New Sleep Therapy Sales Model Pittsburgh, PA

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Sleeprider
Posts: 1562
Joined: Tue May 06, 2008 5:57 pm
Location: Murrysville, PA

New Sleep Therapy Sales Model Pittsburgh, PA

Post by Sleeprider » Thu Oct 30, 2014 7:14 pm

In the news this morning I read that our local Blue Cross/Blue Shield insurer Highmark has proposed creating a new REMWorks Sleep Store where patients can shop for equipment and supplies. This article was in the Pittsburgh Post Gazette http://www.post-gazette.com/breaking/20 ... 1410290170 this morning. If it comes about, it should be a great way to go in and see new equipment and buy what you want, as opposed to what the DME company wants to sell you to maximize profit. The sales model is interesting as Highmark is an insurer. Nevertheless, Highmark has bought a major hospital and medical provider system in the past year, West Penn Allegheny Health Systems, and is competing with the over-priced UPMC to keep costs low, and to ensure a diversified medical provider system in this region.

Highmark Health is diversifying its for-profit operations with a first-of-its-kind retail store focused on sleep apnea and other sleep problems. I'll definitely be looking into getting equipment at REMworks.
By Bill Toland / Pittsburgh Post-Gazette

With millions of Americans suffering from sleep apnea, and millions more who simply have a tough time getting their nightly eight hours, Pittsburgh health giant Highmark is betting its new “sleep store” could fill a market niche unmet by existing clinics and medial suppliers.

In December, Highmark plans to open REMWorks Sleep Store in the Homestead area’s Waterfront shopping district.

Part clinic, part spa, part retail store, part medical equipment purveyor, Highmark is casting a wide net, hoping to catch those with clinically diagnosed issues, as well as people whose habits and lifestyles — split shifts, lots of air travel, chronic insomnia, teeth grinding — make it difficult to get a good night’s sleep.

It’s not a mattress store, though, and it’s not a sleep lab, said Amy Phillips, director of the REMWorks store. She said she believes the store is the first of its kind, providing patients with durable medical equipment — continuous positive airway pressure machines, as well as CPAP masks — and over-the-counter sleep remedies and accouterments: white noise machines, specialized bedding and pillows, teas and aromatherapies.

The over-the-counter devices and remedies account for about three-quarters of the store’s stock space, Ms. Phillips said. For those with clinically diagnosed apnea issues, the store acts as both a provider — it accepts health insurance — as well as a durable medical equipment company.

But “we’re focusing only on sleep,” Ms. Phillips said. “That makes us different than other [durable medical equipment] companies.”

Durable medical equipment companies usually serve as middlemen, ordering medical devices — wheelchairs, walkers, beds, scooters — from manufacturers and supplying them to medical offices or directly to patients. Typically, they don’t open retail storefronts, particularly when it comes to sleep supplies, and manufacturers don’t like to bypass durable medical equipment companies.

One manufacturer that tried was Murrysville-based Respironics. In 2012, Philips Respironics and Kroger launched a pilot retail partnership — seven Kroger’s pharmacies in Ohio displayed and sold replacement supplies for Respironics’ CPAP devices, masks and tubing accessories.

But durable medical equipment companies didn’t like being cut out of the equation, said Edward Grandi, the former head of the American Sleep Apnea Association, and the pilot never materialized into a broader retail campaign for Respironics.

“I think there’s probably going to be some durable medical equipment people who are going to be upset,” Mr. Grandi said. “But this shows a commitment on Highmark’s part on addressing the importance of sleep … they’re taking this thing seriously.”

Others take it seriously, too, and sleep care is a crowded market. The Sleep Center of Greater Pittsburgh has 15 locations; LifeLine Center for Sleep Disorders has seven; UPMC has a sleep medicine center in Oakland; and Highmark’s own Allegheny Health Network has its own sleep medicine specialists.

The new Highmark venture may also tread on the feet of Apria Healthcare and Lincare, which both supply respiratory and oxygen therapy equipment. Both have Pittsburgh-area locations.

But challenging existing clinics and suppliers isn’t a bad thing, Mr. Grandi said, and bringing a variety of services and treatments under one roof is a novel approach.

“My sense is that if it makes [equipment] less expensive, if it improves access to therapy, then it’s a success,” he said.

The REMWorks store — which will be staffed by sleep coaches, nurses and a respiratory therapist — will be in the former UPS Store along East Waterfront Drive.

This is Highmark’s second retail location in the Waterfront; it also operates a Visionworks eyewear and vision store there.

Visionworks, a Highmark subsidiary, is a chain with 640 locations in 40 states. Might the REMWorks model be exported to other cities?

“The sky could be the limit, if this is something consumers really want,” Ms. Phillips said.

_________________
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Additional Comments: Sleepyhead software. Just changed from PRS1 BiPAP Auto DS760TS

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chunkyfrog
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Location: Nebraska--I am sworn to keep the secret of this paradise.

Re: New Sleep Therapy Sales Model Pittsburgh, PA

Post by chunkyfrog » Fri Oct 31, 2014 6:00 pm

I smell HMO.

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Sleeprider
Posts: 1562
Joined: Tue May 06, 2008 5:57 pm
Location: Murrysville, PA

Re: New Sleep Therapy Sales Model Pittsburgh, PA

Post by Sleeprider » Sat Jan 23, 2016 7:24 pm

Ms Frog, you were right! One year after posting this, I went to REMworks and provided insurance information, prescription and signed an authorization for them to pursue a new machine and supplies on my behalf. No cost, and not very high expectations. So since December 9, 2015, they apparently got an authorization for an auto CPAP. I checked with the insurer, and REMworks was not in their network. So I declined and let them know I've been using Bilevel for quiet a while, and need verification they can provide in-network services. I did meet with my doctor and went over efficacy data, and showed that RDI is significantly higher with CPAP than BPAP, and came to the conclusion "patient does not tolerate CPAP". So we'll see.

Last week I provided a renewed BiPAP prescription and forwarded it. Let's see how long until I hear back. Meanwhile I'm well equipped at my own cost so the wait is okay. I'd still like to get the benefits from our policy for a change, but am expecting the HMO/DME same old experience...will update if anything develops.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Sleepyhead software. Just changed from PRS1 BiPAP Auto DS760TS