DMEs Take a Swing at CPAP Internet Retailing - Please help!

MaskedMechanic wrote:This does not bode well for the future of patient care IMHO.

Agreed. Internet retailers must be nipping at their heels just enough to have spurred them into action.

This is worrisome too:
Are industry manufacturers doing enough to make sure Internet retailers of HME provide sufficient service and follow-up after an initial sale?
They are clearly trying to get the manufacturers involved in their little quest, again under the guise that patient care is insufficient as compared to the DMEs/HMEs. It's laughable. Or should I say, if it weren't such a serious threat, it would be laughable.

Since this won't be published:

The HME Manufacturers should spend their time and effort in making products that meet the needs of the end consumer, They should help that consumer to monitor his progress with treatment. The normal DME provider, not the Internet storefront, do a poor job of meeting the consumers needs.

Most decide the equipment you get, based on what needs to move off the shelf and the amount of profit, not what would do the patient the best job.

I was lucky, I went to the DME, uninformed, I was treated as most, 2 weeks of constant phone tag, to get equiptment between the Dr. and DME, being told lies to get me off the phone.

I got lucky, my Remstar Pro 2 with C-Flex, was a fine machine, as it allows me to track my daily data and control my treatment. The Dr. has no idea of how I'm doing, as neither he or the DME, can read my Smartcard, but I can. I live in a city of 80,000 and I am probably the only one with Apnea, that know what his treatment is doing for him and how to reset the pressure for the best results, BTW, AHI under 1.3 @ 8 hours compliance nightly AVG)

If I had been a informed consumer before hand, I would have bought from a internet store, they couldn't have done me any worse, I think you need to clean up your own house, before you take on other sellers of medical equiptment.

I am sure this comment won't make you August Issue, after all who wants to here the truth. Jim B (Goofproof)

LOL Local DME's trying to protect their LICENSE to STEAL!!

They are worse than doctors.

[quote="angry guest"]Who the hell do these people think they are?

They create an industry so bad that online dealers like cpap.com can do a better job from 3000 miles away than they can from next door and THEN then tell those dealers that standards need to be put into place. If there was any justice in the world they would HIRE johnny to consult for the industry and tell them how to clean up their act. Then again, they probably don't want to hear "just have your patients buy from cpap.com"

If this does happen, it will mean higher prices or no internet options at all - won't it? I don't want to go back and buy a CPAP mask for $300.

Angry Guest

MaskedMechanic wrote: Somebody big is behind this. It is a first step against the internet retailers and their customers. It is important that we do a good job of presenting our position in the survey.

Right. No childish DME bashing, tempting though it may be. So before I send them my comments, let me get it out of my system here:

BEWARE THE EVIL DME! .

I saw that survey. I think there is pressure being put on the manufactures from the national DMEs - Lincare and Apria. I don't know this. It's just a feeling.

Personally, I think there is plenty of room for both Internet retailers and DMEs. If a DME does their job right, there are advantages to using them. If they don't, then they don't deserve the business. That's how it should be!

I am concerned about how restrictive our government is getting. Pretty soon they may even be regulating the food we eat.

Here's an excerpt from an interesting article in the same publication:

Whether consumers' heavier fiscal responsibility translates to opportunities for HME providers is up for debate. On one hand, it means consumers will truly become health- care shoppers and view products more as merchandise than entitlements. On the other, the prime HME demographic is the elderly Medicare population that's more likely to opt for conventional coverage that pays for basic equipment.

Still, the consumerism trend will inexorably continue and expand, a development that HME providers should embrace, said retail expert Jack Evans.

"The message being sent to the public is that they have a choice in their home care, here's what insurance covers and here's what people should dig into their pockets for," said Evans, president of Malibu, Calif.-based Global Media Marketing. "There is a phenomenal growth trend of people wanting better products and willing to pay the difference. They're forgoing the reimbursable product for the upgrade."

Joe Lewarski agrees that consumerism will be a force in the future and that the HME industry is already starting to feel its effects.

"Look at diabetic supplies, for instance," said Lewarski, vice president of clinical and government affairs for Santa Barbara, Calif.-based Inogen. "I think sleep therapy is also primed for consumer influence--there are too many products and too much conflict between what physicians and patients want and what the payer will cover."

A system that gives consumers more control over their expenditures will also help them understand the true costs associated with health care, Lewarski added.

To be sure, the primary intent of consumer-directed health care is to correlate costs and utilization for the public, said Patrick Dunne, founder of Anaheim, Calif.-based Healthcare Productions.

"The basic premise is to make costs transparent so consumers can make the most appropriate choice according to their financial obligation," said Dunne, who has been documenting the trend. "Full disclosure of the convoluted billing process is a long time coming."

Still, some wonder whether consumerism will have a discernable impact on HME. Though he acknowledges the trend's ramifications for the acute care sector, Lou Slangen isn't convinced it will change the homecare system.

"For the immediate future at least, HME will be primarily driven by the payer," said Slangen, director of sales and marketing for Elyria, Ohio-based Invacare. "Will it make a difference 10 years from now? We'll cross that bridge when we come to it."

These HME people need to get a clue. How 'bout if the HME manufacturers work on setting standards for the crappy local HME retailers before they go after the good Online retailers? Do these local HME folks really think they are doing a superior job??? What a joke!

Once again, they are working hard to earn their "EVIL DME" moniker.

OY OY OY... a laughable survey. My suggestion was the HMEs need to do more to check up traditional DMEs.

Why don't we start a survey to check on the level and quality of service received from the traditional DMEs????

DME_Guy wrote:I think there is pressure being put on the manufactures from the national DMEs - Lincare and Apria. I don't know this. It's just a feeling.

Probably a good bet. Lincare just paid a $526,000 settlement for overbilling Medicare in Massachusetts. Not to mention the $10 million settlement they paid in May for giving kickbacks to physicians in exchange for referrals in Florida.

They need to do something to keep the money rolling in....

I replied to the survey as well. Basically my comments were to let the customer decide. If the Internet retailer doesn't provide "enough service" the customer won't give them repeat business. Unlike some of the brick-and-mortar DMEs, none of the Internet retailers are the only supplier insurance will approve (as far as I know).

By the way, why aren't the Internet retailers called online DMEs? Aren't they DMEs as well? Or is that done so that the Internet providers will seem to be less than the brick-and-mortar providers? Of course, with the reputations of many of the DMEs, maybe places like cpap.com are better off not being called DMEs.

Could DME manufacturers put in minimum internet resell prices?

Thanks for sharing the survey, Johnny.

I haven't been on in awhile, and saw this posting. I went and added my 2 cents to the survey - here are my comments:

"The requirement to ensure adequate care belongs to an individual's physician, in partnership with the patient. Whether patients get their equipment from an internet provider or a local DME should not be the issue - the care and service, regardless of source, is the key.
In my experience, the local DME provided less service than the online retailer. Follow-up only occurred when they could sell a new mask through insurance - not when the patient needed assistance."

Don't know if it will do any good - but it's worth a try! We are pushing people to be better healthcare consumers, to take on more cost and responsibility. Well, then give us the authority as well!

Thanks again Johnny!

I answered the survey as well. Here were my comments:

It is not the manufacturer's job to "police" internet sales or to "protect" brick and mortar providers. Do manufacturer's do enough to ensure that brick and mortar providers follow up after the sale? The manufacturer should concentrate on manufacturing the best product for patient care!

For the record, when I went to my DME, the first paperwork they had me fill out was financial questionaire. If your insurance doesn't cover your DME needs, how much could you afford to pay on a monthly basis... Then, mind you I had never seen an XPAP device other than at my sleep study, I seemed to know more about the device than the RT I came back twice and then waited an hour to see.

If this wasn't enough, the first mask I got was a medium ff, the RTs "guess" at what would fit me. After struggling with it for a while and then finding the sizing guide on cpap.com, I realized I really needed a small. So I went back and requested a small which I got without question. Only it was a small in a different brand. So, It still didn't fit. I finally ordered a small in the original brand from the internet.

Guess how many times I have been called by my DME in my first month of service (I use the term "service" tongue in cheek)? If you guessed zero, you were wrong. The first machine they gave me was a loaner, which they needed back so they called to swap it out. Then the billing department called because they didn't have my DOB for insurance. But don't feel bad for guessing wrong, because if you were thinking followup to see how things are going zero would be the right answer.

Sorry for venting! But when someone has the idea that defeating a free market improves service it just irritates me. The way to improving service is to level the playing field. I should be able to choose where to purchase my equipment. Insurance shouldn't dictate where I can go any more than they dictate where I can take my pharmacy prescriptions.

I used 2 differnet local DME referred to me my my ins. companies. Both were horrible. One put me ina mdeium mask which was much too big leading me to misery for 1st 6 months; the second one wouldn't give me a CFlex machine like the first one did because " the Dr. didn;t prescribe it" which translated means they were only getting paid a set amount regardless of how good or bad of a machine they stuck me with.
3 months later, I ordered a Respironics Auto with CFlex and heated humidifier and software from CPAP.COM and paid for it myself. I paid about $1000; the local DME would have charged me over $2000 for this same equipment and WOULD NOT have given me any support at all. It's shocking how bad they are; don;t return calls, quote ridiculous prices to buy out your existing equipment, call and ask you to bring in equipment to check it out, then do nothing, never offer to replace masks, etc........If I ran my business like they do, I would be out of business. These devices, I believe, could be made very cheaply in China and sold very cheaply, but they are protecting their turf against internet dealers and others. Internet retail like cpap.com is the way of the future and no one will be able to stop it; they can hinder it, but not for long. I'm just thankful the local DME were so bad, forcing me to look online and find this forum and cpap.com!