
            #2
1
            fees are to low and no one will take the patient
            #3
            some patients did not contract for part D
            #1
            Access to infusion provider
            #2
2
            Unwilling to accept patient until preauthorization
            #3
            Delay in response from provider delays discharge
            #1
3           CHECKING COVERAGES
            #1
            FINDING PROVIDER
            #2
4
            DELAY DUE TO SHIPMENT OF MEDS OVER DISTANCE
            #3
            2-3 DAY DELAY WITH CHANGES
            #1
5           UNABLE TO GET FROM NATIONAL VENDOR SAME
            DAY
            #1
            not able to afford the supplies
            #2
7
            difficult to prior authorize
            #3
            patient refuses to pay anything out of pocket
            #1
            lack of coverage for this treatment
            #2
8
            lack of available in home providers
            #3
            lack of available placements w/this tmt.
            #1
            Length of time to learn if antibiotic is covered
            #2
9
     Discharging Dual Eligibles Needing Home Infusion Therapy
                  Under Part D: National Survey
                  of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

9 If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
8.         Patient not knowing which Medicare D plan
under Medicare Part D, please list the top three problems:
           #3
           Copays under many plans more than Medicaid was
           #1
           pt. does not want to go to facility/wants home
           #2
10
           no providers for home infusion
           #3
           delays discharge
           #1
           verifying who is prescription provider
           #2
11
           securing medication from provider/pharm
           #3
           is pt in/near do nut hole
           #1
           meds not covered
           #2
12
           no provider identified
           #3
           pt cannot afford supplies
           #1
13         Delay related to copays
           #1
           no services available
14
           #2
           pts cannot afford high out of pocket costs.
           #1
           no coverage for equipment
           #2
15
           locating agency
           #3
           medicine not covered depending on plan
           #1
16         inability to pay for meds-our facility covers the
           #1
           Medication coverage
           #2
17
           supply coverage
           #3
           agreement of infusion company to service patient
           #1


18
     Discharging Dual Eligibles Needing Home Infusion Therapy
                  Under Part D: National Survey
                  of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            med not covered
under Medicare Part D, please list the top three problems:
            #2
18
            med not covered
            #3
            pt didn't choose a part d plan
            #1
            delays
19
            #2
            lack of home infusion exp with medicare
            #1
20          DRUG NOT IN FORMULARY
            #1
            obtaining insurance approval
            #2
21
            verification of benefits
            #3
            coverage of specific drugs
            #1
22          Confusion regarding if parenteral needs are covere
            #1
            confirming insurance eligibility
23
            #2
            finding provider
            #1
            slow process to see if iv medication even covered
            #2
25
            most iv meds not covered and need prior auth
            #3
            long delay in getting auth
            #1
            There are only 2 Infusion Co.'s in area servicing
            #2
26
            MCR D. This puts a time restraint on return
            #3
            verification of benifits and coverage of meds
            #1
27          most iv meds are no covered for home use
            #1
            not all agencies want to deal with these patients
28
            #2
            Dont have contracts with all the pharmacy plans
            #1


29
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

            which company they have for part ELIGIBLES’ accessing home infusion therapy
8. If you have experienced problems in DUAL D
under Medicare Part D, please list the top three problems:
            #2
29
            finding a vendor who contracts with them
            #3
            length of time it takes to get approval
            #1
            Non-Formulary Drug Issues
30
            #2
            Prior Authorization Issues
            #1
            Finding infusion providers who will work with D
            #2
31
            Finding home care providers who will bill A suppli
            #3
            Finding drug on D formulary that treats condition
            #1
32          co- pay coverage
            #1
            Unable to verify benefits
            #2
33
            drug ordered not covered
            #3
            patient unable to pay
            #1
            copays for patients w/o funds to pay
34
            #2
            higher copay than if they d/c to a facility
            #1
35          finding Part D information from Medicare
            #1
36          access to coverage information
            #1
            Figuring out pt's Part D coverage program
37
            #2
            Finading a home infusion agency that will accept
            #1
38          Lack of participating providers for both programs
            #1
            finding out which MC D plan the patient has
            #2
39
            finding out what infusion companies are in network
            #3
     Discharging Dual Eligibles Needing Home Infusion Therapy
                  Under Part D: National Survey
                  of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
39
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            getting an infusion company to accept the patient
under Medicare Part D, please list the top three problems:
            #1
          participating phamacies do not do infusion
40
          #2
          if no m/c coverage no other coverage
          #1
          cost of dedeuctibile
          #2
41
          need for 2 separate agencies because of dual statu
          #3
          longer stays in hospital because of dual status
          #1
          Finding vendors that accept Medicare D plans
          #2
42
          Finding vendors that accept secondary payors
          #3
          Patients not willing to accept co-pays
          #1
          Verifying coverage
43
          #2
          locating in-network providers
          #1
          medication not in stock at pharmacy
          #2
44
          insurance coverage
          #3
          insurance response time
          #1
          Approval for IV -ABX with Part D
          #2
45
          Part D- "Donut Hole"-patient cannot afford co-pays
          #3
          Patient unaware of co-pay and unable to afford.
          #1
          RESEARCHING COVERAGE
          #2
46        OBTAINING PRE-AUTHORIZATION
          #3
          SELECTING ALTERNATE MEDS FOR NON COVERED
          MEDS
          #1
          Verifying coverage
47
     Discharging Dual Eligibles Needing Home Infusion Therapy
                  Under Part D: National Survey
                  of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #2
47
under Medicare Part D,issues list the top three problems:
            Donut hole please
            #3
            patient having to pay for supplies
            #1
            the medicaid is just a supplement
            #2
49
            there is still about 75-80% out of pocket
            #3
            they have to have meds changed and set up OP serie
            #1
            Pre-authorization
            #2
50
            Availability of drugs
            #3
            Getting through to correct party
            #1
51          No coverage for the actual drug Iv Atbx
            #1
            await approval
            #2
52
            changes in coverage
            #3
            certain meds not covered
            #1
            figuring out coverage
53
            #2
            providers willing to accept coverage
            #1
            lack of companys wanting to take these pt.
            #2
54
            people ending up in the donunt whole time frame
            #3
            companys not getting paid
            #1
            excessive cost for supplies -ave $<redacted>-<redacted>
            per day
55          #2
            pt's not knowing who is their Med D provider
            #3
            fewer # of companies to choose from
            #1
56
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            companies accepting part D
56
under Medicare Part D, please list the top three problems:
            #2
            accessing part D for coverage information
            #1
            HIT DONUT HOLE
57
            #2
            TOO MANY PART D PLANS
            #1
            when the Med part d does not list the drug then MA
            #2
58
            drug co's won't assist when part D doesn't list it
            #3
            delays discharge
            #1
            Providers in network
            #2
59
            co-pay amounts
            #3
            cost of supplies not covered
            #1
            Providers who have the plans
            #2
60
            Providers have claimed hard to access information
            #3
            Not all infusion drugs covered
            #1
61          No coverage for iv antibiotics
            #1
            NO COVERED. BUT THEY HAVE TO BE ADMITTED TO
            A SNF
            #2
62          THE SNF IS PAYED FOR IV ANTIBIOTICS WITH NO
            PROBLE
            #3
            IF PT. WANTS TO GO HOME MEDICARE DOESN'T
            COVER IV
            #1
            co-pay for drugs
            #2
63
            delay from pharmacy obtaining coverage
            #3
            drug not covered.
     Discharging Dual Eligibles Needing Home Infusion Therapy
                  Under Part D: National Survey
                  of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #1
64          Getting approved/auth the top three problems:
under Medicare Part D, please list by the different plans
          #1
          length of turn-around time on referrals for IV Tx
          #2
65
          finding in-network providers
          #3
          lAck of IV benefits
          #1
          coverage verification
66
          #2
          contacting the right person to obtain approval
          #1
          Contact to Drug Plan for coverage for Medication
67
          #2
          Explaining coverage and any out of pocket expenses
          #1
          no coverage for pump and supplies
68
          #2
          if not covered by medicare, medi-cal does not cov
          #1
          medication approval
          #2
69
          equipment coverage
          #3
          physician certification
          #1
          Can't get IV med approval from the Part D provider
          #2
70
          Hospital CMs don't know the Part D rules
          #3
          <name of provider redacted> no longer does IV infusion
          #1
71        Understanding eligibility of pats for D coverage
          #1
          getting all the information
          #2
72
          getting auth
          #3
          patients not able to understand home infusion
          #1
          No coverage under Part D
73
     Discharging Dual Eligibles Needing Home Infusion Therapy
                  Under Part D: National Survey
                  of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #2
73
under Medicare Part D, please list the top three problems:
            No coverage for medication
            #3
            Poor coverage/reimbursement for medicatio
            #1
            Will pay only certain antibiotics
            #2
74
            Supplies may not be covered as well as home care
            #3
            Delay in delivery of antibiotic to patients' home
            #1
            n/a
            #2
75
            n/a
            #3
            n/a
            #1
            Few agencies carry the Medicare contract.
76
            #2
            We are a pediatric institution
            #1
77          not able to check benefits on weekend
            #1
78          getting patients to deal with the copays
            #1
            Medication not listed in formulary
79
            #2
            Not aware that patient has medicare part D
            #1
            Unaware that it shoud be covered
            #2
80
            No provider available
            #3
            Physician does not D/C to home with IVABX
            #1
            plan formulary
            #2
81
            in-network providers
            #3
            prior auth from PCP
            #1
            infusion companies not handling medicare part D
82
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #2
82
under Medicare Part D, please listprovice three problems:
            questions on who can the top
            #3
            unsure of what is covred with multiple payers
            #1
            unable to determine which drugs are covered
            #2
83
            Medicaid states now with Part D they no longer cov
            #3
            Convoluted process
            #1
            Patient not aware of Part D coverage
            #2
84
            Patient has reached donut hole
            #3
            Vendor had trouble verifying benefit
            #1
            Drug not covered by Medicare Part D
            #2
85
            Drug not the member's formulary
            #3
            Easier to get it thru Medicaid
            #1
86          delay in authorization
            #1
            drug coverage
87
            #2
            supply coverage
            #1
            time for verification
88
            #2
            drug not covered under plan
            #1
            problems knowing what drugs are covered
            #2
89
            different drugs covered by different plans
            #3
            difficult to get thru to the plans
            #1
            the random policy did not have home infusion cover
            #2
90
            not in their coverage/service area of their policy
     Discharging Dual Eligibles Needing Home Infusion Therapy
                  Under Part D: National Survey
                  of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017
90
8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #3
            not Part D, the coverage top three problems:
under Medicareknowing please list thefor their policy
          #1
91        doughnut
          #1
          not enough agencies that accept the ins.
92
          #2
          no coverage for week end needs
          #1
          getting medicare d coverage info from pt
          #2
93
          knowing if they have signed up for
          #3
          medicare d has been used up
          #1
          Pt has reached their donut hole and have no money
94
          #2
          Verifying benefits and suppliers
          #1
          Finding out if paraticular drug ordered is covered
          #2
95
          Then getting MD to agree to change if not covered
          #3
          Patients not knowing who their Part D carrier is.
          #1
96        time consuming
          #1
          not coverage for the medication
97
          #2
          no agency to take the plan, etc.
          #1
          Difficulty finding a provider for infusion
98
          #2
          finding a home care agency willing to service them
          #1
          CO-PAYS TOO HIGH FOR PATIENT
          #2
99
          CANNOT PROVIDE HOME INFUSION
          #3
          PROLONGED HOSPITAL STAYS
          #1
100       payment for drug and infusion services
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #1
under Medicare Part D, please list the top three problems:
            copays
101
            #2
            equipment not paid for
            #1
            Formulary Inclusion of the medication
            #2
102
            Exceptions process inconsistent from plan to plan
            #3
            Provider able to bill Part D
            #1
103         Finding an Infusion company
            #1
            Finding an agency certified to provide service
104
            #2
            Lack of understanding whether to use part B vs D
            #1
            limited reimbursement for meds
            #2
105
            epidural pain management-not covered
            #3
            increased out of pocket expense
            #1
            Time to get approval
            #2
106
            Drugs involved
            #3
            Home care agency
            #1
            beauracracy
            #2
107
            beauracracy
            #3
            beauracracy
            #1
108         finding 2 agencies instead of 1
            #1
            supplies not covered
            #2
109
            inadequate support system to assist with infusion
            #3
            difficulty with billing 2 agencies if Home Health
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #1
110 Medicareall infusion providers will take these pts.
under       not Part D, please list the top three problems:
          #1
111       Cost of supplies to complete the infusion at home
          #1
          ability to verify benefit
          #2
112
          obtaining authorization from the ins..
          #3
          finding a contracted vendor
          #1
113       supplies to administer the IV meds
          #1
          supplies not covered to administer the medication
          #2
114
          the medicine not on the drug plan
          #3
          homebound status
          #1
115       required drug not part of formulary
          #1
          unknown eligibility
          #2
116
          sometimes supplies are not covered
          #3
          Sometimes a VNA referral is also needed.
          #1
          determining plan
          #2
117
          contacting plan administrator
          #3
          determining coverage/confirming lack of coverage
          #1
118       verifying benefits
          #1
          availability of the vendor to get med
          #2
119
          Locating where meds come from to mix IV
          #3
          mail order delivery of med of IV
          #1
          locating contracting agencies
120
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #2
120 Medicare Part D, please list the top three problems:
under       locating agency that will accept the reimbursement
            #3
            waiting for agency to verify benefits
            #1
            Medication covered but not infusion set
121
            #2
            Patient cannot afford $<redacted>/Day to do at home
            #1
            no coverage in our region
122
            #2
            patients non homebound
            #1
123         obtaining auth in timely manner
            #1
            no provider in our region
            #2
124
            no reinbursement
            #3
            patient dissatisfaction
            #1
            no reimbursement
125
            #2
            homebound status
            #1
            No infusion co. in our area will take them
            #2
126
            Patient changed to PO meds early
            #3
            Patient discharge delayed or stopped
            #1
            less benefit covering cost of medication
127
            #2
            limited contracted providers
            #1
            no coverage
128
            #2
            homebound status
            #1
            Confusion over coverage-inaccurate info being prov
            #2
129
            Significant increase in phone calls to verify elig
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
  Survey Conducted August 10 to September 27, 2006
  National Home Infusion Association, Alexandria Virginia
  Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017
129
8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            #3
            Significant increase in the top three problems:
under Medicare Part D, please listreferral managment time
          #1
          no coverage
          #2
130
          limited coverage
          #3
          no coverage
          #1
          Infusion companies refuse Part D referrals .
          #2
131
          Difficulty finding out which plan a patient has.
          #3
          Length of time needed to get auth/check coverage.
          #1
          poor coverage per Medicare D
132
          #2
          Medicaid will not pick up unpaid amt.
          #1
          MEDICARE D PLAN COVERS ONLY PART OF COST
          #2
133       MEDICARE D PLAN DOES NOT COVER COST OF
          SUPPLIES
          #3
          OUT-OF-POCKET COSTS TO PT IS TOO EXPENSIVE
          #1
          Finding an accepting provider
          #2
134
          Finding a physician to follow
          #3
          Confirming eligibility
          #1
          Medication not covered
135
          #2
          Provider not covered
          #1
          authorization
          #2
136
          cost
          #3
          drug formulary
          #1
137
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

137 you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
8. If     Problems getting specific meds not listed
under Medicare Part D, please list the top three problems:
          #1
          not having coverage for supplies.medication is cov
          #2
138
          not having appropriate culture results before ther
          #3
          no one in home willing to learn procedure
          #1
139       It is not a covered item
          #1
          No coverage for the infusion drug
          #2
140
          No coverage for the supplies
          #3
          no cos participating in the medicare/medicaid plan
          #1
          not on formulary
141
          #2
          finding a nursing agency to cover
          #1
          INFUSION CO. CANNOT ACCEPT PT BENEFIT
          #2
142
          ------------
          #3
          ----------
          #1
          The infusion company won't take any PART D
          #2
143
          The infusion company won't take THAT Part D
          #3
          The supplies aren't being reimbursed by MEDICAID
          #1
          Coverage for drugs
144
          #2
          providers willing to provide infusion under Part D
          #1
145       hard to find providers
          #1
          verifying coverage for services
          #2
146
          usually only pays for drug and not supplies
          #3
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
  Survey Conducted August 10 to September 27, 2006
  National Home Infusion Association, Alexandria Virginia
146
  Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            locating a vendor to provide services
under Medicare Part D, please list the top three problems:
            #1
          finding a provider that CAN provide services
          #2
147
          delays in communication from patients, providers
          #3
          formulary issues
          #1
          CAN'T AFFORD THE MEDICATION UNDER PART D
          #2
          MEDICATRION NOT COVERED UNDER THE EIR PART
148
          D PLAN
          #3
          DON'T KNOW WHAT PLAN THEY HAVE SIGNED UP
          FOR
          #1
          finding out from patie which agency part D is with
149
          #2
          infusion company getting benefits
          #1
          Patient is unable to afford out-of-pocket cost
          #2
150
          Coverage gap
          #3
          Waiting to determine drug coverage
          #1
151       supplies not covered/pt unable to afford private p
          #1
          patient not sure of coverage
152
          #2
          infusion company verify coverage
          #1
          not sure of coverage
153
          #2
          infusion company verifying coverage
          #1
155       pt can't afford copays
          #1
          must receive response from 1st to request 2nd
156
          #2
          securing prior authorization delays discharges
          #1


158
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            provider acceptance
under Medicare Part D, please list the top three problems:
            #2
158
            location of available providers
            #3
            coverage of all supplies
            #1
            Pt's don't even know if they have MC part D
159
            #2
            Finding an Infusion company who is contracted w/ D
            #1
            insurance eligiblity
160
            #2
            Patient's can't afford
            #1
161         awaiting prior approval for coverage
            #1
            Formulary of programs
            #2
162
            Delay in response by programs
            #3
            Inconsistency in program benefits
            #1
            obtaining prior auth of the drug
163
            #2
            patient does not know who their coverage is with
            #1
164         prior approval
            #1
            difficulty figuring out which drug program pt has
            #2
165
            difficulty finding agency to see pt
            #3
            poor reimbursement on supplies for infusion
            #1
            takes too long to get approval
            #2
166
            avoidable days in hospital
            #3
            pt becomes upset
            #1
167         drug not covered under their plan
            #1
168
   Discharging Dual Eligibles Needing Home Infusion Therapy
                Under Part D: National Survey
                of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

8. If you have experienced problems in DUAL ELIGIBLES’ accessing home infusion therapy
            COST TO PT WAS HIGH
168 Medicare Part D, please list the top three problems:
under       #2
            HARD TO FIND AGENCY THAT TAKES MC D
            #1
            payor doesn't work with vendor who can provide car
169
            #2
            states no longer accepting paym't guarentee
    Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                             D: National Survey
                       of Hospital Discharge Planners
    Survey Conducted August 10 to September 27, 2006
    National Home Infusion Association, Alexandria Virginia
    Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

12. Considering your answers above, please enter comments you may have on arranging for home
infusion therapy for DUAL ELIGIBLE patients:
#           Response
            Too many plans with limitations for the dual eligible patients. Formularies are
            available, but does not provide a good indication for reimbursement. Providers
1           very cautious and cause much delay and often requires an alternative treatment
            plan due to lack

2            TIME CONSUMING, CONCERNS ABOUT POSSIBLE SUB STANDARD CARE
3            DIFFICULTY FINDING VENDOR FOR MEDICARE D
             Medicare D must pay for the supplies as well as the drug or the benefit is going
4            to be underutilized and medicare will pay more in cost in the long run.
             It would be easier and more cost effective for the government to cover Home
             Infusion at home. This has baffled healthcare workers for years why Medicare
5            would pay more for SNF and not less for Home Infusion. A LOT of $$$ could be
             saved ... a whole LOT of
             i often have younger pts. w/ young children
6            who need to get home to care for family and
             are having to be placed for 6wks in facility in order for iv to be covered.
7            IT'S NOT ALWAYS A "SURE THING" AS IT WAS W/ MEDICAID
8            Medicare Part D has not been helpful as it is currenly in place
             medicaid doesn't cover the cost of the meds. the patients can't pay. the hospital
9            covers the costs-$<redacted> +/day.
             Allow home infusion to continue as prior to Medicare D for dual eligible patients,
10           most meds not on formularys or supplies not covered under part D.
             As with all medicare pts. the pts that are healthy do not need to be in an acute
             care or subacute care setting. They need to be at home with their family and
11           friends. These pts do not need to be made sicker or more dependent. Hospitals
             and nurses are alre
12           delays
13           Some MCD patients can't afford co-pays even though they are small.
             Prior to Dual Eligible and now w/ the Medicare part D program, no one has
             addressed inc'ing the iv meds that will be covered at home. Medicare HMO's will
14           approve almost any IV home antibiiotic to reduce inpt hosp stays. Medciare
             covers 4 iv antibiotics to

15           it is too complicated. They have to wait to see if the med is covered by Medicare
             and how much. Before they just took the csase and it was paid for by Medicaid

16           Infusion providers won't work with Med D, since infusion supplies not paid. Home
             care providers won't bill Med A for infusion supplies when pt. is homebound
17           much more difficult than in past
 Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                          D: National Survey
                    of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

            Patients on state funding please enter comments you if to have home
12. Considering your answers above,do not have funds for copays may d/c to on arranging for home
18
infusion therapy for DUAL ELIGIBLE patients: more coverage on part d then straight
            Dual Eligible patient seem to have
19          medicare patients.
20          More patients with no coverage due to confusion at time of enrolement.
            Because the process is confusing and cumbersome alternative levels of care are
21          being utilized to avoid the delays that would resultfrom use of home infusion
            utilization.
22          Not having that many on my unit to answer appropriately
            The out of state dual eligibles are very difficult to find out their MC D plan info.
            Most plans require the patient to be physically in their state where they reside in
23          order to receive services. Many of our patieints with transplants are required to
            stay

24
           If I've been able to arrange it at all, it was very difficult.

           many nursing homes wont take dual eligibles because of lack of reimburesment
25         for infusion. many dual eligibles cannot access out patient services because they
           are too sick or fraile. out patient services will not perform infusions.

26         Out patients cost to medicare must be very high compaired to Home infusion.
27         Simplify part D.
           Part D does not cover supplies associated with IV-meds, patients cannot afford
           these fees. This could possibly covered by secondary payor. Patients are not
28         aware of the Part D plan they were assigned too, and very unfamiliar with the
           benefits including co
29         MORE MEDS NEED TO BE INCLUDED IN PLANS
           In my experience the fact that patients have medicaid in place is what allows for
30         home IV therapy. If a patient has only medicare we are not able to arrange home
           IV therapy unless the patient bears the cost.
           Medicare part D for all only covers the drug and leaves way too much out of
31         pocket expense for the patient to cover
           Since Medicare D happened all Patients who had Medi_cal as a secondary and
           used to be able to have the Medi-Cal pay for IV atbx, now Medi-Cal says, well,
32         Medicare D can pay for that now,,,,then Medicare D does not cover the atbx
           drug, or the pump, or the
33         home therapy is always more cost effective
           the sad part is these patients end up in SNF and more and more end up back in
34         the hosital with a more drug resten bug.
 Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                          D: National Survey
                    of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

            Some of answers above, please enter comments you may have on arranging for
12. Considering yourthe infusion Cos are saying they can bill Medicaid for supplies and some home
            say for can not. Companies are padding the cost of supplies to recoop losses
infusion therapytheyDUAL ELIGIBLE patients:
35          from the meds-and without a secondary insurance this is passed along to the
            patients- most can't
36          less patient access to funds to cover treatment
            You spend countless hours trying to located providers in network and the co-pay
37          is still so tremendously high that the patient opts for the SNF placement in the
            end.
            Time factors make it much more difficult
38          than just accessing Medicaid
            MEDICARE DOES NOT COVER IN HOME IV INFUSION. MY PTS HAD TO GO
39          TO A SNF FOR THE IV ANTIBIOTICS TO BE PAID FOR.
            patients with medical are not use to the co-pay, most can't afford it, and prefer to
40          go to a snf instead of home
41          Lack of family members to care for patient in their home setting.

           Home infusions providers are taken an active role in obtaining coverage of the
42         various drug plans so that they are able to tell the patient and case managers
           pertinent information to expedite transistion to the home environment.
43         if medicare does not pay then Medi-Cal does not cover
           SNF or outpatient visits seem to be more preferred than patients and families
           learning the skills to manage home infusion. We have a large elderly population
44         without willing and able caregivers to assist them. HHC services are limited to
           visit daily or bi
           assess for home bound status and then most of our patients are under
45         commercial coverage, so medicare is secondary.
           It should not take so long for medication approval and equipment supply approval
46         should be automatic with drug along with nursing.
           A hospital CM told me it was not possible to get a Pt home infusion. She called
           her hospital based provider who no longer does this. She was going to have the
47         Pt billed for $<redacted> worth of meds a day. I had to argue that this could be
           coveed by her Part D.
48         Very few dual eligible patients
           Knowledge or handcap keeping patient from being able to do his home infusion,
49         caregiver is also difficult to find or teach
           sometimes it is not appropriat to send them home on IV due to age and support
50         systems at home jt
           Medicare Part D has made it more difficult for patient's & providers to arrange
           home infusion when in the past it was much easier & less costly to the
51         patient/facility. Patient's are now going to nursing homes due to the cost OOP for
           them. THis is not nec
 Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                          D: National Survey
                    of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

12. Considering your answers above, please enter comments you may have on arranging for home
            Most of DUAL ELIGIBLE patients:
infusion therapy for the patients do not like to go to a nursing home and/or lack resources,
52
            support for hospital outpatient settings so they end up staying in the hospital.
            Since we are a pediatric institution, we only have a few children on Medicare and
53          Medicaid. Our pediatric agencies only support Medicaid patients.
54          The copays are a problem.
            The infusion companies providing services in the home are pretty "on top" of the
55          situation and have "criteria" and Instructions on "how to" -----Thank goodness for
            their input.
56          My experience is basically the same
57          Have never done it.
58          start early!!!!
            patients are frustrated by the confusion and choose to receive care in the
            outpatient infusion area. also, there is a lack of knowledge relative to care of
59          central lines in the rural areas, and patients are choosing to drive or arrange
            transportation to l
60          this is also related to findinf a infusion company to provide drug

61        We don't place many dual eligible patients at home with home health for infusion
          therapy and have never done so. Most go to a SNF or receive outpt care.
62        Not working, placing in SNFs
          Medicare Part D carrier should be able to be identified online as these patients
63        typically have no idea who their carrier is.
          Primary problem is patient's ability to manage home IV tx and lack of support
64        system.
65        See answers to #8
          It's a pain to manage these patients, they would often be better and more
66        economically managed at home, but due to the Medicare D issues, they can not
          use that avenue.
67        it is very inconsistant
          with so many different companies involved, with different coverages, it makes it
68        extremely difficult for us and especially the pts to know what is covered and what
          is not
          It can be very time consuming and difficult finding their policy coverage and many
69        people go to SNF that could be served in their own homes.
          arranging home infusion for MCR &/or MCD has always been an issue as there
70        are not enough agencies to cover the needs.
          Coverage under medicaid not as good. Coverage of drug under Medicare D but
71        not of tubing & pump to infuse which can average $<redacted> to $<redacted>
          per day.
 Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                          D: National Survey
                    of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

            I find that we cannot offer please enter comments you patients do not even
12. Considering your answers above, this as an option. Also, manymay have on arranging for home
72          know who their carrier is patients:
infusion therapy for DUAL ELIGIBLEand it takes time to figure this out.
73          It's a hassel.
            PATIENTS CANNOT PAY THE CO-PAYS FOR HOME INFUSION. THEY MAY
            NOT QUALIFY FOR SNF STAY AND NEED A PROLONGED HOSPITAL STAY
74          THAT TAKES BEDS FROMOTHER PATIENTS WHO NEED A HOSPITAL BED.
            PATIENTS DO NOT RECEIVE THE BENEFIT OF RECUPERATING AT HOME
            WHERE THE CHANC
            antibiotic may be paid for, but the tubing, etc is not so the patients can not afford
75          home therapy
            Prior to Part D, Dual Eligibles had much better access and coverage under the
76          state Medicaid program in NC. Part D had a negative impact to transitioning
            these patients to home.
77          Time consuming and frustrating.
            It is taking twice as long-to find agency or company to accept the patient with
            complex needs-I have had to refer the patient back to the ordering physician's
78          office to assist with covering needs-a real financial hassle for the patient and the
            office pays
            LTAC hospitals are a good alternative although the patient does not always meet
79          the 25 day LOS requirement.
            Usually the elderly do better in a SNF since this service is covered, but they are
80          also overwhelmed with D problems for their pts.
            i would MC to provide all inclusive home infusion services-it seems to make more
81          sense
            hte insurance carriers are very slow in response to authorize home IV infusion &
82          usually request a written LMN from the MD

           Even with MC D, it is more difficult to place. Depends on drug needed and drug
83         plan formulary. At times the drug of choice, is not available. MD then needs to
           change to second choice and keep pt in Hospital to make sure drug is working.
           I find myself getting prices for equipment to administer IV therapy in the home
84         since Medicare part D doesn't cover.

85         Its complicated. Not all external infusion companies are willing to accept these
           pts. Concerns if it indeed will be covered, once pt is discharged to home.
           As a very small hospital, we rarely discharge patients home with infusions,
86         perhaps only 2-3 a year, so our experience is limited.
           Medicare D has made discharge with home infusion much more difficult and
87         costly.
88         It was far easier before Part D
           Infusion set used to be covered under Medicare B but now medicare D doesn't
89         cover it
 Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                          D: National Survey
                    of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

            I've your answers above, please dual comments you
12. Consideringhad very little experience with enter eligible patients may have on arranging for home
90
            Please DUAL ELIGIBLE patients:
infusion therapy forfix it
91
            Prior to 2006 HIT referral was easy currently we do not try to arrange because of
92          difficulty
            Dual eligible patients have taking a step backwards under Part-D. Medicaid
93          would have covered home infusion prior to Part-D
94          Improved process for verifying eligibility
            It is getting more difficult by the day to obtain home infusion. Some patients need
95          to stay inhouse to complete IV therapy. This is a huge waste of health care
            dollars.
            Medicare D has been a farce for these clients of low income. Medicare D has
96          certainly let these people down.
            ARRANGING HOME INFUSION FOR MEDICARE D PATIENTS IS MUCH
            MORE TIME-CONSUMING FOR BOTH THE DISCHARGE PLANNER & THE
97          HOME INFUSION COMPANY B/C OF THE MANY DIFFERENT MEDICARE D
            PLANS & ALL OF THEIR DIFFERENCES
98          Often no one at home to assist with infusion
100         OOP expenses and delay in getting auth
101         Biggest issues are Authorization in a timely fashion and costs
            We have a wonderful DMA company that really works well with us in coordinating
102         home IV infusion services.
103         had to do it in Hospital infusion center.
            Takes a little longer to figure out which plan D pts are enrolled in. Often they do
104         not know if they are not HMO
105         MAKE PART D easy to use so that it mimics Medicaid.
            It is unfortunate that Dual Eligibles went from having good coverage to very
106         limited and poor coverage for home infusion services.
107         No significant impace
            Very difficult and long process, usually only drug is covered, not the supplies that
            goes along with the services, more financial burden for the patient, many times
108         patient is sent to ecf or outpatient setting which really isn't the best option, but the
            o
            very complicated and cumbersome. NO ONE seems to know exactly what to do.
            Difficult to find a provider and response time from providers, with confirmation
109         that CAN provide services, is often delayed. Never have peace of mind that the
            patient will definite
            Need to simplify the process and provide better coverage to cover cost of drug,
110         supplies, and nursing visits.
            soince supplies are not covered I have many patients who cannot utilize home
111         infusion because thay cannot afford to private pay for supplies
 Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                          D: National Survey
                    of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

            the patients perfer above, please enter comments can't due to copays on a daily
12. Considering your answers to go home with family, but theyyou may have on arranging for home
113
infusion therapy for DUAL ELIGIBLE patients:
            basis. ex for pt to be on ivabt for 6-8weeks.
            Problems creating prolonged wait times for discharge on acute untits- wait times
            are creating a backlog of pts who need to go home but instead are SNF. These
114         pts cannot be moved off the acute units due to no LTC beds. 10-12 acute/critical
            patients are hol
            For me it is about the same as arranging home IV for pts w/ straight MC and
            another insurance that does have coverage for IV abx. The issue for me is to
115         identify which infusion companies in my area ARE contracted w/ MC part D and
            then giving the patient c
116         IV ABX
117         very hard to arrnage home infusion for these pts!!!!
            more time consuming
118         Increased difficulty
            Longer hospital stays due to not able to obtain services as OP
            THE COST TO THE PT PREVENTS ME FREOM SENDING THEM HOME
119         WITH IV'S
            The process can be confusing, depending on what plan the person has chosen.
120         It is complex for the infusion vendors and they have needed to do a great amount
            of work for this to happen. Many have chosen not to.
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
    Survey Conducted August 10 to September 27, 2006
    National Home Infusion Association, Alexandria Virginia
    Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

13. (LAST QUESTION) Are you CURRENTLY experiencing complications in arranging access to home
infusion for Part D patients who are NOT DUAL ELIGIBLES? (Please explain how this may differ from
your experiences with DUAL ELIGIBLE patients)
#            Response
             The same concerns apply for all Part D. Reimbursement from the plan is
1            extremely slow. Payment delays and extremely poor reimbursement.
2            NO DIFFERENCE
3            HAVE LOCAL HOME INFUSION VENDOR TO USE FOR ALL OTHERS

4
             Same experience
             The Part D patients have similer complication level. Other managed care
5            insurance can be complicated but often is quick and easy.
             only issues when medicare is only plan and
             need to be placed in facility for long-term
             care. it is more cost efficient to have
6
             option of home infusion since it has been
             nearly impossible to cover iv ther. on
             weekends and off hours in op infusion setting
             Patient don't know what plan they are enrolled in. Takes alot of investigative
7            work to figure this out and then determine plan by plan what might/might not
             be covered.
8            trying to verify coverage of drugs
9            More plans have coverage that is not5 limited to the medication only
10           yes, complications are similar.
             Most Medicare D companies have very limited medications covered (IV
             antibiotics not on formulary) or supplies for dual eligible not covered so that
11           patient's have large out of pocket expense even if they do have some
             coverage. Most patients who are dual e
12           Delays
13           DRUG NOT ON FORMULARY
             patients may have coverage for iv med under part d but patients cant afford
14           the daily cost of supplies to infuse the iv antibiotic at home
             Part D doesn't cover the daily cost of mixing ATB's or supplies. This on
             average cost $<redacted>/day. Most persons can't asume that expense. Most
15           pt must go to an ECF or if ATB is daily and pt can't get to a Out Patient Clinic
             infusion can take place the
             same as above... any pt w/ medicare coverage dual or not, except the
16           medciare hmo's face this issue.
             the patients have no coverage for supplies. The drug at times is the least
             cost...the tubing, dressings, flushes etc. are not covered so they cant afford to
17           go home on IV antibiotics. Before we just stated that Medicare did not pay for
             IV antibiotics and
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

13. (LAST QUESTION) Are you CURRENTLY experiencing complications in arranging access to home
             Patients are confused as to why the part d plan only covers the drug and not
18           Part D patients
infusion for any supplies. who are NOT DUAL ELIGIBLES? (Please explain how this may differ from
             Few want DUAL with Med patients)
your experiences withto deal ELIGIBLED billing
19
             copays or patient financial responsibilities are preventing them from being
20           able to d/c to home
             Yes , recently patients with Medicare part D , had no coverage for out pt
21           medication and were placed in other settings.
             Because of the payment issues/cost and many of our patient's falling through
22           the whole it is not a successful benefit.
             Part D Medicare only covers the medication. There is no coverage for the
23           supplies, pumps or tubing, for home infusion needs.
24           Again, not encountering this on my unit.
25           I don't generally have any.
             Many patients have coverage for the drug only and not the needed supplies
             (tubing, flushes, pumps, etc) to deliver the medication. It requires patients to
26           come up with per diem charges which they often can not afford, thus they are
             placed in a SNF or have
             there is no reimbursement for infusion and the cost of treatmen for infusion is
             prohibitive. also cannot use a non medicare agency for infusion, and many
27           medicare agencies will not accept infusions because of lack of staff and
             reimburesment from medicare.
             It is much more difficult to arrange home infusion services for non-dual eligible
28           part-d clients! Although home care is a covered benefit, IV
             pump/tubing/supplies are not covered.
             Patients are not educated regarding the plan coverage, Part D does not cover
29           the supplies that are associated with IV meds and the expense is far more
             than the patient is able to afford.
             delays in identifying coverage, arranging for provision of non-covered
30           supplies, equipment and services, getting patients to agree to pay. In most
             cases patients choose to go to SNF or outpatient treatment center.
31           AGAIN, TOO MANY EXCLUSIONS.
             Many with Medicare part D only have limited coverage or meds are not
             covered at all. These we have to refer to SNF's or private pay at home, which
32           most cannot afford.

          Have also encountered problem with donut hole and cost of supplies an issue.
          As noted in my previous answer. We have been told by infusion companies
          that Medicare D does not pay for the cost of dispensing, IV tubing, pumps.
33        This can add up to considerable cost for the patient, many of whom cannot
          afford this.
34        same problem
35        MEDICARE D DOES NOT PAY FOR SNOT!!!
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

13. (LAST QUESTION) Are you CURRENTLY experiencing complications in arranging access to home
             Homebound status and limited drugs for medicare patients prohibits cost
36           Part D patients who are care delivery.
infusion for effective and convienientNOT DUAL ELIGIBLES? (Please explain how this may differ from
             coverage DUAL ELIGIBLE understands it.
your experiences withvaries and nobodypatients)
37
             yes with all Medicare D patients, know one knows hhow to bill so the patient is
38           not stuck with a large bill or not paid at all
             Same situation really if they have no secondary coverage for supplies -the
             cost for supplies is more than a lot of folks on Medicare can pay. Often times
39           the infusion cos ask for money up front and they can't pay $<redacted>-
             <redacted> today.
40           Delays related to coverage of flushes, iv tubing and reconstituting meds.
41           NOT VERY DIFFERENT
42           same problems as dual access
             Supplement plans have same issues-network providers and co-pay as well as
43           limited number of SNF days.
             Patients do not have the money to pay for
             pump supplies and services. They have to
44
             pick a more costly alternative to the system of staying in the hospital or
             going to hospital outpatient
             IT IS THE SAME WHETHER THEY ARE DUAL ELIGIBLES OR NOT. THERE
45           IS NO SYSTEM SET UP FOR IV INFUSION TO BE PAID FOR IN THE
             HOME AFTER A HOSPITALIZATION.
46           little contact with dual eligible patients
             some drugs are not covered, or there is a large co-pay and the patient can't
47           afford it.
             No different except some patients come into the hospital and don't realize they
             have signed up for managed care and not just the Part D program. One
48           patient said that she asked the salesman if she still had Medicare and he told
             her "yes", and technically
             The same situation because of the various drug plans that are selected by the
             patient. If the coverage was the same for all drug plans this probably would
49           not as much as an issue. It is just knowing the specific drug plans that are
             offered.
             Medicare does not pay for infusion pump and supplies. Pt's typically cannot
50           afford to pay privately.
             Again our low volume of home infusion relates to the demographics of the
51           Medicare population in having family or caregivers that can assist them.
             This hasn't come up with a straight MCare Part D Pt yet; only with a dual
52           eligable Pt.
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

             The dual eligibles have less of a support system complications in arranging access to home
13. (LAST QUESTION) Are you CURRENTLY experiencing or financial support so often
             Part SNF for needs. The Medicare ELIGIBLES? (Please cover how this may
infusion for go toD patients who are NOT DUALD only are expected toexplaintheir meds if differ from
53 experiences with DUAL ELIGIBLE patients)
your         they are in the gap and that can be an issue. Often those with only Medicare
           have less chronic dise
           Part D is hard for me to understand with experience and twice is hard for the
54         seniors.
           there is not coverage for home IV infusion if they do not have script coverage
55
           and sometimes it does not cover the drug but covers the supplies
56         Part D does not allow for many Infusion medications.
57         So far it is not that much different.
           many infustion companies are not able to determine benefits over the
           weekend. Unlike, home health who know that if they have Medicare B that
58         they have home health benefits, Medicare Part D benefits vary from company
           to company for infusion coverage.
           Not all IV medications are covered. Supplies and solution of NS or D5W are
           not covered under Part D. I have very few patients that are dual eligible. I have
59         to set up Medicare patients all over the United States and this is a real
           problem for the patient.
           with worker's compensation reform in CA, everything goes to UR rather than
           "allowing the case manager to assess and determine what and when its
60         appropriate----and working it out with MD ordering. We can't even negotiate
           our own deals any more.
61         Never arranged for Medicare
           see above. prior auths are difficult when the pcp has had nothing to do with
62
           ordering IV therapy. There tends to be some hesitance to get involved.
63         Part D not covering home imfusion drugs.
64         Most Medicare patients go to SNFs for infusion therapy.,
           I can usually get the drugs thru the medicaid drug vendor program because
65         we are finding a lot of infusions don't seem to be covered or the client has
           already met his limit.
66         Again, delays in authorizations from insurer to infusion company.

           We have one member that is looking at an over $<redacted> bill from a home
67         infusion company that failed to note that the member was Medicare primary
           and Medicare supplement secondary, not commericial secondary insurance.
68         verification of coverage is very time consumeing.
69         the same as above
           Many people don't have a policy with home infusion coverage because they
70         looked at their current meds covered and usually don't anticipate a critical
           need such as home infusion.
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

13. (LAST QUESTION) Are you CURRENTLY experiencing complications in arranging access to home
71           Home infusion companies indicating iv meds/services not covered at home
infusion for Part D patients who are NOT DUAL ELIGIBLES? (Please explain how this may differ from
             Lack of insurance coverage and/or high cost IV
your experiences with DUAL ELIGIBLE patients)
72           medications,equipment,supplies that some insurances don't cover.
             patients dont know what plan they sign for and what is covered, what they
73           have used so far,copays with the tubing cannot afford
74           same reason as above
75           Same as above.
             Their problems seem to be centered around coverage and the "donut hole."
             People have less coverage than they had before. Now they fall into the hole
76           and can't afford the costs and need to go to a nursing home. Also, the
             formulary is so strict, drugs are c
             PROBLEMS OCCUR ONLY IF PATIENTS DO NOT HAVE SUFFICIENT
77           PRIVATE INSURANCE. I HAVE NEVER HAD A PATIENT WHO CAN
             AFFORD INFUSION CO-PAYS FOR HOME INFUSION.
78           No significant difference...the lack of funding is the majow issue
79           still have trouble getting the therapy paid for
          Formulary gaps, exceptions process, and pt ability to pay for the copay portion
80        of medications. Many choose to go to SNF, or come to out patient, where the
          copay is covered - but probably at a higher cost to CMS.
          Medicare does not cover everything as we know and the explanation is
81        complex for pt/family
82        deductibles too high, too many restrictions, too confusing for pts

          part d covers drug only-this means pts will have out of pocket expenses that
83
          usually amt. to approx <redacted> dollars per day. so most pts. cannot pay
          this and must be referred for other sources-this is where DC delays occur.
84        It is difficult to know who the appropriate provider is for the infusion
85        same problems
86        See comment above. It applies to both dual and single coverage.
          equipment to administer the medication is a raal problem. who would have
87        thought that medicare would pay for IV meds but not the equipment
88        No coverage for home infusion supplies.
          Patients who have commercial insurance coverage are generally easier to
89        dischage to home. The insurance facilitates the discharge as home generally
          is a cheaper setting to provide sevices.
90        See answers to question #8.
          Home infusion is very expensive and somewhere in there, the pt enters the
91        "Black Hole" and pays 100% which the majority of seniors did not understand
          would happen when they signed up.
          patients who only have part d are many times having to pay around
92        $<redacted>/day that infusion companies charge for supplies
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

13. (LAST QUESTION) Are you CURRENTLY experiencing complications in arranging access to home
93           Part D to find venodrs that can get the medications to mix for the how this
infusion for Harder patients who are NOT DUAL ELIGIBLES? (Please explain infusion. may differ from
             Same issues as ELIGIBLE patients)
your experiences with DUALw/ dual eligibles. Not many companies are accepting the
94           reimbursement offered or are not contracting w/ many programs b/c of the
             reimbursement issues.
             Again med is covered but not the infusion sets so patient must pay out of
95           pocket
96           same answer as 12
             To my knowledge, these patients did not every have home infusion coverage
97           so nothing seems to have changed for them.
             same reasons as dual eligibles, limited benefits and difficulty attaining
98           contracted providers.
             This is an even bigger problem, as many patients cannot afford the co-pay &
             end up having to go to outpatient with significant difficulty when they are
99           homebound due to a taxing effort to leave their homes. Otherwise many have
             to stay in a Skilled Nursing
             there is no coverage or such high copay patients are unable to utilize home
100          infusion
             It is even more difficult to place these patients since the reimbursement is
101          even worse than Medicaid.
             The medication can at times , be covered but supplies are not. Most clients
             cannot afford the supplies & often don't have resources or the ability to make
102          daily or twice daily outpt. appts. so the only solution is nursing home
             placement. Nusring home plac




103       THE PROBLEMS ARE MUCH THE SAME; WE SPEND ANYWHERE FROM
          1/2 DAY TO 2 DAYS COORDINATING WITH THE HOME INFUSION
          COMPANY BECAUSE OF THE MANY DIFFERENT MEDICARE D PLANS-
          THEY ARE ALL VERY DIFFERENT; SOME ONLY COVER CERTAIN
          DRUGS; SOME COVER NO IV DRUGS; OFTEN T
          This service, if covered is cumbersome with different program parts to pay for
          the medication vs supplies vs nursing. There is variation in plans resulting in
104       unneccessary time calling the insurance company and then agencies to
          provide the coveragte. If i
105       Also OOP expenses and delay in getting auth.
          Same as above, Delays for Authorization, making shoure meds are in the
106       formulary and verifying costs
107       May have no coverage.
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

             if the patient has a Medicare supplement there still may not be in arranging
13. (LAST QUESTION) Are you CURRENTLY experiencing complications coverage for access to home
             Part D patients If the med is DUAL ELIGIBLES? (Please explain how may
infusion for home infusion.. who are NOTcovered with Medicare D the supplies still this may differ from
108
your experiences with DUAL ELIGIBLE patients)
             not be
109          No problems if its straight Medicare or Private insurance
110          See above
           Medicare D programs do not often cover home infusion....Some seniors did
111
           not chose a Medicare D program....Co-pays are too high for most seniors
112        I have problems with NON dual eligibles too.
           Same problems--agencies willing to participate in Part D, coverage for
113        supplies, coverage for drugs, etc.
           Finding in most cases that the Medicare D policy covers the med; however the
114        infusion supplies are not covered.
           The same problems exist for both types of patients, except we are sending
           more patients who are not dual eligles to nursing homes.These patients
115        simply can't afford the additional financial burden for services not covered
           under Medicare Part D.
           same issues. Part D Providers are scarce and often not sure if they can
116        accept patient.
117        pts need assistance paying for IV antibiotics
           due to cost of fluids and supplies, it is more cost effective to place patient at
118        SNF
119        Similar problems
           Only one experience...Medicare HMO had to arrange specific contract
120        w/infusion company because of noncoverage for home infusion.
           Still have prolonged wait times for prior authorization. Also prolonging dc is no
121        local stock of medication. All need to be flown in from Oahu.
           Biggest problem is accepting providers and if they do contract with the Part D
123        plan, the providers are refusing to accept the case due to reimbursement
           rates.
124        can't afford DME part for IV ABX
           hard to verify benefits, no coverage for supplies make it very hard to take
125        good care of these pts
126        if you are medicare part d without other coverage, it is lengthy to arrange
           Usually there is a copay for them and they cannot afford the cost. so they are
127        referred to outpatient
           Patient may not have ANY payor source and cost of antibiotics for resistant
           infections very high. Also, patient may not have adequate support system at
128        home to assist with care required. Home Health can only come for a few
           visits.
129        COST TO PT SA BIG PROBLEM
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

             This is MUCH worse as their is no experiencing complications to bill under
13. (LAST QUESTION) Are you CURRENTLYability for the infusion vendorin arranging access to home
             Part D patients are are NOT provide the service to the patient at home due
infusion for Medicaid. They whonot able toDUAL ELIGIBLES? (Please explain how this may differ from
130 experiences cost.DUALis an addedpatients) to the hospital, either the patient stays
your         to the with This ELIGIBLE expesne
             or waits to go to
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
                        Selected results from 61 hospital discharge planners
                               speaking for their entire organization

 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

2. In considering your perspectives on arranging care for Medicare Part D patients needing
home infusion therapy, are you in a position to speak for the experiences of your entire
organization, or from your own experience only?
My own experiences                                                                   0    0%
Our organization's experience                                                       61   100%
Total                                                                               61   100%

3. Please choose the single answer that best describes your role in arranging treatment for
patients needing infusion or injectable therapies:
I am in a hospital discharge planning or case management role and responsible for        61 100%
I am a physician or work in a physician office and am responsible for referring patients  0  0%
Other                                                                                     0  0%
Total                                                                                    61 100%


5. Are DUAL ELIGIBLE patient discharges from the hospital CURRENTLY being delayed due to
complications related to arranging access to home infusion therapy under Medicare Part D?

No delay: these patients are being successfully referred for home infusion                  0    0%
No delay: these patients are generally being referred to other care settings rather than    0    0%
Yes, delays are occurring                                                                  61   100%
Total                                                                                      61   100%



6. If yes to question #5, how long are DUAL ELIGIBLE patient discharges typically delayed?
No significant delay                                                                        0     0%
One day                                                                                    32    52%
Two days                                                                                   22    36%
3 days or more                                                                              7    11%
Total                                                                                      61   100%



7. If yes to question #5, please estimate CURRENTLY the number of these discharge delays
occurring in the hospital EACH MONTH:
56 Responses
#        Response
2        20
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
                     Selected results from 61 hospital discharge planners
                            speaking for their entire organization

 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

3          1-2
4         3
5         5
11        my division is 1 every 2mths; i also cover weekend
19        unknown
22        20
25         3-5
29        10
30        25
32        5
36        at least 2-4
38         5-10
44         5-6
45        UNSURE OF #
46        difficult to choose a specific number
48        they are set up as series patients
50        10
52        approx 20
55        3
56        5
57         12-15
58        15 to 30 days
59        5
60        10
61         4-5
62        not sure
66        5
72        No IV infsion is arranged for discharge
73        3
77        2 to 3
81         3-5
82         3-5
84         2-3
90        10
92        seven to ten
98         2-3
101       5
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
                      Selected results from 61 hospital discharge planners
                             speaking for their entire organization

 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

103       10
111       8
113       7
114       35-50
115       at least 15-20
117        10-15
118        2-4
126       2
127       unknown
133        2-3
137        6-8
140       unsure
143        10-20
144       10
145       10
146       20-25
149       Varies monthly. Typically 5-10
151       one or two


9. What was the average cost (not charges) in 2005, to the hospital, of each inpatient day? (your
best estimate)
Less than $300 per day                                                               0      0%
$301 - $400 per day                                                                  2      4%
$401 - $500 per day                                                                  1      2%
$501 - $600 per day                                                                  3      5%
$601 - $700 per day                                                                  3      5%
$701 - $800 per day                                                                  2      4%
$801 - $900 per day                                                                  7     13%
$901 - $1000 per day                                                                10     18%
$1001 - $1100 per day                                                                5      9%
$1101 - $1200 per day                                                                2      4%
$1201 - $1300 per day                                                                1      2%
$1301 - $1400 per day                                                                1      2%
$1401 - $1500 per day                                                                2      4%
$1501 - $1600 per day                                                                2      4%
$1601 - $1700 per day                                                                1      2%
$1701 - $1800 per day                                                                1      2%
$1801 - $1900 per day                                                                1      2%
Discharging Dual Eligibles Needing Home Infusion Therapy Under Part
                         D: National Survey
                   of Hospital Discharge Planners
                        Selected results from 61 hospital discharge planners
                               speaking for their entire organization

 Survey Conducted August 10 to September 27, 2006
 National Home Infusion Association, Alexandria Virginia
 Contact: Bruce E Rodman MBA, Director Health Information Policy, 847-362-2017

$1901 - $2000 per day                                                             0     0%
$2001 - $2100 per day                                                             1     2%
$2101 - $2200 per day                                                             1     2%
$2201 - $2300 per day                                                             0     0%
$2301 - $2400 per day                                                             0     0%
$2401 - $2500 per day                                                             0     0%
Over $2500 per day                                                                3     5%
Don't know                                                                        6    11%
Total                                                                            55   100%

				
DOCUMENT INFO
Description: Hospital Discharge Bill document sample