Comparing Traditional and Disposable Negative-Pressure Wound Therapy Use by Medicare Home Health Patients

Since 2017, home health agencies (HHAs) have received reimbursement for the provision of negative-pressure wound therapy (NPWT) using disposable, portable devices to eligible Medicare fee-for-service beneficiaries. This study aimed to describe the use of disposable NPWT (dNPWT) versus traditional, durable medical equipment-based NPWT (tNPWT) in the home health setting over time and compare the types of beneficiaries using and associated Medicare payments for NPWT separate from the home health payment bundle.

Medicare fee-for-service claims were used to identify beneficiaries receiving NPWT from HHAs during home health stays. Assessment and Medicare administrative data were linked to compare characteristics between those receiving tNPWT or dNPWT and to calculate and contrast average Medicare payments for NPWT provided during the home health episode.

In 2019, the vast majority of NPWT used was tNPWT (>99%). Beneficiaries using dNPWT had fewer health risk factors and used substantially less medical care than beneficiaries using tNPWT ($47,187 vs $60,440 in annual total Medicare payments per beneficiary). However, the average Medicare payments for dNPWT exceeded that of tNPWT ($1,624 vs $899) during a home health episode.

Although dNPWT is well-suited for the home, its uptake has been slow. This may be attributable to HHAs' confusion in billing for dNPWT or differences in the wound types appropriate for dNPWT versus tNPWT. Policymakers should continue to monitor the use of dNPWT in the home health setting, especially given the greater average Medicare payment of dNPWT per episode.