Durable medical equipment (DME) per capita costs, at an approximate average of $11 per client per month, are projected to constitute an average of 3.2% of DSHS Medical Programs total expenditures for SFY 09-11.
The average growth in DME per capita costs for SFY 05-08 was 0.5%, which included a 5.8% decrease in per capita costs growth between SFY 2005 and 2006 and a 5.9% increase from SFY 2007 to 2008.
The SFY 2005-2006 5.8% and $0.63 decrease in growth and per capita costs, respectively, was due to a reduction in rates and services for incontinence supplies and enteral nutrition. The more recent 5.9% and $0.60 increase in growth and per capita costs, respectively, between SFY 2007 and 2008 was due to an increase in the use of unedited pharmacy codes for DME products, such as enteral nutrition, and a change in Medicare coverage and payment policies that made Washington Medicaid the primary payor for certain DME (e.g., expensive power wheelchairs).
The forecasted average growth rate in DME per capita costs for SFY 2009-2011 is 2.6%. This does not include the DME rate and service reductions scheduled to take effect on July 1, 2009, which will likely drive the per capita costs growth rate lower.