2020 HME Business Handbook: Oxygen
Expanding Your Oxygen Care and Business Performance
Regardless of the COVID-19 pandemic, the need to serve increasing numbers of home respiratory patients continues to expand. How do HME providers meet that demand?
- By David Kopf
- Jul 29, 2020
Oxygen providers services and
equipment, find themselves
in unique circumstances. They must
provide care to long-term oxygen
therapy patients during a public
Then again, respiratory providers
have always found themselves in
“interesting” circumstances. They
had to respond to the 36-month rental
cap. They had to respond to competitive
bidding. They had to respond
to audits. And while each of these
instances hit their funding, each time
they’ve deftly adapted.
One thing is clear: even without
COVID-19 increasing the need for
home oxygen, other disease states
that have been served by respiratory
providers aren’t going anywhere. In
fact, they’re increasing. The total cases
of chronic obstructive pulmonary
disease (COPD) is expected to grow
rapidly in the United States and
major European countries over the
next decade, according to an analysis
by analytics company GlobalData.
In the report, “Chronic Obstructive
Pulmonary Disease: Epidemiology
Forecast to 2028,” the firm estimated
that COPD cases in seven
major markets — including the
United States, Germany, the United
Kingdom, France, Italy, Spain and
Japan — will go from 59.3 million in
2018 to 67.2 million in 2028.
The highest number of COPD
patients will be located in the United
States, where the amount of cases is
expected to grow from 26.6 million
to 31.1 million over the course of a
THINK OUTSIDE THE BOX
There is a market for long-term
oxygen therapy beyond Medicare.
For instance, there is an increased
need for clinical services in the
skilled care setting like a hospital or
There are providers getting
creative and creating models for
value-based purchasing and alternative
payment methods with private
payers and non-traditional funding
sources. They’re marketing to
commercial plans and showing what
outcomes are possible and actually
creating that model for an insurance
company and payer.
And in working with private payer
funding sources and similar entities,
it’s important to note that the
territory will still seem somewhat
familiar, because most payers look
to CMS as a guideline. The majority
of third-party payers follow the
Medicare template for coverage,
and rentals are most common.
DIFFERENTIATE VIA RPM
A growing way for oxygen to
make themselves stand apart to
referral partners and payers is
remote patient monitoring (RPM).
For years now, PAP devices have
been monitoring patient performance
and feeding that data back
to care management systems that
physicians can use to see unique
health events and tweak care. Those
devices can also connect with
personal apps that patients use to
better manage their care.
Use of remote patient monitoring
in sleep has exploded and
is poised for more growth. In 2015
market research firm Berg Insight
reported the global number of
remotely monitored patients
grew by 51 percent to 4.9 million.
In 2019, ResMed reported that it
alone has 10 million users of its
cloud-connected devices and it
had a database of 4.5 billion nights
Now remote patient monitoring is
starting to find its way into oxygen.
The first forays into remote POC
monitoring came with devices
that were largely founded on the
concept of fleet management:
providers would remotely monitor
POCs to ensure they were being
used and that they were functioning
properly. Moreover, depending
on the situation, providers could
remotely diagnose problems.
That soon gave way to the notion
of monitoring usage data and now
we’re seeing some oxygen equipment
also monitor clinical data.
HME providers could become champions
to both their referral partners
and patients, and would benefit
from an ever-growing reputation for
effectiveness and forward-thinking
care that produces results in an
outcomes-oriented care environment.
That’s a hard value proposition
DON’T IGNORE RETAIL
Providers of portable oxygen
systems must look beyond the
funded market. Medicare and some
private payer are clearly important,
but the retail market for portable
oxygen cannot be ignored —
particularly the online market. Type
“portable oxygen concentrator”
into Google. The results will show
a thriving marketplace — a marketplace
that most providers currently
do not serve.
Retail represents a massive
opportunity to providers. It is where
customers go when providers don’t
give them what they want. This is
particularly true of the Baby Boom.
The massive demand for POCs
and similar devices should clearly
demonstrate that there is a huge
population of underserved patients
looking for — and buying — those
types of systems. Moreover, even
if some of those online buyers are
already receiving tanks, that should
make providers wonder two things:
how much wasted cost is built into
the business, and on how much
retail or funded revenue did they fail
Obviously, selling on a retail
basis can be difficult for Medicare
providers. They need to have
new business infrastructure, they
must adhere to a number of legal
requirements under Medicare,
and the guidelines can sometimes
be confusing. Moreover, many
providers interested in retail will
set up entirely separate businesses
in order to serve a retail
customer base (and even then there
are specific Medicare guidelines
regarding referrals between the two
businesses, and similar issues) that
providers must contend with.
Don’t forget that even with
funded patients, there is retail business
to realize. For instance, COPD
patients using portable oxygen
concentrators are mobile, so think
about the items that will help them
stay mobile. Extended-life batteries
and additional batteries, as well as
additional chargers, help users stay
out of the home longer and even
travel to visit their families. Likewise,
backpacks, shoulder bags and
straps are a great way to ensure that
POC users can keep both hands free
and almost forget that they’re using
an oxygen device.
POINTS TO REMEMBER
- Even during a pandemic, oxygen providers must
still come up with ways to develop new revenues
and drive increased efficiencies.
- The market for their services keeps growing.
The number of U.S. COPD patients is expected
to grow from 26.6 million to 31.1 million over the
course of a decade.
- Providers need to get creative with their funding.
Are you reaching out to private payer insurance?
Health plans? Facilities such as SNFs? Why not?
- The retail market is still very much an important
opportunity for oxygen devices. This is particularly
true of Baby Boom clients who are willing
to pay for the exact solution they want or need
when the funding might not be there.
- Even if your oxygen business is mainly funded,
you should still pursue a caretailing blend of
funded oxygen equipment and retail accessories
To stay on top of key portable oxygen technology
trends, make sure to follow our Oxygen Solutions
David Kopf is the Publisher and Executive Editor of HME Business and DME Pharmacy magazines. Follow him on Twitter at @postacutenews.