Problem Solvers

Recapturing Lost Diabetes Business

Compression products could offer a way for diabetic providers to continue serving patients and recover revenue.

Many diabetes providers are still reeling from Round Two of competitive bidding, which included mail order diabetic supply. The results have been staggering: With Round Two, CMS decreased the fee schedule amounts for retail DTS to the current mail-service fee schedule amounts on April 1 this year, and then further reduced reimbursement to the national mail-service program single payment amounts on July 1. Together, the two cuts added up to a whopping 72 percent, according to CMS.

For diabetes providers, this meant that only contract suppliers are reimbursed by Medicare for diabetic testing supplies delivered to beneficiaries’ residences. The mail-order diabetes supplies included in the national mailorder program are blood glucose test strips, lancets, lancet devices, batteries and control solution.

The result was that a slew of providers got aced out of providing mail-order diabetic supply. With these extensive cuts in mind, providers have been looking for new ways to bring in revenue whether they got contracts or not.

Now providers are trying to find ways to drive new revenue while leveraging and reinforcing existing patient and referral relationships. Compression might be one way to accomplish that. The barriers into the compression market aren’t difficult, and it is an affordable product category. Even better, the market is on the upswing.

On the plus side, the barriers into the compression market aren’t difficult, and it is an affordable product category. Even better, the market is on the upswing. According to the report, “Compression Therapy Market to 2019,” the worldwide compression market will swell from $2.4 billion in 2012 to $3.4 billion in 2019, at a compound annual growth rate (CAGR) of 5.1 percent.

“I think as our population gets older, and that’s been the case for a lot of medical products, there’s more of a need for it,” says Tom Musone, director of marketing for compression products manufacturer Juzo.

Compression and Diabetes

Compression garments can specifically help diabetes patients with venous disease, which occurs when their veins aren’t necessarily functioning properly.

“There are valves in your veins and what happens is as we get older or hereditary or behavioral choices, the valves don’t function properly,” Juzo’s Musone describes. “When they close, what happens is it prevents the blood from pulling back down to the vein and the valve will become ineffective due to the fact that the vein has become elastic.”

Products such as Juzo’s silver anti-odor and antimicrobial compression garments are designed to be effective in combination of treatment or management for ulcers on the leg. One particular product is a diabetic sock with silver in the sole.

“The sock is a diabetic comfort sock, and it’s great for protecting someone who’s either on their feet or diabetic that has issues where they want to protect their feet, and then overall compression is just good for increasing blood circulation,” Musone explains.

Beyond Diabetes

Doctors use compression to treat various conditions, including foot swelling, mild edema, varicose veins, thrombosis, varicosities of varying severities, and circulation problems from diabetes. Geriatric patients, those with diabetes, lymphedema and post-surgery patients often depend on compression therapy.

Compression garments, such as socks, stockings and wraps, deliver support and increased circulation to affected limbs and other areas of the body. Compression is graded in millimeters of mercury and can range from 15-50 mmHg; the higher the compression, the tighter the garment.

“What you’ll see with compression is that not only can you address that particular segments, which is diabetics if they have venous disease they will need to wear compression garments, but you can also expand that into other resources or other disease states, like lymphedema,” explains Musone.

The Compliance Challenge

Getting patients to comply with the compression treatment from their doctors can go a long way toward helping providers maximize compression sales by getting repeat referrals.

“You want to be educated so you can understand how to explain to the patient how to put the product on, take it off, care for it,” explains Musone. “Generally when that happens compliance increases. The referral source will be a lot happier, so you’ll grow in your business through that.”

Educating patients on how to put on and take off their compression garments is the biggest thing because that can be a challenge for patients.

“Once a provider educates them properly, that really helps in increasing compliance,” says Musone.

Other ways to increase compliance is by teaching the patients how to launder their garments (machine wash and dry), when to put them on in the morning and when to take them off in the evening, talk about donning gloves and recommend they take jewelry off their hands so it doesn’t snag on the garments.

The days of compression garments as unfashionable medical wear are long gone, thus eliminating an excuse for patients not wanting to wear them. “If you have venous disease and you like thigh highs, you can wear thigh highs with open toe or full foot,” says Musone. “We have different colors. We have men’s socks that are for dress. Whatever your preference is: opaque, sheer, a casual sock, those are just help for compliance sake, and it can be worn with any particular symptom.”

Maximizing Compression Sales

How else can a provider maximize compression sales? Musone recommends partnering with a manufacturer to get trained properly. Manufacturers have the representatives to help train providers and those reps also can assist in helping set up the business and provide the best steps forward.

“With compression, like a lot of medical products, you have to differentiate yourself and one of those ways for the medical providers is to provide you as an expert,” Musone advises.

He also says providers should have a well-stocked product mix of different styles, colors, sizes on the wall so that the patient can come in and leave with the appropriate product that they want.

“I think a quality product is the main thing,” he says. “What we try to reflect in our product is that it’s comfortable for the patient, that it looks good so the appearance of it whether color or style, and then we want to make sure it has therapeutic compression. And also that it’s durable, and it provides value to the patient so that they’ll want to wear it again.”

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

About the Author

Cindy Horbrook is the associate editor for HME Business, Mobility Management, and Respiratory & Sleep Management magazines.

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