Hyperbaric oxygen chambers are a significant investment for an advanced wound care program. While they provide healing benefits to a specific patient population, they also come with a considerable overhead in the form of cost, maintenance and specialized technicians. Here are a few things to think about before adding an HBO chamber to your program.
When is the Right Time?
If your team is beginning to see a rise in the following conditions, it may be time to start looking into the HBO chamber market. The non-invasive treatment has been approved by Medicare and most private insurers for the non-emergent conditions listed below and several year’s worth of studies have shown that, when combined with traditional treatments, HBOT can greatly speed healing times.
- Compromised skin flaps and grafts
- Chronic refractory osteomyelitis
- Diabetic wounds of the lower extremity
- Soft tissue radionecrosis
Unsatisfactory heal times are another sign you should consider implementing HBOT into your treatment plans. Wounds that fall outside of the standard time to heal window increase the risk of infection, decrease patient satisfaction, and leave the wound open to further injury.
With advanced wound care treatments, hard-to-heal wounds should generally show improvement and be fully healed within eight weeks. If you’re consistently seeing times outside this window, an HBOT chamber can help get your patients back on track.
You’ll also need to ensure that you have the space required for an HBO chamber. Standard size chambers are about 3 feet wide and 9 feet long. However, the process of loading patients in and out will require a 22 foot clearance from the chamber opening to the opposite wall. It’s advisable to have at least two chambers in your center. If one needs to be cleaned unexpectedly or is out for maintenance you won’t lose your whole day of patients. Be sure to account for at least 4 feet clearance between chambers to give space for your technicians to work.
New or Used?
Once the decision has been made to add a hyperbaric chamber to your wound care program, you’ll need to weigh the options between new or used chambers. If budget is an issue, it’s a smart strategy to take advantage of the deals offered by the used chamber market. They are usually in great working condition and offer significant cost savings. A brand new chamber typically costs more than $100,000 while a used chamber generally costs about half of that. As precious as capital budget dollars are, that could make all the difference in terms of whether or not to develop a full-service wound center including HBOT.
Hyperbaric Clearing House is a great place to start when looking for used chambers. Hyperbaric chambers have a 15-year depreciable lifespan and are mostly pneumatic machines, which means very few parts will need to be replaced over time.
Lease or Buy
Another consideration is whether to buy your own chamber or lease it. Here’s the math: A typical monoplace chamber will run around $125,000 per chamber (this is only a median price and will rise or fall based on several issues).
As stated above, a center should always start with a minimum of two chambers. If you were to lease the chambers, a ballpark payment would be around $7,000.00 monthly on a 5 year lease for 2 chambers.
Medicare allowable without wage index factor adjustment for 30 minutes of hyperbaric oxygen is around $100.00 ($104.00 currently). A typical treatment will consist of 4 segments which works out to be a ballpark reimbursement of around $400.00. An average patient will receive approximately 25 treatments, which are conducted once a day, 5 days a week. The average Medicare patient, in a 20 day month, would generate about $8,000.00 in collections. That is roughly $1,000.00 over your monthly lease payment with just one patient a month. Keep in mind the lifespan on these chambers can be more than 20 years.
The flip side of that coin is that your hospital, of course, would be committed to that payment.
The attractiveness of most turn-key models offered by wound care management companies is that they provide the equipment without much “risk” to you. While it keeps $250,000 of cost off your books, the program is still under your provider number. You still have risk and we believe you should have the revenue that goes with it.
One option we offer is an arrangement where we purchase the chambers and after a certain period of time (3-5 years) the chambers can be purchased by the hospital for a pre-determined value. It’s important to find a partner that is flexible and responsive to your clinic’s needs.
As always, if you have questions or need help making a decision on whether to purchase a single hyperbaric chamber, or if you’d like information on building a wound care program from scratch, give us a call at 888.484.3922.