Look at costs of other products hospitals currently use to aid in healing difficult wounds.
Let’s compare to RecoveryRX.
Remember hospitals are now reimbursed based off results and not how many expensive products can be used. Hospitals and doctors used to be rewarded by delaying healing because they could toss as many products as possible and keep the money coming in. Now if this is happening hospitals pay will decrease from Medicare/Medicaid.
RecoveryRX: <$100 24/7 treatment with once a month application (published results in the International Wound Journal.
Medicare reimburses these below—remember the hospital bills Medicare 3 things: product reimbursement (means bill must be paid upfront before getting reimbursed) facility costs and physician costs. Reimbursement is not guaranteed!!
Below are product reimbursement for the most common wound care allografts used today and considered HIGH cost assignment. The current low cost assignments are often never billed out as it’s not worth the hospitals effort to find an extra $50-$100 when there are much bigger claims to battle.
Apligraf: >$1200 weekly/bimonthly application (only 12% reduction in costs even while paying this with treating Diabetic wounds year 1)
Dermagraft: >$1200 weekly/bimonthly application
PuraPly AM: $109/sq. cm weekly to bimonthly
Grafix: >$1500 with Medicare only covering 80% and patient paying 20%
Epifix: >$1000 weekly/bimonthly
HBO treatment: recently shown to not be as effective as previously thought and VERY expensive and time consuming. Patients go for ~3 hour dives 5x a week until healed which can be months and months!
Mind you there is a LOT of product waste as you must cut the graft to the exact size of the wound and trash the excess. This means that if the wound is slightly larger than the graft the hospital will tell you not to go the next graft size up because it possibly will be a denied claim.
None of these products treat pain as does RecoveryRX. There is currently nothing good used to treat painful chronic wounds. There is no product waste here. RecoveryRX will be easy for hospitals to adapt even if Medicare does not cover YET.
Coverage determination by CMS (Medicare/Medicaid)
“The fact that a drug, device, procedure or service is assigned an HCPCS code and a payment rate under the ASC payment system does not imply coverage by the Medicare program...MACs determine whether a drug, device, procedure, or other service is reasonable and necessary to treat the beneficiary’s condition and whether it is excluded from payment.”
These expensive products are not a guaranteed reimbursement which means the patient must then pay for the bill!! Often the patient can’t afford and the hospital and physician eat this cost!!!!
This makes RecoveryRX an easy solution due to the effectiveness and cost reduction in other medical expenses.
