Viemed Healthcare Inc VMD

CMS study NIV/ventilation

[besttobe]

Noninvasive Positive Pressure Ventilation in the Home (cms.gov)

Conclusion In patients with COPD, home BPAP (compared to no device) was associated with lower mortality, intubations, hospital admissions, and dyspnea. There was no change in quality of life (pooled analysis of 9 studies). In patients with COPD, HMV (compared individually with BPAP, CPAP, or no device) was associated with fewer hospital admissions. In patients with thoracic restrictive diseases, home HMV (compared to no device) was associated with lower mortality and better exercise tolerance. In patients with neuromuscular diseases, home BPAP (compared to no device) was associated with lower mortality, better quality of life, and reduced dyspnea. In patients with obesity hypoventilation syndrome, home HMV/BPAP mix (compared to no device) was associated with lower mortality; home BPAP (compared to no device) was associated with improved sleep quality. Current comparative evidence is not available to assess the impact of many device capabilities on patient outcomes. Criteria to initiate home NIPPV and home respiratory services vary and are not validated in comparative studies

[JackLambert]

Nice.  "Lower mortality" does not imply higher "quality of life".   There may well be a case for aligning the various standards into one over-arching standard for all agencies and providers. Makes sense.   but let's say again that CMS is currently reimbursing based on its standards and that use of NIVH is based on physicians recommendation.   And