Products & Technology

Sharing Best Resupply Practices

Sleep therapy was the proving ground for how technology and smart resupply practices can benefit care and expand revenues. Now, other corners of HME are starting to apply those lessons.

puzzle people looking at each otherMuch has been learned about resupply in the realm of sleep therapy. Now providers of other HME categories are starting to apply those lessons to improve their care and boost their bottom lines. Sleep therapy providers depend on resupply to ensure good care, keep patients complying with their therapy, and optimize reimbursement revenues. Furthermore, good resupply has a multiplier effect for physicians and referral partners, who need to ensure patients benefit from continued therapy in order to secure their funding.

So, sleep providers have learned to combine technology ef ciencies and smart business practices to  ne-tune their resupply performance. And, now that those providers have scaled that learning curve, the industry has started to realize that resupply applies to many more HME product and service categories than sleep. Smart resupply programs can be a key revenue driver for a variety of HME categories. Providers of products, such as incontinence, diabetic supply, and enteral nutrition, can apply these lessons to expand and optimize their resupply programs to increase revenues and patient care.

To learn more about how the resupply game is change, HME Business sat down with some technology experts, as well as a national provider of enteral nutrition and infusion services. We examined the resupply opportunities and issues for providers of other categories, and then looked at the tools and best practices available to help them improve their resupply.

The Resupply Opportunity

First and foremost, the primary value of resupply is that a quality resupply program has a direct impact on the provider’s patient.

“Being able to provide a regular, efficient, successful program drives the kind of compliance that the patient really needs,” says Morgan Dopplick, the director of Connect operations for HME software company Brightree LLC, which makes resupply solutions for HME providers. “It helps ensure that the patient is getting the supplies that they need when they need it, on time every time.”

Moreover, getting those supplies also benefits the bottom line. Having that regular, recurring program generates a dependable, low-touch, and profitable revenue stream for the provider, as well.

“So it’s really a win-win,” Dopplick says. “It’s a win for the patient, because they’re having their therapy needs met, and it’s a win for the provider, because they have that dependable revenue stream coming through.”

And it’s a win for more than just sleep providers. While we think of resupply in the context of sleep therapy — all those mask parts, tubes, etc. getting resupplied to patients — there other categories of home medical equipment besides sleep that can benefit from well-executed resupply programs. Now, technology companies such as Brightree are trying to export those gains to other care categories.

“Over the last several years, there has been a distinct focus on resupply in the sleep area, but we’ve taken what we’ve learned in the sleep space — what benefits patients in a regular resupply program in the sleep space — and have been expanding the benefits of an effective resupply program to other therapies: incontinence, diabetic, and enteral nutrition,” Dopplick says. “In each one of those areas, we know that it’s critical that patients are being resupplied timely; that they’re getting what they need; and they’re getting their full orders.

“So we’re applying what we learned in sleep and carrying that over into other key lines of business that our customers are,” she adds. “This has really proved to be the next phase in terms of resupply.”

Collectively and respectively, incontinence, diabetic and enteral nutrition have a fairly large patient footprint. And those footprints are unique, with their own resupply challenges and needs.

“Also, the demographics of the patient varies as well,” Dopplick says. “So, it all becomes that much more critical to make sure you have an efficient program that can handle different patients, different payers, different ages, different needs. All of that really comes together in focusing on what your resupply program can do.

Case in Point: Enteral Nutrition

Similar to PAP therapy, there are various resupply items for enteral nutrition, but most importantly, the entire care category is based on refills: they need their nutrition. That said, in addition to nutrition formula refills, there are other items such as feeding tubes and dressings. The entire service is based on ensuring that patients have all the supplies they need at all times. Also, enteral nutrition services are often paired with infusion services, which also include items like pumps and other items.

“Resupply [for enteral nutrition] is tied to patient safety and improve patient outcomes,” says Kelly Kinnare, clinical nutrition manager for national enteral nutrition and infusion provider Option Care Health. “Providing these ongoing, timely refills ensures that our patients continue to receive the nutrition and supplies they need in order to sustain their life. Without resupply, they don’t get their food and they can’t feed themselves without the formula. The syringes, the bags, everything they’d need to be able to feed themselves — it’s a matter of life or death really, to these patients, if you think about it.”

And ensuring that resupply creates a secondary opportunity to ensure patients are healthy and getting what they need, because it creates a point of dialog, both for Option Care Health’s enteral patients and infusion patients, according to Kinnare.

“Resupply also provides us the opportunity to follow up on our patients,” she explains. “The patient contact allows us to make sure that they’re meeting their nutritional goals, tolerating their infusions, being compliant with their therapy, making sure their pump is working properly.

“It’s our chance to kind of troubleshoot anything that’s going on right then and there to avoid them having to call in again,” she adds. “So if a patient’s experiencing any problems during the call, then we’ll immediately troubleshoot and problem solve with the patient. If the care is a little bit more at that clinical level, that patient would be referred directly to a registered dietician right then and there to get involved with that patient.”

So refill calls let Option Care Health see if the patient experiences weight loss, weight gain, or any kind of event that would raise a flag and perhaps require a change in nutrition or therapy or some kind of clinical intervention. That kind of proaction results in reduced hospitalizations and reduced healthcare dollars.

“We’ve done a lot of outcomes studies where we’ve pulled data and really looked at it,” Kinnare says. “The earlier you intervene, the more you’re going to prevent a patient from being re-hospitalized or having to take themselves into the ED.”

That resupply outreach, in turn, improves physician relationships, she adds.

“If we’re doing a good job taking care of that physician’s patient, then that patient is calling into their physician’s office less with questions or complaints or complications related to their feedings,” Kinnare explains. “The patient has increased knowledge through us because we’ve been able to help them through things. I think they have greater success rates of weaning off their therapies sooner when we’re more involved as their provider. This allows the prescriber to put their trust in us.”

Getting Resupply Right

That said, Option Care Health and enteral nutrition provider does face resupply challenges, according to Kinnare. After diagnosis and getting set up for an enteral nutrition program, patients start getting 30-day supplies that need to be refilled. At that resupply, Option Care Health can start determining if they need more of something, less of something, along with any other needs.

“On those first couple of refills or resupplies, there might be some changes in the quantities or the types of items they receive until we get their 30-day supply down pat,” she says. “Maybe we sent four syringes with the first delivery and they want 10 a month. We have some wiggle room within our supply kits where we can go up or down based on what they need. So that’s when we start to kind of fine-tune that for them.”

Additionally, the patient might be changing items as well.

“We have physicians or prescribers that are changing orders,” Kinnare explains. “So, especially in the pediatric realm, we might see their formula orders changed on a bimonthly basis, every other month, because as the child grows, they need more nutrition to meet their calorie needs.

“Maybe it’s the same formula, but it’s a higher amount,” she continues. “So next month they need more formula. Maybe they had a nasal gastric tube in, but now the child has been converted to a G-tube. Well, they’re going to need different supplies now that they have a tube in their stomach versus their nose. So, we have to be really in tune with these changes and we have to be able to keep up with it.”

So, if you think that Option Care Health’s resupply situation sounds a lot like sleep providers’ resupply situation, you shouldn’t be surprised. There are probably more similarities than differences in this scenario: patients’ therapies are unique and require fine-tuning; there is a lot of communication involved in that process; that fine-tuning and resupply process is ongoing and not without change. So constant outreach, communication and dialog between patient, provider and referral partner is critical.

Software Lessons Learned

Bearing all that in mind, sleep providers have leverage technology and revised workflows to turn resupply into equal parts art and science. What has the sleep segment learned that can be applied to other categories that want to improve their resupply programs?

“One of the things that we’ve learned through the sleep resupply process is to set the patient and the provider up for success from the patient setup,” says Margaret Lindskog, director of operations for ReSupply LiveCall at Brightree, which provides a live patient contact center for resupply providers. “Resupply success begins at the onset of therapy and focusing on the initial patient education; changing out the supplies; the reasons the patient should pay attention to resupply; and the benefits that they’re going to see.

“You want to set expectations with the patient; explain the follow-up process; and what patients can expect going forward once they start their therapy, and once they’re at home with their equipment,” she continues. “When providers start resupply from the get-go, we find that it increases compliance and sets the patient up for success.”

In terms of the infrastructure of an effective resupply program, the right resources really begin with technology. For instance, Brightree offers Brightree Connect, an integrated solution that manages a provider’s resupply patient base. It identifies the right patient at the right time for the right supplies and then it helps the provider make outreach to their patients. Patients can click resupply orders in a multiple of different communications modalities. So the software not only helps providers manage that list, but make contact in the way that’s most appropriate for the patient.

This lets the provider assure that it is contacting the patient effectively and at the proper time. So, offering different contact modes based on the patient’s preference, but also their success, is critical. Providers want to ensure they are contacting patients the right way, at the right time, with the right messaging. In effect, technology is helping them formulate a “secret sauce” for each patient’s resupply.

“There’s something for everyone,” Dopplick says. “For example, if a patient is a busy business traveler and they don’t want to be tied to a phone and call in, they can use a method such as the Patient Hub. Patient Hub is a Brightree patient engagement app that gives patients a short alert on their phone letting them know that it’s time to reorder their supplies. That’s a really seamless solution for that kind of busy patient; they could be walking through the airport and open the app and pop in their order and they’re good to go. They know that those supplies are going to arrive on time when they need them.

“We also have a more of an automated an IVR solution and we have a guided work list if you have staff at your location that can make those calls, that’s available as well,” she adds. “We also have our ReSupply LiveCall service that can help assist your staff in making some of resupply calls.”

Beyond that, software also creates efficiencies and seamless processes between not just the provider and patient, but provider and referral sources, and even between funding sources.

“Software really is the key to managing multiple patients across multiple payers; multiple outreach methods; and multiple disease states,” Dopplick says. “Leveraging technology can take the burden off the HME and ensure that the patients are being contacted the right way, at the right time, and about the right supplies. Software can really do a good chunk of that patient management work for you. That’s a huge benefit to an HME provider. It allows the provider to identify and overcome different pain points or any bottlenecks that they have within their organization so they can streamline their workflow, processes, and create a consistent resupply program for patients.”

Judging Performance

After the provider has done all the work with software to implement an effective resupply program and it has patients reordering, and complying with therapy, software then lets the provider go back and start fine-tuning its performance.

“What does your data tell you?” Dopplick asks. “Do you have patients who are at risk of retention? Do you have opportunities to maximize your orders? That’s really where the analytics component can come in.

“So, providers want to make sure they have good quality data that allows them to keep tabs on their patient base and be proactive when there are concerns or issues,” she explains. “This ensures that the resupply program you’ve worked hard to build remains solid for your business and your patients.”

And, in creating the kinds of tools and those analytics that lead to better resupply, Dopplick says Brightree is starting to see key performance indicators that are turning into the barometers for a good resupply program.

“Of course, the clinical outcomes improve, but they grow their business,” she says. “We see, on average, a 30 percent increased resupply revenue, and 37 percent increased revenue per order. And then, when it comes to retention, we see about a 9 percent to 10 percent improvement in overall patient retention, which we know just generates the downstream bottom line, as well.”

But for all the metrics that can be collected, there is still a human element that providers of resupply items need to prioritize. Interaction still reigns supreme when it comes to resupply, at least for Option Care Health’s Kinnare. The resupply effort benefits most when there can be live dialog with the patients, and IT and workflow enhancements need to foster that.

“When I look at the number of refills we do per day and the number of patients we help … there is this huge opportunity for us to do something different,” she says. “So, I’m loving the sound of the different technology that other providers are using. I think ultimately, that’s probably the biggest piece to making all of this more efficient: still taking care of the patients.”

This article originally appeared in the January/February 2020 issue of HME Business.

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