Monthly bills can increase up to 40 percent
In the United States, the market for durable medical equipment (DME) – including oxygen concentrators, continuous positive airway pressure (CPAP) machines and peritoneal kidney dialysis machines – has a projected market increase from $43.3 billion in 2022 to $64.8 billion in 2027. Operating this equipment can add significantly to household energy bills. Those who rely on this equipment tend to be energy insecure.
In a novel study evaluating the electricity costs of running a range of common in-home DMEs, a team of electricity, energy market and economics researchers from Indiana University, Regenstrief Institute, University of Pennsylvania and Yale University found that Americans who rely on DMEs such as oxygen concentrators, CPAP machines, ventilators and peritoneal kidney dialysis machines face annual electricity increases ranging from $120 to more than $700, depending on device type, usage frequency and state electricity prices.
The research team, which focused on 11 of the most common types of DMEs used in the United States, correlates that usage costs can increase a household’s monthly energy bill by up to 40 percent – and even higher in states with elevated electricity rates, such as Hawaii, California and Massachusetts.
“Because we know health and wealth generally go hand in hand, people whose health is very compromised tend also to face strained financial circumstances,” said Kosali Simon, PhD, M.A., a Regenstrief research scientist and IU professor. “This is not a small expense for them. Patients are plugging in DMEs without knowing how much it will cost, but they may be in high need of that device. When we look at these numbers, depending on the state, cost increases could be burdensome.
“The ability to have dialysis available at home rather than keep going into a center could improve quality of life but could be a substantial cost. The takeaway is that while it might not seem like a big issue for the average healthy person, among people whose health really requires them to have these specialized machines, it could end up being a substantial burden.”
Electricity costs could limit patients’ use of necessary in-home medical devices. While some Medicaid and Medicare programs cover expenses related to social drivers of health, they do not currently cover the electricity costs of DME. Addressing these hidden costs through insurance coverage could reduce financial stress.
Identification of these cost burdens have been provided to help inform policymakers and to encourage discussion around tightening disconnection protections and instituting more expansive health insurance coverage.
Electricity burdens can also lead to unexpected consequences. More than half of low-income households engage in coping methods which can lead to severe health and development outcomes. An example would be opening an oven to heat a house/apartment, which can emit dangerous pollutants and gases into the home and could lead to a fire.
Next steps include examining real-world evidence on the people using DMEs, what sort of settings they are in and how important the issues surrounding energy security seem to people who end up having to use a medical device often or every day.
“The electricity cost burden of durable medical equipment in the United States,” is published in the journal Scientific Reports.
Author list and affiliations as listed in the publication
Sanya Carley1, Shreya Bansal2, Charles Harak3, Peter Kahn4, David M Konisky5, Kosali Simon5
1Kleinman Center for Energy Policy, Weitzman School of Design, University of Pennsylvania, Philadelphia, USA
2Climate Policy Initiative, San Francisco, USA
3National Consumer Law Center, Boston, USA
4Yale University School of Medicine, New Haven, USA
5Paul H. O’Neill School of Public and Environmental Affairs, Indiana University, Bloomington, USA
Kosali Simon, PhD, M.A.
In addition to her role as a research scientist in the William M. Tierney Center for Health Services Research at Regenstrief Institute, Kosali Simon, PhD, M.A., is a distinguished professor, Herman B. Wells Professor, Paul O’Neill Chair at Indiana University, Bloomington, O’Neill School of Public and Environmental Affairs and the associate director of the IU Irsay Institute. She also is the associate vice provost of health sciences for the IU Bloomington campus. A health economist, her research focuses on the impacts of state and federal healthcare policies on health and related outcomes, especially among at-risk populations. She is an elected member of the National Academy of Medicine.
