CategoriesOxygen,  Reducing Costs

Reducing Supply Costs


Shop around for oxygen supplies in the New Year.

Controlling costs on supplies isn’t a new concept for most oxygen home care providers. Unlike the CPAP market where suppliers are reimbursed for each product provided to patients, oxygen suppliers are reimbursed a flat rate for each patient, no matter how many supplies they provide. But with the Affordable Care Act and competitive bidding, suppliers need to push those cost savings even further.

When everyone is getting reimbursed the same amount, you don’t want to be the one paying more for your supplies. The biggest tip I can give you is to shop around. If your company has been purchasing supplies from the same manufacturer for years, this might be a great time to shop for new suppliers.

Are All Oxygen Filters Created Equal?

Off-brand companies frequently carry the same quality supplies or even the exact same products for a lower cost, but they don’t have the name recognition. Let’s say you purchase your oxygen concentrators from Acme Manufacturing. That concentrator comes with a foam filter that needs to be replaced regularly. Acme probably does not manufacture that filter; they likely purchase it from a supply company that makes various products such as foam pillows and mattresses in addition to filters. That foam supply company probably sells the same filter to multiple manufacturers and distributors, so in many cases you can get the exact same filter from a different company for a lower price.

Additionally, there are companies that focus mainly on replacement parts for all of the different manufacturers, sort of like the “AutoZone” of the oxygen industry. You can buy an air filter for your Ford Explorer directly from Ford, or you can go to AutoZone and get one for your Explorer and your Audi in the same place for a lower price.

Original Equipment Manufacturers (OEMs) like our fictional Acme Manufacturing or real companies such as Ford make most of their money on the original device like the car or the oxygen concentrator, not the filters, so they don’t focus on offering the best value for replacement parts like some other distributors and manufacturers do.

How-to Guide

The first step to finding better prices is to research supplier options. Industry tradeshows and publications like HomeCare and HME News are great resources to find other manufacturers and distributors who might offer the same products you are currently purchasing at a lower price. They may not be a name you recognize, but they might carry parts for many of the brands that are familiar to you or that you already carry like Invacare, Philips Respironics or DeVilbiss.

Reach out to a few of those companies and ask them what they would be willing to do to earn your business. Let them know that you are interested in potentially switching suppliers and you would like to have some samples of their products shipped to your office for testing purposes. Manufacturers are often willing to provide free samples so they can prove the quality of their products to you. Distribute samples to your patients and see how they compare to the products from your current supplier.

Additionally, check with those suppliers to see if they have any price breaks with higher quantities, sales promotions or free services they can provide to sweeten the deal. Many suppliers are able to provide services such as private labeling, kitting and free or discounted shipping, as well as product guarantees or discounts for new customers, but you won’t know until you ask. The suppliers that are willing to work hard to earn your business are probably the same ones that will offer extra service and perks to keep you happy in the future. In the end, you might decide to stay with your current supplier, but at least you have done your due diligence and know you are getting the best prices you can.


Introduction to Pulse Oximeters


How they work and how to select the best products for your client.

Pulse oximetry is a non-invasive method for monitoring the oxygen saturation levels (SpO2) in your patients’ blood. SpO2 is the percentage of oxygen that blood carries compared to the maximum it is capable of carrying. A normal rate is 94-99% in adults. Patients with COPD or other lung diseases generally have blood oxygen levels of 92% or lower, causing them to require supplemental oxygen treatment.

 When is a pulse oximeter used?

In general, pulse oximeters are used to provide insight into the functioning of the patient’s respiratory system. It can be used anytime these levels need to be tested or diagnosed.

In the senior care and homecare setting, a portable pulse oximeter like the one shown above is most commonly used to treat or diagnose patients with respiratory diseases that cause low levels of oxygen in their blood when they breathe air. A pulse oximeter is an easy, non-invasive way to measure oxygen levels at any time so supplemental oxygen amounts can be adjusted as needed throughout the day.

In addition, different types of pulse oximeters are also commonly used in the hospital setting, often during surgery with anesthesia or in the recovery room. They are also used in sleep labs as a part of sleep apnea diagnosis. In a non-medical setting, pilots and athletes commonly require spot checks at high altitudes or during rigorous training.

How do pulse oximeters work?

Generally, pulse oximeters work by shining two different kinds of light (red and infrared) through a thin part of a patient’s body, usually a fingertip or earlobe. Blood absorbs light differently depending on the level of oxygen it contains: oxygenated blood absorbs more infrared light than red light. So by comparing the changes in amounts of red and infrared light received, the instrument can calculate the SpO2 reading.

As a side benefit, you can also check your pulse, as the increase in the amount of blood with each heartbeat also affects the light.

 Is a prescription required for pulse oximeters?

It depends on the device and how it’s being used. According to the FDA, if an oximeter is accurate enough to diagnose or treat a disease, a prescription is generally required. If not, a prescription may not be needed. For example, if an athlete or rockclimber wanted to monitor their pulse and oxygen levels, they could purchase an OTC model that is not intended for diagnosis and would not require a prescription. To be sure, ask the manufacturer where you purchased the device.

What type of pulse oximeter does my client need?

There are three common types that fit a variety of needs. The most common is the portable fingertip pulse oximeter, which is often used at home. It is relatively inexpensive, lightweight and easy to use. However, it doesn’t always provide an accurate reading for those with circulatory problems. Also, it is designed for spot checks, instead of continuous monitoring so there are also several other options available.

The handheld pulse oximeter is most commonly used in hospitals and has a clip and wire attached to a handheld monitor. It can be clipped to a finger, earlobe or toe in an emergency situation and can be used for spot checks or continuous monitoring. The monitor can record the patient’s information for several hours at a time. Many models also come with a built-in alarm that sounds if the patient’s SpO2 or pulse rate goes outside a designated range. Some also include the ability to connect directly to a printer to prevent documentation errors.

The final type is a wrist pulse oximeter that has a small fingertip sensor that is attached to a wristwatch style recording system that continuously monitors the blood oxygen saturation level and pulse rate. It is ideal for monitoring daily activities or for an overnight sleep study because it allows the freedom to perform daily tasks and has a memory that can last for several days at a time.

CategoriesCPAP,  In The News

Sunset CPAP Kits Featured in HomeCare Magazine Article on How to Build Lifelong PAP Customers


Excerpt featuring Sunset Healthcare from an article in HomeCare Magazine by Larry Anderson. 

Full Service Approach.

Fully servicing existing patients enables providers to maximize profitability in PAP products, said Ashley Wood, director of operations at Sunset Healthcare Solutions. Replacing masks, tubes, cushions, chinstraps, humidifier chambers and filters as often as the patient’s insurance will allow can maximize HME reimbursements and profits. Wood noted that the reimbursement for supplies can add up to more per year than the device rental fees for a new CPAP setup.

Sunset Healthcare Solutions specializes in replaceable PAP accessories, including their own line of tubes, filters and masks as well as masks, cushions and humidifier chambers from major manufacturers.

“We also carry many hard-to-find filters or replacement parts for machines and masks that are previous-generation and might be discontinued by the original manufacturer,” Wood said.

Sunset Healthcare Solutions offers a customizable Resupply Kit that includes an entire three- or six-month supply of CPAP tubes, disposable and nondisposable filters and even a mask, cushions, chinstrap or humidifier chamber in a single easy-to-handle kit.

Wood suggested the addition of retail products such as CPAP mask wipes or accessory cleaners that provide continuous revenue in addition to reimbursements. “By adding retail products to their line, HME providers have a diverse product set to fall back on as reimbursements are being cut,” Wood said.

Read the full article in HomeCare Magazine here


CPAP Cleaning and Cash Reimbursement Tips

CPAP cleaning supplies

With declining reimbursements, cash products are a great way to increase revenue while also providing your patients with convenient, easy-to-use cleaning products. This article describes the best products for cleaning CPAP equipment, as well as recommendations for cleaning schedules and techniques.
To prevent growth of mold and bacteria, regular cleaning is essential. However, this task can be tedious without the right supplies.

Daily Care

To remove dirt and oils and prevent buildup, clean the mask and cushion with a cleanser or wipe that is gentle enough for daily use. As a general rule, people can use any cleaning product on their mask that they would use on their face. Anything stronger with scents, alcohol, antibacterial agents or bleaching ingredients can cause the cushion to break down or irritate the skin.
Several products are designed specifically for CPAP masks with all-natural ingredients that are safe enough for daily use. One of the most popular brands is Citrus II, available in a dispenser with 62 wipes or a box of 12 individually wrapped wipes. Both options have their uses. The dispensers are compact. Many of our customers provide each of their respiratory therapists with a few dispensers of wipes, one to demonstrate to the patients how to clean their masks during the initial fitting and additional ones to sell. This helps show proper maintenance and can also lead to a cash sale on the spot.
The individually-wrapped wipes are great to give away as a sample with each new patient setup, and are useful for patient travel or in-store promotions.
If your patients prefer to use a spray, Citrus II offers CPAP Mask Cleaner Spray in either 8-ounce or 1.5-ounce travel size bottles.
In addition to wiping down the mask, instruct your patients to empty the humidifier chamber each morning and leave it open to air dry for the day. They can refill it with distilled water at night. Avoid using tap water to prevent mineral buildup in the chamber that could damage the machine.

Weekly Care

Clean all equipment on a weekly basis, or more frequently if the patient is recovering from illness. First detach the mask from the tube and remove the headgear and cushions. Soak the headgear, tube, mask, humidifier chamber, reusable foam filter, chinstrap and any connectors or adapters in a 50/50 solution of warm water and Citrus II CPAP Concentrated Cleanser for 10-20 minutes.
After soaking, rinse thoroughly with warm water. For best results, hang the tube, headgear and chinstraps to allow them to dry completely. The mask, cushions, chamber and filter can be left out on a towel to dry. Ensure the filter is fully dry before placing it back into the machine. If your patient lives in a wet or humid climate and they have trouble getting their tube and mask to dry fully, Hurricane makes a Home Edition CPAP Equipment Dryer that safely dries products without damage. However, make sure patients are aware that they should not machine wash or dry headgear or chinstrap as it will damage the material or affect the size.
To clean the machine, make sure it is unplugged, and wipe it with a cloth soaked in warm water or a mix of warm water and CPAP Concentrated Cleanser.
With filters, a good rule of thumb is: If it is foam or labeled as reusable, it can be washed weekly and reused for six months, per Medicare guidelines. If it is labeled as ultrafine or disposable, it cannot be washed and must be thrown out and replaced every two weeks. Washing a disposable filter will cause it to lose shape and effectiveness. Some machines use only disposable filters while others can accommodate reusable foam filters, as well as disposable ones. Check with the manufacturer, and explain the difference to your patients to avoid confusion.
During the weekly washing, patients can substitute vinegar, unscented liquid dish soap or hand soap in place of the CPAP Concentrated Cleanser, but they should not use rubbing alcohol, bleach, scented soaps or antibacterial soaps as they can break down the equipment.

Effective Display

How do you encourage patients to clean their products regularly? First, inform them of the health implications of inhaling mold and bacteria growing in their equipment. Also, make the cleaning products easily accessible, and start them off on the right foot with samples or cleaning demonstrations during setup. To assist in this, one product is the CPAP Cleaning Product Display Kit, which is a full display of all the most popular CPAP cleaning products in a tabletop format. The display signage spells out the features and benefits of the cleaners. It displays well next to the register to encourage cash purchases.


Product Instructions for Health Literacy


Studies show that almost 90 percent of adults struggle to understand health information readily available in hospitals, clinics, stores and the media. Meanwhile, the government is cutting reimbursement to the HME industry, which is pressuring providers to reduce the one-on-one care and training they now give to patients.

It’s a recipe for confusing older and ill patients who must use HME products for the first time. But there are steps you can take to ease their stress. HME providers can give patients simple instructions through a variety of mediums to increase health literacy—the degree to which patients understand medical information and use it to make good decisions about their health and medical care.

Placement With Packaging

The easiest place to teach patients how to use your products is on the packaging or on inserts you include with products. Many manufacturers cover this step with instructions that you can pass along to your patients. However, if your products do not come with instructions or you think they could use further explanation, add a supplemental flyer, booklet or instruction sheet. Here are tips for making instructions simple to understand:

  • Put the most important information first—many people with limited health literacy read only the first few words of a page.
  • Use simple language, short sentences and define technical terms.
  • Do research—chances are, somebody has already written instructions on how to use a product similar to yours. So check to see what other people have done and pick the most clear example to use as a guide.
  • Make the instructions easy to read and understand for all patients. This includes printing them large enough to read for people with poor vision, as well as making them bilingual if you serve a high percentage of non-English speakers.
  • A picture may be worth 1,000 words, but it’s worth 2,000 words if you count writing the instructions in two languages. Photos or diagrams can help patients no matter what language they speak.
  • Test instructions by having someone who has never used the product try to follow them. This can uncover gaps that are not obvious to you.
  • Ask patients for feedback on instructions and continually improve them if you hear the same questions multiple times. For example, if you receive phone calls from patients asking which side of their CPAP filter should be facing in toward the machine, then add a photo and description of the correct placement onto the packaging.

CPAP Filter insertion instructions

New Patient Set-up Kits

Another helpful piece of marketing that some providers have adapted is a new patient set-up kit. It can include everything from instructions, forms and manuals, to any replacement parts or tools they might need.

For example, many HME companies provide their new oxygen patients with a new-patient set-up kit that the manufacturer or distributor helps them to assemble. The kit includes all of the supplies that should be regularly replaced such as oxygen tubing and cannulas, as well as an accessory kit that includes every tool new patients might need to use with their oxygen device, such as a wrench for adjusting the cylinder pressure, a replacement washer and various connectors.


In addition to the supplies, many customers include their own instructions on best practices for handling the device, frequently asked questions, what to expect and other supplemental instructional materials that can make the transition onto oxygen therapy easier.

Instructional Videos

At a time when 16 million people per month visit WebMD to diagnose their own ailments, why not use YouTube videos to instruct patients on the correct way to use your products before they get incorrect information somewhere else?

Making a video is now surprisingly easy with the help of many digital cameras, smart phones and webcams. And YouTube now has free video editing tools available online so you can edit and add captions to your video at no cost. For information on tools to help you create your videos visit

Videos can be a great way to explain how to select, use, clean or fix one of your products without having to send a technician to a patient’s home. They provide the information impossible to convey through printed packaging.

Once your video is complete, post it on no fewer than these two locations:

1) Create a YouTube channel for your company—make it searchable by your company name and place all of your videos in one place for your customers and the general public to search. You can even customize your channel background to include your logo and color format. Be sure to tag the videos on YouTube once they are posted so people can easily search for them by subject, item or issue. As an added bonus, if you include your company’s web address at the end of your video, this could increase traffic to your website.

2) Embed the YouTube videos directly onto the corresponding product’s page on your website. That way if your patients are visiting your website to purchase your products, they can see the video and refer back to it if they have questions later.

Additional ways to get your video out there: Google Video, industry or company blogs, social networking and sites such as Facebook. You can even embed it in an e-mail and use it as a response to questions you receive from customers.

While the best solution is to send a trained technician to teach patients how to use new equipment and troubleshoot problems, with declines in reimbursement, the costs are not always feasible. When personalized attention isn’t an option, make sure you find other ways to educate your patients.


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