Page 16 - HME Business, May 2017

Wound Care: Financial First Aid
take some time to heal because the blood flow is poor.
With the elderly population, the issues are similar: poor flow, plus a
propensity to wounds, but for different reasons.
“As we live longer, we develop various conditions, where maybe our circu-
lation isn’t as good,” Trumm explains. “So, venous blood flow, arterial blood flow, isn’t as good. So if we bump our leg on a corner table, or if we get real dry skin, the chances of our skin breaking open are greater. Then, it’s going take longer for the wound to heal.
“There’s some physiological things that happen to us as we age,” she adds. “We have less fatty tissue right underneath our skin, and so our skin is a little bit more frail. So therefore, there’s less fatty tissue as well, you’re going to get to the bone quicker. So, they’re at a higher risk for pressure ulcers.
“Also, as we age, our sensations decrease,” she continues. “So if we burn ourselves on the stove, or get hit, or whatever, our reaction time is a little delayed, and so more damage occurs.”
And, the bariatric population has its unique wound care issues, as well.
“I would say number one, they have more adipose tissue, or fat tissue on them, and there’s no vascularity in adipose tissue,” Trumm explains. “You have to have blood flow to get to the wound, and you’ve got to have the nutrients, the enzymes, all the co factors getting to that wound to heal it. Well if there’s fat in the way, and no vasculature — I know that sounds kind of blunt — [blood] has a hard time reaching those areas.”
Add to that a less active lifestyle typically associated with overweight conditions, and that adds to bariatric patients’ wound care needs.
“They have a harder time moving around,” she says. “Therefore, they may develop pressure ulcers easier. Because you’ve got to move around, I mean, you and I, if you’re sitting in a chair whether you know it or not, you don’t even know you’re doing it, but you’re switching positions all the time. With the overweight population they have a tendency to not move as much.”
And, like in other wound care patient groups, nutrition is an important concern for bariatric patients.
“It all comes down to blood flow and nutrition,” Trumm says. “A lot of times, they [bariatric patients] are not getting the right nutrition. They’re not getting the right protein, the right vitamins and minerals in their body, as well.”
And with that broad blend of patients comes an equally broad business
opportunity. Wound care patients need wound care equipment equipment and supplies throughout their care, and that care can last a while. Wounds can be tricky for physicians, nurses and healthcare partners such as HME providers to treat. One therapy might look like it will do the trick, but as the wound is treated, it might be determined that a better approach is available. A smart provider can strategically position itself to assist throughout that process.
“You find wound care in every setting, and it’s just not going to be one healthcare arena that you’re going to find the wounds,” Trumm explains. “Generally what happens is, if you start from the hospital as an acute care setting, patients are in the hospital and have a wound, and they’ll be going go to one of many settings. ... Whether they’re sending the patient home, or you can dig in that business. Unfortunately they might be sending the patient to a hospice, or to a hospice home or in their home, hospice care. They may be sending them for follow up to a wound care center, who may be sending them to a skilled nursing facility.”
This presents providers with multiple opportunities to become a partner and trusted resources to not just discharge planners, but a variety of care professionals.
In terms of products, Trumm points out three key categories a wound care provider can offer: dressings and bandages, therapeutic support surfaces, and negative pressure wound therapy (NPWT). These can offer points of specialization, or perhaps a spectrum of items that can support a very broad wound care business. Let’s take a deep look at a couple of them:
Closer Look: Support Surfaces
A cornerstone offering in the home medical equipment industry is support surfaces. That said, support surfaces have seen considerable change, particularly when CMS added Group 2 support surfaces to the list of categories for Round Two of competitive bidding, which caused a major market shift. This includes alternating pressure and low air loss mattresses, which make up a considerable percentage of the therapeutic surfaces being provided to patients. The population patients that need a support surface that either helps prevent or treat wounds and pressure sores is sizable.
Fortunately, Group 1 surfaces, such as non-powered mattresses and overlays, and Group 3 surfaces, which are air-fluidized surfaces, but the fact that volume of patients need Group 2 support surfaces cannot be ignored. This is where the wound care market really comes into place, because wound care is more than just Medicare. There are a variety of healthcare referral sources, health plans, facilities and private payer sources that can fund group 2 support surfaces. Providers might be working with hospitals, the Veteran’s Administration, a hospice provider, and they can be working with a range of staff, such as wound care coordinators, a wound care doctor, or a wound care nurse.
They key for a provider succeeding in such a highly diversified environment? It comes down to commitment, according to Ron Resnick, president and owner of therapeutic support surface manufacturer Blue Chip Medical Products Inc.
“Wound care is a commitment. It’s a commitment in education and training,” he says. “It’s also financial commitment. You can’t just say
we’re wound care and not carry adequate type products. You have to be committed. That’s number one. So before they [providers] even decide ‘oh, this is a great opportunity.’ They have to be committed.”
Learn More—A Lot More
FREE WOUND CARE WEBINARS
More industry intelligence is available at hme-business.com.
Free On-Demand Webinar — Wound care can put HME providers in the fast lane to increased profitability, but which is the right on-ramp for your business? Now available for free at hme-business.com/webinars, you can watch and listen to “Wound Care: Picking the Right Path,” which is avail- able at no charge thanks to sponsor McKesson Corp. Presenter Heather Trumm, BSN, RN, CWON, the director of wound care for VGM Group Inc., explains the market basics, the various wound care categories, and the payment opportunities for HME providers.
Free, Upcoming Live Webinar — VGM’s Trumm will return to HMEB’s webinar “stage,” joined by her colleague Maria Markusen, director
of Operations & Development for VGM Retail, on May 31 to discuss how providers can take their wound care businesses to the next level. Registration for this webinar is FREE thanks to sponsor McKesson Corp.
Sign up for both wound care webinars at hme-business.com/webinars.
16 HMEBusiness | May 2017 | hme-business.com
Management Solutions | Technology | Products
“One of the interesting things about our negative pressure wound therapy HMEs that we have today: most of them didn’t start in the negative pressure wound therapy business.”
— Patrick Schwab, Medela LLC