Reaction

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Thursday, February 28, 2002

MARIETTA, Ga. - Industry sources are denying that physicians have plotted against HME suppliers to keep patients in hospitals, despite recent comments from Matria Healthcare's president and CEO that allude to just that.

"I think there's skepticism or hesitancy out there, but I haven't seen much evidence of a grand conspiracy," said Schuyler Hoss, president of the Vancouver, Wash.-based consulting firm Northwest Healthcare Management. "I don't see greed or financial self-interest there."

In a January press release, Parker H. Petit slammed the results of a New England Journal of Medicine study titled "Frequency of Uterine Contractions and the Risk of Spontaneous Preterm Delivery," saying he believed it unjustly discredited home obstetrical care. The study looked at 306 women who used a home contraction monitor from 22 to 24 weeks of gestation until delivery and found that no threshold frequency of contractions effectively identified women who delivered before 35 weeks.

Petit defended uterine activity monitoring as just one piece of home obstetrical care and strongly questioned the motivation of the study's authors.

"When I see this continuing publication of irrelevant studies that draw conclusions which in no way relate to current medical practice, it is my opinion that this group has an interest in seeing these high risk patients hospitalized," Petit said in the press release. "This is very hard to justify in today's environment where hospitalization would cost 10 times more than home obstetrical care and telemedicine."

Generally speaking, industry sources say physicians are conservative in adopting home care technologies for several reasons. One is that they're liable for a patient's health, and the 24-hour monitoring and immediate response a hospital can offer is extremely attractive. Physicians also believe that home care takes away from their face-to-face time with patients.

Hoss, who includes home monitoring and telemedicine companies as some of his clients, said allowing physicians to toy with HME and develop their own ideas on how to use it can go a long way in putting them at ease.

"We had a home monitoring system placed in one physician's office," he said. "He played with it, tested it and became our biggest advocate."

Furthermore, several industry sources, speaking both professionally and personally, downplayed the ability of physicians to keep patients in hospitals. They said current payment systems encourage early discharges, which create business opportunities for HME suppliers who can trump their products as effective yet cheaper.

"Insurance companies want you out of the most expensive option as fast as possible," said Dave Williams, director of government relations for the Elyria, Ohio-based Invacare. "If there's a less costly option, they're going to go for it. The healthcare institutions are looking for those opportunities; HME suppliers need to take advantage of them." HME

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