As providers look to broaden their revenues, one category that offers a good mix of funded and retail revenue is wound care. That said, some providers might have a little trepidation entering that category of care — but they shouldn’t.
Here’s a quick outline of what providers need to consider as they explore wound care services:
Products
Many referral partners want a provider that can serve up a full product line. So, one of the first things providers should do is squelch any fears of the new and start familiarizing themselves with the sorts of products they can offer. Some of the key wound care products that providers can offer:
- NPWT, which uses a sealed bandage and a vacuum pump to draw fluid away from the wound and draw blood to the area to promote healing. (She describes this as the cornerstone of a full-line wound care business.)
- Therapeutic support surfaces.
- Enteral nutrition to deliver proper nutrition for healing.
- Compression therapy.
- Bariatric products, because many wound care patients are bariatric.
- Standard dressings.
Many referral sources specializing in wound care are very knowledgeable in many wound care products, and having to deal with multiple providers can frustrate their efforts to provide seamless care, so having a DME that carries multiple lines decreases the contact points for that referral and solidifies the provider’s value to that wound care doctor or nurse.
Referral Partners
And when it comes to referrals, a key referral partner in addition to hospitals and physicians is wound care centers. These centers often server diabetic patients, people with pressure ulcers and other patients that need treatment. Also orthopedic facilities are another source.
Working with referral partners in wound care is just like other aspects of HME: it comes down to relationships. Providers should develope solid bonds with the local wound care center and work closely with its doctors and nurses to ensure it is a trusted partner in the patient’s care.
Reimbursement and Payors
In terms of getting paid, obviously, Medicare is an important funding source, but it isn’t the only one. Also, in addition to competitive bidding’s impact on NPWT, it is important to note that Medicare has cut back on reimbursement for other wound care supplies, and has limited coverage in recent years.
Private payor insurance, such as Blue Cross Blue Shield and others, is another solid source of funding, but it is important to note that most carriers follow Medicare guidelines when it comes to wound care, Stockham says.
And, of course there is retail sales, as well. There are patients who will purchase additional dressings and other wound care supplies out of pocket because either Medicare or their private carrier will not fund everything they need. Also, some patients might want more than what is covered just for good measure.
Working With Family, Caregivers
Because staff can’t be in the home 24/7, a key element in its wound care support is coordinating with caregivers and family. An ideal time for this is when a nurse or other referral partner or patient calls upon his business to address a support surface or seating need. Consider performing patient evaluations and home evaluations to get a sense of a patient’s full care scenario. That process could uncover skin issues, diet, seating problems, sleeping issues and anything that could impact healing.
In terms of education, some key elements in instructing patients and caregivers regarding wound care is helping them understand the various factors related to the causes and treatments of wounds. Some prime examples:
- Diagnosis — The patient has met with other healthcare professionals and has specific, prescribed needs. This will obviously dictate what the provider teaches them.
- Incontinence — This is an issue that is experienced by various patient groups, and when incontinence is not addressed properly, it can lead to sores.
- Nutrition — Many patients do not heal properly because they are not eating the right goods and getting the proper vitamins.
- Hypoxia — In the same way they need good nutrition, wounds need to get properly oxygenated in order to heal properly.
- Where are patients sleeping? — Many patients wind up sleeping in places that aren’t ideal situations in terms of pressure relief. Dozing in lift chairs is a good example, he says.
- On what is the patient sitting? — Obviously this is a key concern for mobility patients, because the wrong seating surface can combine the pressure, moisture and heat that leads to a pressure sore.
Ultimately the key in a patient education and home survey program is to review and ask lots of questions.
Gaining, Using Expertise
Like a lot of aspects of HME, the key in ensuring successful patient and partner relationships for wound care lies in establishing expertise when it comes to the products and treatment options available. The provider needs to have people that can talk intelligently about the variables that are involved in skin management.
So where do providers start to gain this product and care knowledge? A great place to start is with training from the manufacturers of wound care products.
Then, as the level of complexity of wound care services increases, providers can take on more clinical expertise. For instance, once a provider starts offering NPWT, it will probably awn to get someone on board with some clinical expertise in that area.
There are a few credentials available for wound care nursing that would benefit a provider looking to specialize in wound care: Certified Wound, Ostomy and Continence Nurse (labeled CWOCN or WOCN); Certified Wound Specialist (CWS); and Wound Care Certified (WCC). Having that expertise will build strong bridges with referrals, optimize patient outcomes, and expand the provider’s business.
