How To Make A Profit On Your Wound Care

Transcription

1 WOUND CARE PEARLS AND REIMBURSEMENT WOUND CARE BUSINESS SURVIVAL

2 Cheryl M Bongiovanni, PhD,RVT,CWS Director, Vascular Laboratories and Wound Clinics Lake Health District Lakeview, Oregon And Lake Wound Clinic-Klamath Falls, LLC Klamath Falls, Oregon

3 Attestation Dr. Bongiovanni has nothing to disclose.

4 OUTCOMES-BASED CARE REQUIRES OUTCOMES-BASED SPENDING

5 Wound Care Provider Models Free standing, outpatient wound clinic Hospital based wound clinic Rural Health Clinic based wound care Mobile wound care providers

6 Wound Care Provider Models, continued Wound care as part of hospice care Wound care in home health care Wound care in foster care Wound care for podiatrists Wound care in Concierge practice

7 ONLY THOSE MODELS THAT PROVIDE OPTIMAL WOUND CARE AT TIGHTLY CONTROLLED COSTS WILL SURVIVE

8 Industry Status pre 11/6/12 Wound care products > $7 billion and growing at 6% annually Insurance and gov t have and are reducing wound care reimbursement levels Current modalities: Mixed results Costly Slow healing time Limited doctor-patient capacity

9 Industry Status post 11/6/12 Drastic reductions in reimbursement Outcomes-based care protocols Reduced # of providers/increased # patients Contractual payors Delayed payments Reduction in care product availability Meaningful use, EHR and HIPPA

10 Wound Care Products Replaced by Hypochlorous Acid Solution (HCA)* Acticoat 4 x 4 $18.00 ea 4 x 8 $26.85 ea Santyl (collagenase) 30 gm tube $ *Puracyn Plus Professional, Innovacyn, Inc.

11 Wound Care Products Replaced by HCA, continued Wound Vac $150.00/day + materials MediHoney (4 x 5 ) $16.86 ea Duoderm $ 5.12 ea Mepilex $ 6.13 ea SilvaSorb Hydrogel (5 gm tube) $ Puracol + Ag $ 9.60 ea Aquacel Ag $10.88 ea

12 Wound Care Products Lake Wound Clinics Avg 10 ml Puracyn Plus Professional /Tx $ 0.55 ABD pad $ 0.13 ea Coban (4 in roll) $ 1.65 ea Curasorb (alginate felt) $ 3.75 ea 4 x 4 sterile gauze pack $ 0.06 ea Hypafix (4 ) $ 0.25/ft Kerlix 4 roll $ 0.64 ea Chux $ 0.16 ea

13 Wound Care Products Lake Wound Clinics, cont Stockinette (4 ) $ 0.53/yard Unna s Boot $ 5.63 ea Xeroform (2 x 2 ) $ 0.48 ea (4 x 4 ) 0.53 ea (5 x 9 ) 0.69 ea

14 Diabetic Plantar Ulcer Care Protocol: Standard of Care Debridement Revascularization Infection Control Offloading

15 WOUND CARE ECONOMICS Plantar Ulcer CONVENTIONAL TX Avg time to heal: 233 days Avg # Treatments: 63 Avg Tx time: 25 min LWC TX Avg time to heal: 41 days Avg # Treatments: 15 Avg Tx time: 25 min

16 Avg. Cost per Treatment CONVENTIONAL TX Professional: $ 96 Clerical: $ 17 Total: $ 113 LWC TX Professional: $ 96 Clerical: $ 17 Total: $ 113

17 Avg. Material Cost per Treatment: Debridement CONVENTIONAL TX 5 gm Santyl $54.21 Hydrogel Dr $8.00 Offloading bandage $5.00 TOTAL $ LWC TX 20 ml HCA $ 1.10 Sterile Gauze + 10 ml HCA dressing $2.50 Offloading bandage $5.00 TOTAL $8.60

18 Total Cost to Heal CONVENTIONAL TX $ x 63 $ 11,353 LWC TX $ x 20 $ 2,432

19 Factors that Increase Costs Multidrug resistant infection Large wound size Malnutrition Charcot arthropathy Poor glycemic control Use of steroid medications Use of street drugs (methamphetamine)

20 Factors that Increase Costs, continued Peripheral artery disease Venous insufficiency Lymphedema Obesity Offloading noncompliance Smoking

21 FACTORS THAT INCREASE COSTS INCLUDE VIRTUALLY ANYTHING THAT WILL INCREASE THE NUMBER OF DAYS AND THE NUMBER OF TREATMENTS TO ACHIEVE COMPLETE HEALING

22 ACTIONS OF HCA Antimicrobial: Effective against multidrug resistant organisms thus drastically reducing the need for systemic antibiotics Immediately increases wound bed TcpO 2 via capillary dilation. The increase is maintained up to 48 hrs (in nonsmokers)

23 ACTIONS OF HCA, continued REDUCES MAST CELL DEGRANULATION THUS REDUCING INFLAMMATION PROVIDES SOFT DEBRIDEMENT ACCELERATES GRANULATION AND MICROVASCULAR REVASCULARIZATION

24 CONCLUSION The addition of HCA to the wound care armamentarium will greatly increase healing rates while drastically reducing costs. We have found this to be true across the spectrum of wound modalities. HCA can actually eliminate or at least reduce the effects of some of the factors contributing to increasing the costs of wound care.

25 WOUND CARE PEARLS AND REIMBURSEMENT WOUND CARE BUSINESS SURVIVAL