Whether due to heightened physician awareness of the symptoms of obstructive sleep apnea (OSA), a general decline in Americans’ physical fitness, or a combination of the two, the market for continuous positive air pressure (CPAP) and bilevel positive airway pressure devices has been booming for a decade and shows no signs of slowing down.

Patients suspected of having OSA still wait as long as 6 weeks for an open slot at a sleep diagnostics facility, sales of sleep therapy devices continue to increase every year, and health care dollars spent on the diagnosis and treatment of the disorder have grown from millions to hundreds of millions in what seems like the blink of an eye.

The higher incidence of diagnosis and treatment is all to the good. Most studies suggest that there continues to be millions of undiagnosed sufferers of OSA. And there is no lack of studies to show that patients who are appropriately treated for OSA are more likely to avoid complications such as cardiac arrhythmias, pulmonary hypertension, and heart attacks that befall those who suffer from the disorder. In addition, because diagnostic testing for OSA is highly objective and the criteria for treatment well accepted, the reimbursement process for sleep therapy equipment is relatively clear-cut and free from some of the financial pitfalls that HME providers typically encounter.

Given these factors, it is easy to make the case that increasing your company’s share of the sleep therapy market is a worthy goal. When you consider the fact that the typical four-bed sleep diagnostics center is capable of referring out 15 to 20 prescriptions for these devices per week, it makes sense to develop a marketing strategy that will leave the local sleep laboratory thinking of your company first when it comes time to call in an order for CPAP or bilevel devices on behalf of a patient.

Naturally, your core sales techniques still apply. Differentiating your company from the competition and building relationships with referral sources are the keys to success. However, accomplishing these objectives will be easier if you first acquire a thorough understanding of the typical sleep diagnostic facility’s mission and goals. When it comes to HME sales, you can forget the saying “Treat others the way you would like to be treated.” It is the platinum rule that you must remember—“Treat others the way they want to be treated.”

Clinical Staff/Patient Education
You are likely to find that the top concern of sleep laboratory referral sources is that their patients are instructed by a competent professional on how to effectively use the prescribed equipment. A patient education program worthy of bragging rights will include an easily understandable written and illustrated guide that covers topics explaining the basics of OSA; how it is treated; how to operate, troubleshoot, and care for the positive airway pressure equipment; and how to use and care for the prescribed mask interface correctly.

While it is true that many states’ laws do not require HME dealers to employ respiratory care practitioners to set up and instruct patients on the use of sleep therapy equipment, you may find that your referral sources do require it of providers to whom they send referrals. In addition to highlighting the patient education you provide at setup, make sure that your referral sources know that you have experienced clinicians on staff who can properly fit mask interface devices, follow up on patients as needed, and offer tips to help patients be more compliant with the therapy.

Compliance Monitoring/Outcomes
A reliable compliance monitoring program is also high up on the list of criteria used by sleep laboratories when deciding where to refer orders for sleep therapy. There are a myriad of tools available to HME providers to help monitor and measure patient compliance ranging from the basic hour meter on the bottom of the machine to computerized devices that send daily, near real-time compliance data.

While some referral sources may appreciate receiving detailed compliance reports on a patient-by-patient basis, most are content to know that your company is closely monitoring compliance in the first 3 months, and responding with the appropriate follow-up to patients who are noncompliant. To that end, develop compliance monitoring and follow-up protocols that meet or exceed the standard of care expected by the referral sources in your area and make sure your sales representatives are touting them during sales calls.

You can objectively demonstrate that you have an effective compliance monitoring program in place by collecting outcome data on your patients. There are a variety of methods you can use to produce outcome reports suitable for marketing purposes. You can develop your own short questionnaire, collect the data, and aggregate it yourself using spreadsheet and graphing software, or you can employ a software program that will automate the aggregation and graphing process. If you are convinced that your company does a better than average job of ensuring patient compliance and excellent outcomes, you can even benchmark your outcomes data against the data of other providers.

Whichever method you use to collect patient outcomes, be sure that the reports you produce include both objective data, such as how often the device is being used, and subjective data, such as comparing the patient’s health satisfaction before and after treatment.

Support for Community Programs
Accredited sleep laboratories and sleep diagnostics centers are required to provide community awareness and OSA education programs to their patients and the public as a condition of accreditation. Indeed, even facilities that are not seeking accreditation often include community education as part of their mission. This represents an opportunity for HME providers whose expertise in treating large numbers of OSA patients leaves them uniquely positioned to assist diagnostic facilities in meeting this goal. Partnering with these facilities to offer OSA-related community events is a sure way to help build valuable relationships with potential referral sources.

Your company’s involvement in these activities can be large in scope—for instance, taking on the task of organizing OSA support group and community education events—or small in scope—such as providing clinicians for facility-sponsored events to offer educational presentations and free equipment pressure checks to OSA patients.

If you happen to find that another HME provider has already beat your company to the punch in this area, consider asking event organizers if willing providers in the area can take turns sponsoring or staffing the events. Not only do such events represent an invaluable professional networking opportunity between your company’s clinicians and potential referral sources, they also offer a vehicle to showcase the patient education skills of your employees.

Equipment Preferences
Next to rehabilitation professionals, there is probably no single group of referral sources that is more exacting about the specifications and brands of equipment provided to their patients than sleep disorder diagnosticians. When developing your marketing program, keep in mind that the manufacturers of sleep therapy products are also marketing to your referral sources, always touting the latest and greatest features of their flow generators, humidification systems, and mask interfaces. A major goal of the manufacturers’ sales representatives is to build demand for their products among referral sources, and they typically do a very good job at it. Consequently, you will want to foster a partnership with the manufacturers’ representatives to make sure your organization is continuously made aware of new products as they become available and that your clinicians are trained in their use. Your sales representatives should, in turn, make sure that referral sources know that your company is able to provide a wide range of state-of-the-art sleep therapy products.

No one benefits when patients are noncompliant with the therapy that has been ordered and the equipment is subsequently returned. Experienced HME providers know that patient compliance with CPAP and bilevel devices is often dependent on the type of equipment and supplies that have been prescribed. The trial and error approach to finding the right equipment for the patient is costly for the provider, and frustrating for everyone involved. Fortunately, there are now software programs available that are capable of tracking compliance associated with the use of various flow generators, mask interfaces, and humidification systems. While clinicians may often have a gut instinct about which products result in the best compliance, it is always helpful to have objective data to share with potential referral sources.

There is no doubt that the sleep therapy equipment business is poised for continued growth in the foreseeable future. By taking the time now to develop a comprehensive sleep therapy equipment sales and marketing program that highlights the services and expertise that your company can provide, you can help ensure that your business shares in that growth.

Roberta Domos, RRT, is owner and president of Domos HME Consulting Group, a consulting firm in Louisville, Ky, and Redmond, Wash. For more information, contact her at (425) 882-2035, or visit her Web site at www.hmeconsulting.com.