Problem Solvers

Spreading the Good Word

How patient education and smart marketing can improve respiratory provider performance.

• By David Kopf
• Jan 01, 2016

The home respiratory segment of the HME industry provides us with an excellent example of how a nice within one market can help demonstrate to the rest how the market can move forward.

Like the rest of the industry, home respiratory faces challenges such as competitive bidding and CMS’s ramped-up claims audit program, as well as the nationwide expansion of competitive bidding. It also has been dealing with a 36-month rental cap for several years now. Suffice it to say that oxygen continues to face serious threats to its revenues, while still needing to provide an expensive product and service that requires clinical involvement to its patients.

At the same time the segment is also seeing growth. According to HME Business magazine’s Eighth Annual Oxygen Market Survey, which we conducted earlier this year, roughly 65 percent of respondents said that their oxygen business grew in the past 12 months. This is a significant jump from last year, where 53.1 percent of respondents reported growth. More about this year’s growth:

• 54.7 percent of respondents said they had an increased number of patients due to referral sources (54.5 percent in 2014)
• 13.3 percent had an increased number of patients due to being awarded a competitive bidding contract (9.1 percent in 2014)
• 6.7 percent has an increased number of patients due to marketing campaigns (10.2 percent in 2014)
• 13.3 percent of respondents said their growth was due to the reduction of competition in the marketplace. (14.8 percent in 2014).

Those figures are pretty telling. While competitive bidding is winning some providers additional business, it is clear that there are other factors to which they can attribute their growth. Moreover, while competitive bidding isn’t necessarily within a provider’s control, trends such as working with referral partners and marketing are. Let’s examine some of the ways providers can foster growth in ways they can control.

Refining Non-Delivery Through Education

Obviously low- or no-delivery business models have been pivotal for respiratory providers. The innovation of and proliferation of portable oxygen technology, including portable oxygen concentrators and home filling systems, has meant that providers have been able to free themselves form the confines of a delivery business model, which entails a massive amount of overheard.

The numbers of portable oxygen uptake don’t lie. According to Medicare HCPCS claims data, the portable oxygen concentrator (POC) code E1392 has been in use since 2007. In 2007 there were an estimated 1,500 patients receiving a POC billed to Medicare and in 2012, approximately 37,400 patients. Payments for POCs in 2007 were about $2 million and almost $23 million in 2012.

Moreover, portable oxygen technology is helping patients, as well. By freeing them of having to stay in or near their homes, patients can get out and live life to the fullest. Getting out and living translates into increasing ambulation, which is improving outcomes for patients.

And still, providers can further refine their non-delivery businesses. One key way to do that is through harnessing their most important asset: their patients. Portable oxygen has a steep learning curve and the more patients know, they more they will benefit from their devices — and clinical students have shown that patients benefit from education on their disease and how to manage it have been documented in a large number of clinical studies.

The more “expert” patients become with their portable oxygen devices, the more they will obviate the need for providers to send staff their way, which reduces overhead. And, perhaps most importantly, this will cut down on extremely expensive hospital visits, which not only means less cost for the patient, but demonstrates to referral partners that the provider is generating real results.

So how does a provider start? It comes down to outlining an actual patient education program. Providers should work to ensure new and even experienced portable oxygen patients take full advantage of their portable oxygen devices. Providers should give clear instruction on how to properly use, clean and care for their portable oxygen equipment. Patients also need to be educated on why they need oxygen, what the benefits of oxygen and ambulation are and what breathing techniques they can use to help when they encounter challenges, including stairs and hills.

But education doesn’t stop at the outset. Providers should undertake programs that can help them measure how patients are faring, and then provide any follow-up education and instruction that might be needed to further improve their outcomes.

Create regular efforts to track patient progress and satisfaction. Hospitals, physicians and other new care models are monitoring their performance by metrics, such as readmission, patient satisfaction and experience, because they often face related payment incentives and penalties. Providers should function in a similar fashion.

Moreover, managing and monitoring patients generates a considerable amount of patient data that HME providers can then use to help referral partners generate improved incomes.

This is also important because it helps supplement the level of care that a patient “feels.” One of the negatives of portable oxygen is that it can diminish the need to continually interact with patients. Regular follow-ups, even automated check-ins, keep the patient relationship going.

Measurement and Marketing

Another key way providers can improve their businesses and care is through better understanding their marketplaces. As the old saying goes, what gets measured gets managed, but how many providers actually take the time to get a solid sense of how many respiratory patients are in their area? Furthermore, how many providers are taking the time to determine which of those patients need home oxygen and related services?

Without those kinds of numbers, providers are flying blind. For starters, providers need to better understand patients on a more granular basis. Providers should know the number of oxygen patients in the area by product category. This provides insights into a provider’s market share position and what opportunity exists without expanding your geographic market. Also, providers should have a decent idea of the number of oxygen patients that are prescribed each day, and for which treatments are they being prescribed, such as CPAP, aerosol, ventilator, etc.? Different strategies and tactics are needed for each of those patients in order to move more market share in the provider’s direction.

And chances are, the way that patients can get a lot of that information is through their referrals. This means that providers must work to deepen their relationships with referral partners. Going back to the patient follow-ups, the more data that a provider can collect about their patients and their care, the more they can help their referral partners to optimize care for their patients.

Providing that kind of information will position the oxygen provider as an expert resource for physicians and other healthcare providers, and allow the provider to become a more involved participant in how care for the patent is outlined and managed. It’s the proverbial win-win.

This article originally appeared in the January 2016 issue of HME Business.