Getting Smart about Supply Replacement

Creating and maintaining a supply program for patients with obstructive sleep apnea makes good sense — both clinically and financially. HomeCare Xtra conducted a Q&A with Laurie Scott, a United States marketing manager for patient interfaces at Respironics, to help HME providers get started.

XTRA: How can HME providers boost their sleep therapy supply business?

Scott: There are a few key things that help. First, understand that patient compliance is fundamental to the supply replacement business. OSA patients do not need supplies if they are not being compliant or adhering to their therapy. Some tips include:

• Develop a patient care model to promote and/or enhance patient compliance, including a policy for contacting patients after initial set-up, after three months, six months, etc.
• Provide innovative, industry-leading products to your patients that will give them the best chance of therapy success and, therefore, create an ongoing need for supplies.
• Evaluate and weigh your investment options. Compare your profit for the initial positive airway pressure and mask with a slightly larger up-front investment to drive longer-term compliance and long-term profits from supply replacement.

Providers should discuss supply replacement with new patients during their initial set-up. Be sure to:

• Describe why it is important for successful therapy to have fresh supplies on a regular basis, and inform new patients about their specific payer’s supply replacement policies and frequency tables, if known.
• Describe how you will be contacting them about their supply.
• Collect several means of contacting them, including email addresses and cell phone numbers, along with their home phone numbers.
• If using a third-party solution, such as [a] voice- response patient management application, introduce your patients to a sample call.
• Also, inform your longer-term patient base about how your program will make it easy for them to receive the supplies they need on a regular basis. It [may be] helpful to invest in updated computer systems or vendor-supplied software to help track when patients are eligible for supplies.

Be methodical in updating records. If a mask is swapped out for a new size or new style, update your records to ensure that you can eliminate any guesswork when the patient needs a replacement.

Consider holding regular clinics to bring patients in for re-fittings or to see new masks or out-of-pocket accessories. Providers can also incorporate supply replacement messages in all communications with patients. Making supply replacement part of the regular, ongoing dialogue continues the education process about the importance of therapy and the benefits available through the patient’s payer.

XTRA: What are the guidelines for how often patients can receive new supplies? Does this vary between managed care payers and Medicare?

Scott: Replacement supply tables can vary greatly from payer to payer. While Medicare will reimburse for a new mask (with medical necessity) every three months, some payers will not pay for any supplies after initial set-up. On average, masks are reimbursed every three to six months. Policies for other accessories, such as tubing, filters and headgear, also vary by payer. Medicare has a published schedule for frequently replaced supplies.

XTRA: What are the best methods for contacting patients for re-supply?

Scott: A personal phone call allows you to better assess a patient’s compliance progress and enables you to guide a patient who may be reluctant to purchase new supplies. Unfortunately, OSA patients are much more active than traditional respiratory patients, so these phone calls are best made in the early evening or on weekends.

Direct mail, e-mail and automated phone call options help you to reach these active patients in a cost-effective manner, since repeated attempts are often required regardless of method. For a personal touch, regularly scheduled CPAP clinics also are effective.

XTRA: Aside from the revenue generated from the supplies, what added benefits do a re-supply program offer?

Scott: A supply replacement initiative gives providers the perfect opportunity to assess how successful a patient is with therapy and whether a clinical intervention is required. Timely intervention can keep a patient compliant for a lifetime, which has three primary benefits.

First, you improve the patient’s health in a tangible way. Second, offering exceptional patient care along with your supply replacement program can earn new patient referrals based on your supply patients’ recommendations. And lastly, an OSA patient is a patient for a lifetime — and during that lifetime the need for your other products and services grows.

Laurie Scott is a U.S. marketing manager for patient interface products at Respironics, Murrysville, Pa., where she is responsible for launching and promoting mask-related products, programs and service solutions for the home care market. Her current focus is in the area of OSA supply replacement, assisting HME providers to incorporate best practices into their supply replacement initiatives. She can be contacted at [email protected].