What's in it for Mario?

Back in the day, when Theresa Flaherty and I were working under Jim Sullivan and Mike Moran, they had a saying, “What’s in it for Mario?” 

This is something they’d encourage us to keep in the back of our minds as we were reporting on and writing stories. The Mario in question was Mario LaCute, a now retired business exec who used to head up Seely Medical in Ohio. The point being, when news happens, always ask yourself, what’s the impact on the HME provider? 

When Resmed announced that it had acquired VirtuOx, an independent diagnostic testing facility, to address a backlog in sleep apnea testing, it had an answer for “What’s in it for Mario?” Namely, that by combining VirtuOx with NightOwl, a home sleep apnea test that it recently made available in the United States, Resmed was increasing testing and helping providers “get to patients faster." 

Which is true, even a skeptical HME provider would admit. The more patients who are tested, the more patients who will be diagnosed and the more patients who will need CPAP therapy. “What’s in it for Mario?” Well, potentially more business. 

But it’s not quite that simple. This could be a huge disruptor to the traditional model for sleep testing, diagnosis and therapy. We now have an IDTF, VirtuOx, that’s backed by Resmed, a company with a $36 billion market cap, that can provide a home sleep apnea test and score it and connect patients with a sleep physician to prescribe therapy – all virtually. 

Conceivably, this could reduce the number of patients who see local sleep physicians and, therefore, the number of referrals HME providers receive from said physicians, but the referral would still be there – it might just come via telemedicine. Except that some providers fear this model also opens the door for Resmed to more easily work with fewer HME providers, if not a single provider. Then it potentially reduces business for the sleep physicians and HME providers. 

It’s hard to argue against this model if it increases a consumer's access to testing and therapy. If I’m a person who snores in their sleep and I am comfortable accessing testing and diagnosis virtually, this may be the easiest and quickest way for me to get treatment. Theresa was recently referred to a sleep physician and was scheduled for an appointment – five months later. 

Of course, there are still a ton of wild cards in this model, including the consumer’s comfort level with virtual care (is it preferable – even doable – for older patients), the efficacy of virtual care (is it a good fit for anything beyond mild cases of OSA) and the bandwidth of virtual care (is it moving the bottleneck from one model to another).  

“What’s in it for Mario?” It's hard to say right now, but one thing’s for sure, we'll keep asking.