Wound Care: A Misunderstood Opportunity

Many DME pharmacies side-step offering reimbursable wound care products, but an expert explains why wound care might be much more approachable than they think.

• Dec 01, 2021

DME pharmacies often represent a lifeline provider of home medical products and services in their local communities, but sometimes they might miss an important healthcare category because of perceived roadblocks to entry. A classic example is wound care.

Why? Wound care offers a lot of opportunities for DME pharmacies to expand their range of care services within the communities they serve, along with their revenues. But there are a lot of reasons why those pharmacies might initially hesitate.

And hesitating is a bad move not only in terms of community service but from a dollars and cents point of view, as well. The global wound care market will expand at a compound annual growth rate of 4.3 percent from $33.9 billion in 2017 to $45.5 billion by 2024,according to research from data and analytics firm GlobalData. Also, recent data from market researchers Future Market Insights projects that the North American market for negative pressure wound therapy (NPWT), the lion’s share of which is in the United States, will grow to $3.2 billion by 2029, largely due to the growth of single-use disposable devices.

Furthermore, wound care is tied to a wide spectrum of product offerings that includes dressings, lotions, compression wraps and garments, pneumatic compression, negative pressure wound therapy, and therapeutic support services — all items that are ideal elements in a DME pharmacy’s or provider’s product lineup.

AN UNDERSERVED SEGMENT

So why are some DME pharmacies and providers hanging back on wound care? Heather Trumm BSN, RN, CWON, the Director of Wound Care for industry member group VGM & Associates (vgm.com), has some insights on that and some very strong reasons why they need to take a closer look.

For starters, if a DME pharmacy thinks it might not be the right “type” of business, it’s taking the wrong approach. Trumm says there is no single wound care business model when it comes to DME. Rather, a wound care practice will be reflective of a pharmacy or DME provider’s marketplace, payer mix, referral partners and patient mix.

“There isn’t an ideal wound care DME dealer out there,” Trumm says. “They all look kind of different … no two providers are the same out there.

But there is one truism about wound care that is universal for DME pharmacies and providers: it is a largely untapped care and business opportunity. Furthermore, the opportunity goes ignored because there are some central misunderstandings about wound care’s complexity of product offerings and supplies, profitability, and documentation.

“Wound care is underserved,” Trumm says. “And I believe it’s underserved because — and I hear this from a lot of people — there’s a lot of product SKUs and there’s no money in it. … What they don’t understand is that you can make it more simple than it looks.”

Trumm explains that while there might be something like 10,000 SKUs for the dressings alone, VGM Wound Care guides DME pharmacies and providers through a step-by-step process to research the right dressings for their market and patients.

“So, yes, there are 10,000 SKUs out there for dressings, but what we teach them how to streamline, just focusing on roughly 10, 12 of them,” she says. “It’s a guided hand-holding process that we take them through.”

When it comes to profitability, Trumm says VGM Wound Care provides a wound care calculator on its portal that, while not a profitability calculator, does help them start to paint a financial picture for a potential wound care practice.

“They can actually visually see what the reimbursement, what the gross profit is going to be, and what the gross margins are going to be,” she says. “So they can use that to answer those questions right away.”

For people who might not necessarily have access to that calculator, the numbers side of wound care can start to paint a much more attractive picture than they might have initially had in mind. For instance, in the dressing market, Trumm says the gross margins can be anywhere from 15 percent to 25 percent (ish), which are pretty solid figures. Suffice it to say, there’s a viable business model for simple dressings and other reimbursable wound care products.

Another point of pushback on wound care is documentation because providers and pharmacies believe would care entails a high level of claims documentation.

“Some of the people I talk to will say, ‘Oh my gosh, there’s so much documentation,’” she says. “But if they if they’re already doing rehab, or they’re doing therapeutic support services, it’s no different; it’s just as much documentation. So I would say, when you really look at it, there isn’t any more documentation than some of the other categories that you deal with for DME.”

THE RIGHT RESOURCES

One last point of pushback about wound care is the nature of the care itself: taking care of wounds can be kind of, well, intimidating because we’re talking about wounds. However, Trumm says that even that trepidation is misplaced.

“They don’t have to physically touch the patient,” she says, adding that VGM Wound care offers education that helps them understand how to work with patients and referrals to provide the right items and instruction. “We help them understand it so that it’s not so scary.”

And a way that VGM wound care does that is through a partnership with Healiant Wound Solutions, which offers educational programs designed to empower clinicians and commercial associates.

Healiant provides certification for the nonclinician and the clinician as well. The nonclinician certification program is called the Advanced Wound Product Specialist (AWPS), and together VGM and Healiant offer a virtual, on-demand education program designed to train non-clinicians. The course cover’s the same material that certified wound care clinicians are trained in.

“They provide kind of a Wound Care Boot Camp,” Trumm says, so that DME pharmacy and provider staff understand the different types of wound care, how to select the right dressings, and generally expand their expertise when it comes to wound care.

“We developed Wound Care Boot Camp to provide a no-cost, high quality, on-demand on-ramp for all caregivers and organizations who want to take their next step in becoming a ‘wound hero.’ Whether you are a patient, lay caregiver, nurse, therapist, NP or physician...if you are interested in wound care, this is a great place to start,” says Josh Heuchan, founder and managing director, Healiant Training Solutions.

Additionally, VGM Wound Care recently released a Wound Care Program Guide that helps VGM members assess whether or not they should add a wound care program to their business, and if so, how to launch and develop that wound care program. It also provides additional resources and contacts. VGM members can download a copy of the Wound Care Program Guide from the members-only portal. VGM Wound Care is also developing a companion for the Program Guide that focuses on the wound care vendor partners available to VGM members and how they can offer support in the wound care space.

“This Wound Care Program Guide is designed to help our members, who are part of something bigger, develop and grow their wound and skincare business,” Trumm explains. “The home medical equipment community provides patient-focused care every day. Implementing a skin and wound care program within your HME business means you are providing positive outcomes for your patients and touching lives.”

To help relate all this information to reimbursement, Trumm works with her colleague Ronda Buhrmester, senior director of Payer Relations & Reimbursement at VGM to provide an hour-long “Wound Care 101” course in which Trumm discusses the care aspects of various dressings and other products, and then Burhrmester covers the various reimbursement requirements for the related items per Medicare.

“To me, the more that they are educated and the more that they get entrenched into wound care, the more successful they will be, the more referrals they will get,” Trumm says. “They will be looked at by their referral sources as local solutions providers that know the patients already.”

YOUR CLIENTS WILL NEED IT

Regardless of any points of hesitation, wound care is an important care segment because while it might seem a little daunting or scary due to potential complexity or the very nature of the care — wounds — it’s pretty clear that many of the clients with whom a DME pharmacy or provider will be working either has or will have a wound. In fact, there are a lot of clients that need wound care. Trumm offers seniors as a good example:

“Older adult patients are at risk because the fat content in their skin decreases,” she says. “Older people get skin tears so easily because we lose fatty tissue in our skin as we age.”

“The diabetic population is another population that is at high risk for wounds, because of neuropathy; they can’t feel,” Trumm continues. “And with diabetes, you’re going to heal slower than a person that doesn’t have diabetes. Also, with diabetes, you could have a cardiovascular component as well. You probably have some venous issues or some arterial issues that compound the problem, which therefore decrease the wound healing even further.”

Another good group of clients for wound care is patients using long-term oxygen therapy because they typically also have comorbidities, Trumm says.

“When these folks get a wound — maybe they hit their foot or bump their arm — if they’re on oxygen, then obviously they’re not getting their own oxygen for a reason,” she explains. “The body needs twice the amount of oxygen in the first phase of wound healing to heal a wound. So if they are depleted with any oxygen, it’s going to take them longer to heal.”

If anything, the list of client groups that potentially need wound care from a DME pharmacy quickly stretches to cover people with any type of peripheral arterial disease, cardiovascular disease, venous disease, and any of those with comorbidities.

“So those are some great examples, and I think they really show that wound care applies to really anyone that providers are serving,” Trumm explains.

This article originally appeared in the DME Pharmacy December 2021 issue of HME Business.