Carmichael's back, and he's got a plan for pulse ox testing

Thursday, October 31, 2002

MARIETTA, Ga. — When Coloplast/Amoena Authorized Network announced a potential deal with the Kaiser Foundation Health Plan recently that would require women's health providers to use Coloplast products almost exclusively, it threw some members of the Northern California women's health community into an uproar. But even as the critics cried "monopoly" and "unfair practices," others found the deal encouraging and looked forward to easier access to managed care patients.

Now, Marietta, Ga.-based Coloplast is trying to figure out what went wrong and why the women's health community is so polarized on the issue, given that it has successfully operated a similar scenario in Southern California since 1997.

"There have been a lot of misunderstandings, misconceptions and even misrepresentation of facts in some cases," said David Heffner, executive vice president of sales and marketing for Coloplast Breast Care Worldwide. "We're still not sure what happened, though it seems the cart went before the horse, early information leaked out and a lot of rumors snowballed. We've been speaking with providers and women's groups directly for the past six weeks trying to clear it all up."

One misconception that has been widespread, Heffner says, is that the Coloplast-Kaiser agreement is a done deal. In fact, he says, nothing has been signed officially.

Also at issue is a condition in the pending deal that women's health providers furnish Kaiser patients with only Coloplast/Amoena products and that the payer will issue credits for new product purchases instead of cash reimbursement. This led to some claims that Coloplast was trying unfairly to corner the women's health market.

"We have a wide portfolio of offerings, though; a wide choice of products," Heffner said. "So, patients are well-served. Still, if a Coloplast product isn't right for a specific patient, there is a mechanism in place for alternate products."

"Maybe it's because I came out of the business world originally, but I don't see a problem with the arrangement," said Susan Brooks, owner of Women's Health Boutique in Torrance, Calif., who has been working under the Southern California version of the deal since she opened her shop two years ago. "Kaiser is a business, and in the business world you try to get the best product line for your purposes that you can at the best possible price."

In 95% of the cases, using a Coloplast/Amoena product is something patients are fine with. In the other 5% of cases, Brooks said, she tells Kaiser she needs a different product and it still gets reimbursed.

Brooks' only concern with the Coloplast-Kaiser arrangement is that the quality control on providers seems too loose, with non-healthcare retailers like Nordstrom's carrying Coloplast products.

"Patients need to connect with a provider who understands their needs and can properly fit and recommend products," Brooks says. "I don't think a 19-year-old clerk at the department store qualifies in that regard." HME