The 2013 HME Handbook: Oxygen

Breathing Easy Despite Hard Times

How to reinforce oxygen patient care in a cost-cutting environment.

OxygenNo matter how HME providers decide to reduce costs to survive a wounded economy and the onslaught of cuts, caps, audits and competitive bidding assaulting their industry, the most import challenge is keeping patient care at the highest level possible.

Adding new processes, downsizing, outsourcing and spending less to survive can certainly help the bottom line, but change can also threaten the pace of company growth and overall profitability. How do you stay competitive and not alter your goal of achieving a high standard of patient care?

One option is to use some of the savings found with downsizing or implementing new technology and business models, such as low/no delivery, to oversee that patients are achieving good outcomes.

“We implemented a delivery tech manager who is responsible for making sure every patient is seen for tanks or checks,” says David Baxter, President, Medical Necessities. “This person evaluates utilization of tank usage and frequency and is responsible to pull the frequent flyers (patients who need tanks all the time) and have them schedule with therapists to get them evaluated for conserving devices or new technology systems to cut back on usage but provide patients with necessary equipment to keep them active. The delivery tech manager is also responsible to get patients scheduled with a routing system that we developed to eliminate unnecessary trips to areas that we are not in daily, which optimizes productive of technicians.

“Secondly, we have a dedicated therapist who contacts oxygen patients after initial setup to go over multiple questions about what their experience and expectations are about oxygen,” Baxter continues. “In addition, we identify how active or portable patients are in order to evaluate what system or technology would best fit each patient. We try to customize oxygen patients by giving them a questionnaire that helps us get them on a system that works while again eliminating unnecessary trips to areas we are not in all the time. This has worked great to help outcomes (keep patients active and out of hospitals) and managing their care on the front end with nondelivery technology.”

The 2011 American Association for Respiratory Care (AARC) Congress in Tampa, Florida, offered multiple presentations on how HME providers can help reinforce oxygen patients’ care in a cost-cutting environment. The common denominator is education.

One group of presenters said successful DME-based programs showed a commitment to OGPE technologies and multiple patient touches during the first 30 days of therapy. Patient contact strategies included in-person visits, telephone calls and supportive written materials.

Also, clinicians conducted in-person visits that included equipment training and background information about COPD; nutritional information; the importance of activity and compliance with the oxygen order and how patients can recognize if they are getting worse; and what actions they should take. Next, some clinicians contacted patients by telephone, or office personnel contacted patients using a script. These personnel were trained to recognize responses that are noted for follow-up by the clinical team.

The result? Providers agreed that tracking patient outcomes resulted in data that the marketing staff could take back to referring hospitals as evidence of their ability to support the hospital’s objectives.

So, your ability to provide a high standard of patient care relates to how efficient your operation is. Here are some common areas of inefficiency to explore:

Make sure your home visits are under control. Experts say to create a visitation protocol that uses Medicare requirements with the manufacturer’s guidelines. Home visits can be expensive. Use other forms of communication to help patients seeking assistance outside scheduled visits.

Rank your patients. To help keep costs under control, rank your patients low, medium and high and develop a protocol for each level.

Know your state laws. Knowing your state laws will help you decide if your clinicians should be performing all the duties they are currently performing. For example, if a clinician is not required for equipment delivery and set-up, have a technician do it with clinician supervision.

Make only necessary deliveries. Have you invited your patients to pick up their own equipment at your company site? Develop standard operating practices for each piece of equipment and the type of patient you are servicing.

Many providers are still considering how business model changes will affect both revenue generation and patient care. They do realize, however, that changing one can have a serious effect on the other. Therefore, create a plan with predicted outcomes before implementation. Experts say to expect be a tidal of wave of operational changes once the effects of competitive bidding Round Two begin to wash across the industry.

Points to take away:

  • With money saved from downsizing or new technology implementation, create a position that monitors patient care.
  • Implementing aggressive patient education is key to providing a high standard of care.
  • Becoming more efficient leaves time to better care for your patients.
  • Plan today for industry changes that might challenge your ability to care for patents.

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This article originally appeared in the June 2013 issue of HME Business.

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