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At first glance, absent a contract for reimbursement from a managed care organization, disease management programs may not seem to be profitable business endeavors for the HME provider. However, experience has shown that this is far from the truth. Disease management programs, when properly planned and implemented, can effectively spur a company's growth in the more profitable respiratory equipment market. The majority of the costs of a COPD disease management program lie in the labor and benefits associated with the clinical staff needed to administer the program. But if you look carefully at the numbers you will likely find that even if you have to hire a full-time therapist you can break-even with as few as 30 oxygen referrals that stay on rental for a year. How do disease management programs work to help grow your business? Several ways: Disease management programs differentiate your company from the competition with a huge value-added service. Think about it - wouldn't your referral sources prefer to send their oxygen patients to a company that has a program available to help them manage their disease and avoid exacerbations, rather than to a company who only provides oxygen equipment? Many companies that have put disease management programs in place have succeeded in becoming the provider of choice in highly competitive marketplaces. One of the frustrations over the years for the HME industry has been the difficulty it has had in being seen as a "care" provider with clinical expertise instead of simply a purveyor of medical equipment. Disease management programs can enhance the image of an HME provider. For instance, it is a simple task to build non-invasive ventilation protocols into a COPD disease management program available to patients receiving oxygen therapy. And physicians are, traditionally, much more comfortable with using non-invasive ventilation therapy when presented with objective criteria from patient assessments. The physician feels assured that the therapy is being used appropriately, and the HME provider gains the credibility that they deserve. Outcomes tracking can lead to eventual program reimbursement by managed care organizations. In some markets, organizations have been able to use patient outcomes from COPD disease management programs to convince managed care organizations to reimburse up to twice the provider's program costs. How? By demonstrating that program participants decreased their utilization of medical services. For the same reason, managed care organizations in California and Florida are actively soliciting HME providers to contract with them to offer COPD disease management programs to their members. There are other benefits to be gained by implementing a COPD disease management program, but these are the top three reasons that make it an all around win for the patient, the payer, the physician, and the HME provider. ~o~ What's stopping your company from offering a COPD disease management program that can help grow your business? If you're like many providers you lack the human resources to plan, develop, and implement a program that includes all the necessary components to make it a success. Strategic Healthcare Programs, in association with The Domos HME Consulting Group, offers a cost effective, turnkey solution that includes specialized implementation consultation, as well as a complete outcomes tracking package. |
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