PROGRESSIVE MEDICAL

Contact: Melanie P. Arledge
760-448-4448
www.progressivemed.org

Progressive Medical
Using Technology to Boost Crucial Compliance Rate

The criteria and guidelines in the treatment of Sleep Disordered Breathing (SDB) have finally been dragged into the 22nd Century, albeit kicking and screaming. What does this mean to the companies who don't have a solid compliance program in place? Increased cost, decreased revenue!

In yester-year Home Medical Equipment Companies (HME's) relied upon the patient's word as to how they felt and how many hours a night they used therapy. Hour meters were the next best thing in the progression, however, this advancement wasn't full proof either, patient's realized they could just run the motor without utilizing the therapy, just give the reading to the HME of hours used. Therefore left untreated, the patient's disease process continued in a downward spiral but the HME's were reimbursed by the Carriers. HME's cost were minimal; the PAP's were simple blowers, the overhead to the company was low do to the fact they could staff unskilled employees. Compliance rates were also low; approximately 30-40% of patients actually utilized therapy.

Only within the last 7 years have companies had the luxury of utilizing smarter PAP devices that are downloadable. Of course these devices were more expensive leaving the HME's to absorb the cost while at the same time reimbursement from the Carriers decreased. Along with the improvement of technology came the need for skilled employees to decipher the information. Did compliance improve with these advancements? Not necessarily. Sure we had the ability to extract the data whether it was the "law of averages" or "real-time", the information was forwarded to the carriers to prove compliance for reimbursement but efficacy was lacking. With the advancement in technology and the increased cost of skilled employees, Compliance rates only increased slightly; 40-45%.

Progressive Medical's compliance rate is one of the highest in the industry; 90% and higher. How do we achieve this? Through education and efficacy of therapy. It isn't enough to absorb the cost of more expensive PAP devices and skilled employees, the patient must be educated on their disorder and the physiological ramifications of untreated Sleep Disordered Breathing (SDB). We have an extremely tight program starting with the initial order and intake. There is no need to worry about compliance, it is a given, when we empower the patient with knowledge! Not only are our employees skilled and registered in their field, they are investigators who are trained to discover what isn't readily addressed through little to no pertinent medical history. No stone is left unturned, we insist on significant others being present at the initial appointment to gather information that the patient is usually unaware of. If the Sleep Study was performed by an outside entity, the pressures are verified through the current technology of "real time" downloads. If the pressure isn't effective, Progressive Medical requests the ability to re-titrate the patient to find the appropriate pressure and device needed from the referring physician. Post discovery the physician is notified of the findings, the patient is set on effective therapy and our tight follow up program is implemented.

The new AASM recommendations commencing July 1, 2009, state patient compliance must be proven quarterly in the first year and then annually. This has not been an Industry Standard and many HME's and Sleep Labs are going to be left holding the bag of denied claims. The answer to the HME's who want to succeed with the new stringent guidelines need to follow suit. While this might seem to be a hardship to companies not set up to handle the new criteria, it is a tremendous benefit to the patient and further down the line, the HME. Having knowledgeable staff trained to meet the individual needs of a patient and empower them to make a positive impact in their own lives by taking ownership through education and effective treatment, compliance isn't an issue. Healthy living becomes the patient's lifestyle and compliance is a given. Therefore the improvement in technology utilized to prove compliance is worth its weight in gold to the HME. The new AASM recommendation opens the door wider for Savvy HMEs to become in-valuable to their local Sleep Labs by assisting the Lab with an effective follow-up program. It is essential for the Accredited Sleep Lab to meet the following criteria; patients initiated on PAP therapy must have objective data from the device in an effort to trend patterns and remediate problems. Again at the 12th week of use and quarterly thereafter for the first year.

Melanie P. Arledge, Progressive Medical