Dealers Discuss: Jessica McMillan, Respiratory Care Manager, Meriter Home Health
Describe your company’s respiratory division. We’re a small department. Our Respiratory Care department has 6.3 FTE. One of them is a respiratory technician. Our real growth profitable service line is our CPAP/BiPAP with obstructive sleep apnea. We have two clinical locations: one here at our offices on Beltline, which is off the retail store, and then we have another clinic set up at our local hospital to service our sleep apnea patients when they come in for follow-up with their physician. And we run those like a clinic. We also do a six-month reorder program for those particular patients. On our oxygen line, our technician does our transfilling here at the Beltline location, and she checks all of the oxygen equipment. We have an automated system for scheduling oxygen cylinders, which she also takes care of, and that’s by geographic location. We also just started utilizing the Invacare HomeFill systems and those are for our outlying patients. That actually helps cut our delivery costs and makes us more efficient. And the patients are better serviced because they don’t have to wait for us.
You said that sleep apnea is an area where you’re seeing a lot of growth. Can you talk more about that?We’ve actually been very aggressive with our growth. What we’re also finding out is sleep-disordered breathing or obstructive sleep apnea is underlying in type 2 diabetes, hypertension, cardiac trouble and obesity. That area has just taken off and grown. Currently we’re in the process of joining two hospitals to get a sleep center, which will be 14 to 16 beds. So, we’re going to be growing; we’re going to be tripling in size to service our population. Right now, we have a three- to four-month backlog.
Are you targeting diabetes educators?We actually haven’t started that program yet. We’re just working on how to get it in line and do an education plan for them.
Are you targeting cardiologists?Yes, we are. We also just started a program, which is the Apnea Link with oximetry. I’m working with a couple of our primary care physicians and developing a tool. This is a little four-channel that they’re using as a prescreening tool for patients who come in complaining of daytime fatigue, short-term memory (loss), memory loss, hypertension, any underlying things associated with sleep or possible sleep problems. The indicator will come out as a normal range or suspected breathing disorder. In that case, it gives (the physician) more information to refer (the patient) to a sleep doctor.
What is your opinion of CMS’ review of in-home sleep testing?I think it would be very good for the home care companies to be able to provide that service, but I do have mixed feelings because of the thoroughness of the sleep labs and the polysomnographs. I think you’ll see a decrease in the actual sleep labs and the polysomnographs.
Describe your relationship with sleep labs in your area.We’re very close. We have a very good working relationship. We try to attend the quarterly physician meetings, and we go over reimbursement, technology — anything new We try to keep an open communication. We want to be their resource for any new equipment, information (and) education to help them have better clinical outcomes for their patients.
What do you believe are the most pressing challenges facing respiratory today?Right now, I really believe it is the Medicare oxygen reimbursement. My director actually went to Washington to try to fight it today (AAHomecare Legislative Fly-In, June 6-7). We just feel that with the transfer of ownership of an oxygen concentrator, we see so many patients that just can’t take care of the equipment like it should be taken care of. It’s life-dependent, and it can be life-threatening to them. I would rather see it go into a maintenance program instead of an ownership transfer. I think that’s our biggest challenge because oxygen has always been the backbone of the industry.
This article originally appeared in the Respiratory Management July/Aug 2007 issue of HME Business.