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birdshell wrote:If, as the ResMed representative said, experienced users know as much, if not more, about their masks and equipment than the DME providers and their representatives--

and the experienced users would be perfectly safe purchasing from an Internet vendor--while saving money--

WHY ARE THEY MAKING IT IMPOSSIBLE FOR THE EXPERIENCED USERS TO DO SO?

Aw, come on. Let's give them a chance. Some sort of sliding scale based upon user experience is surely in the works over at the Resmed braintrust. After all, since they are now in the business of artificially inflating prices for certain segments of the cpap equipment-buying population, they probably wouldn't balk at setting different price levels depending on the experience of certain individual buyers. Stay tuned...

If Resmed is so concerned about patients getting proper treatment why are they not demanding that all DMEs selling their equipment get extensive training and certification by them? So many people have come here with improper settings on their xPAPs, masks are not fit properly and some units are not even set up. Heck, give a DME an Auto and they leave the pressure wide open, not to mention that they can't set up a VPAPIII properly.

Resmed's Chairman explained on the audio posted elsewhere that Resmed wanted to defend the DME pricing structure from internet comparisons. There is a long taped discussion in response to an analyst's question. This is the reason for their attack on the internet. They do not want any harm to be done to their DME customer base. They are trusting that the little storm of criticism created by their actions will soon fade away. The internet CPAP websites are standing in the way, they will destroy it if they can, with or without their approval. They spoke of providing industry leadership. This is an obvious attempt to get the other manufactures to follow them.

Darth Vader Look wrote:It really comes across as the tail wagging the dog or in xPAP terms, Apria commanding Resmed to get in line.

Exactly.

It just seems that if one was in another company's board room, the news of ResMed cutting itself out of the sizable Internet market would cause applause, cat calls, huzzahs, etc.

It would be especially welcome among the smaller companies, one would think. However, without a business background it is hard to predict an outcome.

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CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, news

Well, I have no axe to grind with ResMed and I am all for a company being able doing what it wants to do, as long as it is willing to take the consequences. If my DME wants to provide me with a ResMed and it works for me, that's fine. If I have to buy any CPAP stuff online, I will buy what seems like the best buy for the buck, which will probably be another brand.

Just as a business consultant, however, I do have to say that I found the answers to the question about internet sales disingenous at best. If the #1 concern is patient care, then they should only sell to distributors who meet certain patient care standards set by ResMed, whether they are internet or bircks and mortar. If they really believe internet sales are a problem, then they would just not allow internet sales of their products at all.

They are obviously wanting to do selective pricing in favor of DMEs, but that doesn't make a lot of sense either. I mean, it looks like two different markets to me. People with insurance are likely to get thier machines from DMEs, where pricing is mostly the insurance companies' problem. People without insurance and people wanting second machines probably rarely get them from DMEs.

So obviously ResMed wants to cater to the insurance market. I am thinking out loud here, but I wonder if they don't want price comparisons with the insurance people. For instance, some PPO cost cutting guy could be saying ot the DMEs, "Hey, that S8 Elite you are charging us $600 for? I found it online for $500. So we're only paying $500 for it from here on out." Or the PPOs may be threatening to just let people buy out of pocket and get reimbursed. I don't know, but I think there is another angle to this whole thing. None of the arguments I've heard so far make business sense to me.

MandoJohnny wrote:but I think there is another angle to this whole thing.

I agree. I guess time will tell what is really going on!?!

Cheers,

Bill

MandoJohnny wrote:I don't know, but I think there is another angle to this whole thing. None of the arguments I've heard so far make business sense to me.

When we first learned of this issue in the Investors.com article on 6/20/06, Resmed told the public they were implementing the 40% increase on internet prices to get them in line with reimbursement rates.

Then Resmed changed their tune. They must have decided it wasn't politically correct to admit they were bowing to the pressure of the Aprias and Lincares of the world. They must have decided it sounded bad to openly admit they were artificially inflating prices for internet equipment providers to appease their biggest (and angriest) clients. They must have decided it wasn't a good thing to reveal to the public they have no backbone. They must have figured it didn't do much for their image to be raising the prices paid primarily by those individuals who can't afford insurance.

So, Resmed reworked their public relations blunder and, in the July 2006 issue of HME News, claimed the REAL REASON the 40% price increase on internet prices was being implemented was to combat low compliance. That sounds A LOT better, doesn't it? Resmed cares deeply for the patient. They contend compliance is lower if the equipment is obtained via the internet than via a brick and mortar DME.

Two problems with this theory:
1) Resmed did not have the foresight to investigate whether or not this theory was actually true. Quite an oversight on their part. The very existence of this forum is testimony to the failure of the brick and mortar DMEs in dealing with OSA patients. We came here seeking answers, suggestions, education and support; none of which our DMEs provided. Resmed has absolutely no idea of the compliance rates of patients of the brick and mortar DMEs vs. the internet DMEs. It might have been wise to research that before using it as an excuse for raising prices.
2) Resmed has absolutely no standards set for follow-up care and education from ANY provider. It's too bad they don't. Cpap.com would meet and exceed all standards, and Aprias and Lincares, et al. would be shut down all over the country for failing to do so. (We could probably eliminate the majority of them right off the bat, just by requiring them to pass a test on how to properly set up the equipment per the prescription.)

So, now Resmed is going to have to come up with another reason behind the implementation of a 40% price increase for internet equipment providers. Maybe they should just be honest and be done with it. The real reason? Greed. Pure and simple greed.

The real reason? Greed. Pure and simple greed.

Well, I hear that, but some version of greed is why any company is in business. That's a given. I just don't see how this is going to satisfy any greed. They are cutting off a whole market segment. They would still have the DME/insured segment, but even they can't be thinking that people who pay out of pocket will continue to buy thier stuff 40% higher with so much competition out there. Thier stuff was already on the high end, now it will be beyond that. So all those internet sales will go down the drain. How does that help the greed argument? That, and the fact that other providers haven't jumped on this bandwagon, is why I think there is something more we don't know about this.

Anonymous wrote:Resmed has absolutely no idea of the compliance rates of patients of the brick and mortar DMEs vs. the internet DMEs.

Does anyone?

Cheers,

Bill

MandoJohnny wrote:I don't know, but I think there is another angle to this whole thing. None of the arguments I've heard so far make business sense to me.

I've said it before and I will say it again - that I do think that the majority of the DME companies out there provide excellent service and followup. Look at the requirements to be JHACO certified. Look at the requirements to get a Respiratory Therapy Licsence.
I also think that ResMed HAS done surveys and analysis and found this to be true.
I still think what we see here is a very tiny fraction of the market.
This is not to say there aren't DME companies out there that suck. Quite clearly there are. I just honestly don't think it's as widespread as people think.
Hey, I could be wrong. I could have been amazingly lucky with the DME companies I've dealt with who all provided excellent service. It makes sense to me though.

billbolton wrote:

Anonymous wrote:Resmed has absolutely no idea of the compliance rates of patients of the brick and mortar DMEs vs. the internet DMEs.

Does anyone?

Cheers,

Bill

No. Which proves Resmed's use of this notion as a reason for raising prices for internet providers is a bunch of crap.

Anonymous wrote:No. Which proves...

Nothing at all then!

Look at the requirements to be JHACO certified. Look at the requirements to get a Respiratory Therapy Licsence.

Well, I'm sure they are impressive, but I don't think that's the root of the problem, so respectfully I have to say that argument is nearly irrelevant. My guess is that all the docs and all the DME RTs out there could technically do the job well. But if the whole medical community has learned anything in the last few decades, it is that attitude counts almost as much as technical qualifications.

My first PSG was messed up by a sleep lab tech who made me feel so uncomfortable that I couldn't sleep half the night and then he proceeded to mess up the paperwork. He obviously just didn't give a damn. I was the only study he had that night, so he wasn't overworked. My current DME RT may have passed all the tests, but he just hasn't taken the time to learn ResMed equipment very well, even though he issues mostly ResMed machines. I know more about my S8 than he does. Also, he forgets things and messes up paperwork also. I can tell he is obviously not overworked either, so he would have the time to do it right.

I deal with this as a management consultant all the time, working with highly technical clients. Technical competence is a prerequisite, a "learner's permit" if you will. It is where the job starts, not where it ends.

there is so much misinformation regarding this topic! In fact, there is so much that I can't even respond.

We will NEVER, again, NEVER reach the day where a newly-diagnosed CPAP patient will be told by his doctor to "go on the internet and order your supplies." The very notion of this is, frankly, laughable. Just because, admittedly, many of you had a sub-standard experience at your DME you are ready to broad-brush them all as a bunch of money-hungry idiots.

What internet retailers do is simply buy and resell. They are clever and they will always find a market doing this---anyone would who gets the opportunity to erode a historically-proven distribution line.

I wonder how 'greedy' you'd call johnny if he rose his prices just to want to make more money. God knows, there's room to. Maybe the DMEs aren't as dumb as you think.

P.S. Resmed's decision to raise prices has nothing to do with 'greed'--did you folks take Economics? The prices they charge the internet folks STAYS THE SAME!