Durable Medical Equipment: What Determines Cost is ...

Patient healthcare costs are a top concern for both patients and healthcare organizations. A   survey by the Kaiser Family Foundation  showed that almost a third of the U.S. population has forgone needed medical care due to cost concerns, and more than a quarter of patients find it difficult to pay their medical bills.

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Consumers have been given the message that shopping around when seeking healthcare is a good way to save money, and that's generally true. But when it comes to durable medical equipment (DME) such as wheelchairs, walkers, oxygen tanks, and infusion pumps, there is more to the picture.

Patients may think that some DME providers have better prices than others, but the truth is that DME pricing is often relatively consistent across providers. The greatest savings opportunities related to DME often derive from utilization management and care coordination, in addition to unit cost comparisons.

A Bit like Buying a

In some respects, buying DME is not unlike a cell purchase. Consumers pay similar amounts for the latest smartphone no matter which service provider they choose. The true cost hinges upon how the is utilized: what data plan the consumer selects, what's included in that data plan, whether the consumer pays for using extra additional data, and what perks are included in the plan.

Assessing DME can seem pretty basic in that many products cost about the same. The true cost is associated with how those products are used.

If managed by a vendor like EviCore, utilization management and care coordination can result in substantial savings of between 20-30%.

The Role of Utilization Management

High-quality utilization management will include:

• Processing medical equipment referrals
• Reviewing clinical appropriateness of DME
• Expert guidance on coverage and claims submissions
• Important information on regional availability and a list of available providers.

Utilization management for DME at EviCore, for example, helps patients evaluate the medical necessity and efficiency of applicable DME. In addition, our utilization management services can review risk and quality assurance to help reduce costs.

The Benefits of Care Coordination

Care coordination helps all those involved in the delivery of equipment, including the ordering provider, patient, and equipment supplier. Coordination should be occurring within the various departments of healthcare organizations, as well as with outside vendors, insurance providers, referral sources, and others involved in a patient's care. 

Appropriate and timely care coordination will provide patients all the services they need while keeping costs manageable across the board.

The Bottom Line on DME

The greatest value of a DME program for patients and health plans is measured in how utilization management and care coordination are implemented&#;more than just the unit cost.

by: James Fleming

The ever-growing cost of healthcare is rarely more prevalent than in the price tag associated with home medical equipment. If you are in need and looking to save money, don&#;t miss this quick guide:

Link to APC Med

What is Durable Medical Equipment?

Often referred to by its acronym, DME, durable medical equipment is any tool or device that generates therapeutic benefits for a patient with a diagnosed medical condition or illness. DME is durable which means it can withstand ongoing re-use and can be utilized in the home. Some examples of DME include:

• Mobility aids like a knee walker scooter, cane, or wheelchair
• Hospital beds
• Pressure mattresses
• Nebulizers
• Oxygen equipment
• Hoyer lifts
• Kidney machines

If you or a loved one experienced an immobilizing injury as the result of a fall, a wheelchair or walker may be prescribed by your doctor. That type of equipment qualifies as DME. One of the most important aspects of DME, at least when it comes to insurance coverage, is that the equipment would be of no use to you if you did not have your medical condition.

How to Save on Durable Medical Equipment?

When it comes to purchasing or leasing DME, pretty much every piece of equipment is available at a retail price for someone looking to pay out of pocket. The costs can be astronomical, however, which is why it is important to either get it covered by health insurance or find deeply discounted options when possible. Keep these helpful tips in mind when shopping:

Get a Doctor&#;s Order

A prescription from your doctor for a specific assistive device will trigger a process by which insurance connects you with local providers and covers some or all of the cost of the equipment. While the journey from seeing your doctor and receiving the equipment can take anywhere from a couple of weeks to a couple of months depending on the provider and type of device, this is the primary way to save money.

Similar to writing an order for home health care, a prescription for a medical device that aids your specific condition needs to be written by your doctor. In addition to the order, your doctor will also have to provide medical history information and evidence that effectively backs up their recommendation. If approved, an insurance company will have a local medical equipment company contact you in regards to fulfilling the order.

Check a Local Lending Library

You might be surprised to find out that lots of senior-focused organizations like the National Council on Aging and elder resources nonprofits offer free DME lending programs for adults over 65. The programs are donation-based but can be a true asset, especially if you need temporary medical equipment, like crutches.

These types of programs collect gently-used equipment that other people have donated and then clean and repair it as needed for lending. Most often, if you are in need, you can get on a list to be notified when the tool or device you require becomes available. You may be asked to sign a form saying you are borrowing the equipment and will return it when you are finished using it.

Sometimes churches and regional medical resource centers will also offer medical equipment exchange programs so it is definitely worth looking around. Either search online or contact your nearby Council on Aging to see what programs they may know about.

Look Online

In the digital age, it&#;s no surprise that an array of discounted, quality medical equipment can be found online. Whether it&#;s on big sites like Amazon or independent DME distributors, your chances of finding the item you need on the internet are high.

When shopping online, make sure to watch out for steep shipping costs and always check product reviews, they can be illuminating and save you an expensive purchase you regret.

Try the Pharmacy

With senior care demand on a rapid rise, more and more pharmacies are taking cues to stock up on home medical supplies that can effectively improve a senior&#;s quality of life. Everything from mobility aids to bed rails, grab bars, toilet seat risers, transfer benches, overbed tables, even lift chair recliners are available at pharmacies or their online websites.

In addition to purchasing items in-store when they are on sale, one way to save money is to sign up for the store&#;s rewards program. If you&#;re going to be picking up prescriptions and medical equipment there, might as well earn rewards points that qualify you for special coupons and cashback the more you shop there. Pharmacies often include you in sweepstakes to earn even bigger savings too simply for completing things like online surveys.

If you want to learn more, please visit our website Durable Medical Equipment Manufacturers(uk,es,it).