Look at these price increases!

[Guest]

One thing most of us agree on though, this is NOT about patient care or compliance! It is about profit and nothing more. They certainly have the right to maximize profits (and even the obligation) so long as they do it ethically and legally (and this is borderline at best). Just don't lie to me and tell me its for my own good.

If they want to improve service and compliance, set policies that will result in these goals. Here are some examples of policies I would love to see. But I'm sure that the DMEs would find a way to mess this up too.

1. Make it mandatory for the dispenser to complete a followup questionaire with the patient after some number of days. This would provide the DME and the manufacturer valuable market research and give the patient an opportunity to discuss problems they are having.

2. Require that all RTs dispensing their equipment actually be trained IN DETAIL on the functions, configuration, and patient demonstration of their specific equipment.

3. Require that all dispensing DMEs offer a 2 week follow-up to read data from the equipment to determine that things are functioning as expected. For instance, is the average leak rate within the tolerance level for the particular mask? Are there any large leaks? Are there numerous leaks?

4. Respond to E-Mail sent to their public relations e-mail address whether it be positive or negative.

5. Require that dispensing DMEs provide a 24 hour hot-line for therapy related problems.

Any or all of these policies could positively impact patient care. I predict you won't see any of them implemented because DMEs don't get paid any extra for providing service or caring. They get paid UCR charges for product codes nothing more. I like others here advocate separate billing for RT time. But not while they still charge extremely over inflated rates for equipment.

2) I'm certainly no expert in this field, and it would be interesting to see Johnny Goodman's take on all this, but I suspect he is somewhat constrained in what he can say publicly ...

I agree it would be interesting to hear his take on it but, as you suggest, I'm sure he must choose his words carefully. There may even be contractual requirements regarding what he can say publicly.

I really hope that the insurance companies and the government wake up and put ResMed on notice! However, I live in the real world and fully expect that ResMed will get away with this, at least initially. However, as I also suggested in another thread, I believe that ResMed's market share may already be decreasing, and definitely so in the "informed and educated" market.

[snork1]

As always, I am fascinated about how this works.....

DME's complain about how little they ACTUALLY get paid by insurance companies even though they submit a huge bill. i.e. they submit $240 and get back $61. So the claim goes.

BUT, if someone WITHOUT INSURANCE buys that same item that the insurance company is only paying $61 for, the PERSON will be expected to pay the full $240 price now, if I understand where this is all going.

And this is a fair business practice......how?

Maybe I can "buy" durable medical equipment the same way insurance companies do and only pay part of the bill. haha.

Regarding "price fixing", I think the concept of that being "illegal" is for all practical purposes out the window in our so called Capitalist society. Have you seen a authentic Apple Ipod "discounted" more than $2 from its overinflated MSRP? fer instance.

[Snoredog]

[quote="snork1"]As always, I am fascinated about how this works.....

DME's complain about how little they ACTUALLY get paid by insurance companies even though they submit a huge bill. i.e. they submit $240 and get back $61. So the claim goes.

BUT, if someone WITHOUT INSURANCE buys that same item that the insurance company is only paying $61 for, the PERSON will be expected to pay the full $240 price now, if I understand where this is all going.

And this is a fair business practice......how?

Maybe I can "buy" durable medical equipment the same way insurance companies do and only pay part of the bill. haha.

Regarding "price fixing", I think the concept of that being "illegal" is for all practical purposes out the window in our so called Capitalist society. Have you seen a authentic Apple Ipod "discounted" more than $2 from its overinflated MSRP? fer instance.

[snork1]

[quote="Snoredog"]
well said snork. I get a tear in my eye every time I hear of DME troubles

So much so I just ordered a Hybrid mask to replace my UMFF to express my gratitude.

Did you finally give up on that tongue thingee?

[wabmorgan]

If Resmed wants this pricing scheme to work they better hope that other CPAP manufacturers follow suit, for if they don't... the only thing Resmed has really done is cut their own throat.

[NightHawkeye]

. . . and I think I actually get better sleep with it than with CPAP . . .

Snork1, since you have an oximeter, I assume that you've measured how well your oxygen saturation is maintained using the dental devices. Do they work as well as CPAP does for you? do they work better? or are you among the many for whom dental devices are not as effective?

Regards,
Bill

[NightHawkeye]

If Resmed wants this pricing scheme to work they better hope that other CPAP manufacturers follow suit, for if they don't... the only thing Resmed has really done is cut their own throat.

The way the airlines worked their price [fixing] model was whenever one raised fares, the others would usually immediately join in. Sometimes, although not very often, not all followed suit. After a week or two, those that had raised fares would then back off the increases. The way the airlines worked things at least had a minimal appearance of competitive pricing.

It may be that ResMed is simply testing the waters to see how far others are willing to go. My guess though is that ResMed has not taken this action unilaterally. I suspect they have knowledge that at least some of the other manufacturers will be willing to go along with the internet price increases. If not, ResMed will certainly "cut their own throat" as you say, and that would be exceptionally stupid, even as bad business decisions go.

It will be interesting to see how this plays out. Long term, the forces seem overwhelmingly allied against ResMed, but in the short term anything could happen. Who knows what pressures are being applied at the various manufacturers.

Regards,
Bill

[snork1]

. . . and I think I actually get better sleep with it than with CPAP . . .

Snork1, since you have an oximeter, I assume that you've measured how well your oxygen saturation is maintained using the dental devices. Do they work as well as CPAP does for you? do they work better? or are you among the many for whom dental devices are not as effective?

Regards,
Bill

[GUEST 123]

The only thing people do on this website is complain. If they were the ones that had to run a million dollar corporation and decided to make more money they would be as happy as can be. So all this sad sobbing about the price increase and how its insurance fraud and price fixing is junk. First, the insurance companies will only pay what they want, they can just deny the claim. How is raising prices insurance fraud? Second price fixing, ha, raising prices to meet demand is not illegal, its the smart thing to do. Look at classic cars- the more demand- the higher the price. Look at that. And almost everyone in America has the opportunity to get 1 form of insurance or another, so stop feeling bad for cash pay patients. Also the DME companies make there money from the machine, not the disposable equipment. Don't be mad at them, be mad at the insurance companies for making it their policy to pay so much.

[roztom]

There is more to the Corp balance sheet. when Resmed raises prices and an Insurance Co only pays a fixed, under retail amount, can't Resmed aggregate that and create a paper loss?

Can't they use the numbers to offset income generated elsewhere?

COnsider how much of their business is Insurance based vs. COnsumer generated. I bet the direct purchase market is still a small percentage of the overall mkt and Resmed is looking at how they can maximize net $.

Are they wrong to do it? Not really. Is it morally right? That's a different issue.

As consumers we can vote with our dollars. Also, we will have to let our Doc's know that we want a different manufacturer. Consider those consumers who don't know any better. Consider those with high deductible insurance's.

It is offensive that Resmed is doing this. They must see their products as commodities. With all the publicity OSA has gotten lately and the aging of the population they see their market expanding.

Expanding market means more demand and since they are prescribed more often than others - they have the market edge, at least for now.

I assume they are a public company, if so they have a market Cap of at least 10, maybe much higher. This means that every $1 in net profit relates to appx $10 in stock value. If they bump their net then they will end up 2006 with great performance. Think of those executives who will get to exercise their stock options when the stock pops up with the higher net

Short term it will bump the numbers and the stock price - longterm it could cost them market share and down the road erode the stocks value. It really depends on how the market responds and that may take some time before it shows up.

Best,

Tom

[Sleepy-in-AL]

Hi to all. I work for a dme company and I am cpap user (Pro 2 cpap and a comfort select mask)....
If a dme wants to be Jcaho certified, which th emajority now do, those things you listed are required anytime a new patient is setup.More and more insurance companies are also now requiring certification before they will bring a company on as a covered supplier.
...
From seeing the dme side now, I would always now tell someone to go with a privately owned local company whenever possible. The difference in service is amazing, at least in my experience!

snoozer

If they are "required," they aren't enforced. This might be an interesting poll. I think maybe I'll start a poll. I know that my DME has not followed up with me at all and the RT seemed to know less about the equipment than I did. My "introduction" to BiPAP was a joke. It was mostly heres a stack of papers and heres the on/off switch.

The only thing people do on this website is complain. If they were the ones...

Theres alot more going on here than complaining. Try reading some of the other threads. There is lots of helpful information being exchanged and support being provided. Some of the support that should be provided by the DMEs that so many complain about.

As for the price fixing / insurance fraud point. They aren't raising prices to meet demand, they are enforcing a minimal fixed price with the expressed intent to maintain artificially inflated insurance payments.

With regards to whether people have insurance or not, I think this is a moot point. Most of the people who are compliant with their therapy end up paying out of pocket for at least some supplies.

There is more to the Corp balance sheet. when Resmed raises prices and an Insurance Co only pays a fixed, under retail amount, can't Resmed aggregate that and create a paper loss?

Can't they use the numbers to offset income generated elsewhere?
.....

ResMed doesn't get paid directly by insurance companies. They manufacture and sell to DMEs who sell to patients, some of which have insurance that pays. As I understand the intended policy, ResMed is not raising the wholesale prices of their machines, but enforcing a minimum sale price.

[rested gal]

As I understand the intended policy, ResMed is not raising the wholesale prices of their machines, but enforcing a minimum sale price.

Thank you, Sleepy-in-AL. That's the way I understand it, too....that ResMed is implementing a minimum sale price in order to force INTERNET sellers of their products to put the same high price tag on ResMed machines and masks as what the bricks and mortar DMEs charge. If an internet store does not go along with ResMed's policy, ResMed will not let that internet store have ResMed products to sell.

Fortunately there are other manufacturers of machines and masks every bit as good or better than ResMed products. We can only hope the others don't follow ResMed's agressive protectionism of their biggest customers -- the bricks and mortar DME stores. Uninsured end users will suffer the most if all the cpap manufacturers go the route ResMed has chosen.

[Darth Vader Look]

I agree. What I read from that article was that Resmed is telling the internet stores to up the price to current DME levels. The only conclusion I can draw is that Resmed has been beat up by the evil DME and we end up having to pay for it. .

[Jim Eads]

[quote="roztom"]There is more to the Corp balance sheet. when Resmed raises prices and an Insurance Co only pays a fixed, under retail amount, can't Resmed aggregate that and create a paper loss?

[Parts omitted]

Best,

Tom

[Guest]

Um....

Don't you think that sooner or later Insurance companies are going to come on here, see what CPAPs, etc., are being sold for on the internet, then significantly LOWER their reimbursements across the board to ALL DMEs?????