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.
- By David Kopf
- Apr 28, 2020
Much 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
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
“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
“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.”
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
“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
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.”