Page 40 - HME Business, March/April 2021

Business Solutions
“If you think about the future of the U.S. healthcare system being value-based connected care in the home — which I think it is — the HME sector really is
the last mile infrastructure needed to provide for that future healthcare system design. ”
— Gary Sheehan, MBA, Spiro Health
HMEB: What about HME as a whole? Sheehan: There are certain pieces of our business that we’re operating at normal levels and some somewhat significantly above normal levels. If you think about home oxygen as a real means to bridge patients from the acute environment and into a COVID recovery in the home. As we saw, home ventilation solutions were deployed, especially at the beginning,
to assist with integrated health care sys- tems’ response to the recovery verall.
So I think HME broadly played a sig- nificant and substantial role in combating the COVID-19 pandemic in serving as
a relief valve for integrated healthcare systems, if you will, to get more patients out of a more acute setting and into the home as a more of a stable resting and recovery environment.
The other piece of our business is our orthopedic bracing business that runs through a lot of emergency departments, and that has continued to struggle.
I think it’s safe to say that folks with sprains and strains have been avoiding the acute care environment as much as possible. So maybe you’re resting and icing something that otherwise during a pre-pandemic timeline, you would have been seeking active treatment for.
So we’ve seen various puts and takes across the product categories, but overall we’re really happy with the re- sponse that our team members provided throughout the pandemic. But more broadly, the HME sector overall, did re- ally critical and significant work through- out COVID-19 that I think is starting to reshape and reset the healthcare system at large. Especially as our healthcare sys- tem’s view of what we do, how we do it, and the value our industry provides and serves across the healthcare continuum overall.
HMEB: When it comes to the respira- tory side, we really even saw some acute care happening with supplemen- tary oxygen in the home setting, right? Sheehan: The whole “hospital at home” movement has been plodding along for a number of years now. As many technolo- gists and strategists have said, COVID ultimately pulled forward a lot of trends and accelerated a lot of trends that were already happening in the marketplace. That goes for healthcare and beyond.
So, the idea that you can deliver more acute care in a home environment where safety capacity became paramount issues in a way that they’d never had historically, is absolutely part of the re- sponse. As I’ve said many times recently, if you think about the future of the U.S. healthcare system being value-based connected care in the home — which I think it is — the HME sector really is the last mile infrastructure needed to provide for that future healthcare system design.
I think that’s been proven out over the last 12, 13 months through the pandemic, and will continue on from here as more decision-makers from across healthcare have seen what companies like ours can do, and get excited about deploying new solutions that are patient preferred, lower cost, and ultimately safer and more conducive to recovery and management of chronic conditions in the home.
HMEB: Getting back to sleep, where would you say sleep therapy providers are at present in regard to COVID-19? Sheehan: Yes, I think it’s very local in nature — all healthcare is local at the end of the day. So it depends where
you are. What are the state restrictions that are in place? What are the caseload volumes that are in place? Also, we are at the whim essentially of the diagnostic
channel. So to the extent the diagnostic channel is up and functioning and hum- ming, you’re probably doing really well. In other areas where it’s not, or it’s just reopening, there’s going to be a little bit of a lag effect.
In terms of volume, on balance, what I’ve heard is we are at, call it 85 percent of pre-pandemic levels. Could be a little bit higher in certain places, a little bit lower in others, but I think you’re in the mid
80 percent to 90 percent in terms of pre pandemic volume and that will continue to restore and recover. Again, it could be some at above usual volume as things reopen and patients who delayed or deferred diagnoses go ahead and enter in and receive those diagnoses.
HMEB: Do you think that the market demand — this bolus you mentioned earlier — might overwhelm sleep providers in some case or do you think everybody’s ready for it?
Sheehan: I think providers are ready. In a market where it’s more controlled by lab-based testing, there’s a real capac- ity issue, right? There are only so many beds. To the extent that that folks have not adopted home sleep testing (HST) as a more patient-preferred, scalable method of diagnosis, there’s going to be some constriction.
But certainly I think the HME market is ready, willing, and able to scale aggres- sively as patients have ultimately what is needed from a diagnostic point of view and a coverage point of view, right? It’s one thing to have an HST. Getting the accompanying documents and prescrip- tions that are required to bill insurance, it can be another matter altogether.
If volume was down in the 50 percent to 60 percent of normal range for a
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“The HME market is ready, willing, and able to scale aggressively as patients have ultimately what is needed from a diagnostic point of view and a coverage point of view.”
— Gary Sheehan, MBA, Spiro Health