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Reality check: Why HBOT may not deliver the benefits you expect

March 26, 2018

    Wound care was historically viewed as just a necessary component of care—not a service that planners sought to grow intentionally—but it has recently emerged as a strategic priority for many hospitals. With that, we're getting more questions than ever on how to capture wound care demand, and how to think about the new, and sometimes flashy, technologies associated with the specialty.

    For some, investing in advanced technologies such as hyperbaric oxygen therapy (HBOT) can be an alluring option to grow wound care services. The treatment, which involves patients immersed in an oxygen chamber to speed up healing, has a futuristic quality that appeals to patients and practitioners alike. Planners are drawn to the offering for its potential to improve clinical efficacy, increase volumes, and build revenue. However, it's important to truly consider the real magnitude of change an HBOT investment is likely to produce. Here, we've dispelled some of the common misperceptions about the true benefit of an HBOT investment:

    Expected benefit: Significantly improved clinical outcomes

    Reality: HBOT is rarely the most important factor in successful wound healing

    Several studies have shown that HBOT is effective in treating common wounds such as diabetic ulcers. However, according to our research, these results are not significantly better than those of more common wound care treatments, particularly for less complex wounds, like pressure ulcers. Nonclinical factors, such as patient education and care plan adherence, are more important to ensuring good patient outcomes.

    Expected benefit: Increased volumes

    Reality: Greater number of wound care programs with HBOT reduces differentiation potential

    HBOT is often touted as an innovative technology, and hospitals frequently market this offering on their websites. But in recent years, more hospitals have begun offering the technology, making it less of a unique differentiator. As HBOT offerings become more common, they're less likely to boost your reputation and lead to higher volumes.

    Expected benefit: Boosted revenue

    Reality: Increased regulatory scrutiny could curb HBOT profitability

    In 2015, Medicare cut reimbursement for HBOT procedures and imposed preauthorization requirements for HBOT in three states—Michigan, Illinois, and New Jersey. These preauthorization requirements caused HBOT volumes to fall in these three states. As of 2018, more than 10 additional states are under CMS scrutiny for HBOT misuse and overbilling, meaning more payment restrictions could be on the horizon. If preauthorization and payment scrutiny continue, planners might see a lower return on investment than expected, especially given the high cost of HBOT equipment.

    It's not all bad: Third-party vendors can make HBOT reasonable

    In spite of these realities, a HBOT investment can be reasonable if planners carefully weigh market demand and options for investment. For example, third-party management services offer equipment rental, staffing, and billing services for HBOT. Management companies increasingly offer these services "a la carte," allowing providers to minimize costs while still getting the services they need. Overall, while wound care is rising in strategic importance, planners must consider the realistic benefits and costs of HBOT for their program in order to take full advantage of this growing opportunity.

    3 imperatives for sustainable delivery of wound care

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