This post was written in 2011 and we updated it here.
An essential component to a comprehensive Wound Care Program are Hyperbaric Chambers. The speed in which this approach can turn around potential amputations, among other benefits, is truly extraordinary. I am often asked by hospital administrators if they should buy their own Hyperbaric Chambers, or have them provided as a component of a turn-key management contract. The answer is simple; it depends. My friend calls that the diaper answer because it holds the same thing. However, it really does depend on the objectives of the hospital.
The first item to determine is whether you plan on using a monoplace chamber or a multiplace chamber (Class B and Class A respectively). The benefits and drawbacks of those two options have and will be argued forever and will be a topic of another blog on this site. If you choose to move forward on a multiplace chamber, my opinion is that you should absolutely have the management company you will be working with provide the equipment. This type of chamber is very expensive, and can be technically challenging both for the set up and operation. There are only a few companies out there that I would suggest you work with for multiplace Chambers, and we are not one of them. I feel it is best to go with a company that works with multiplace units almost exclusively.
Having said that, I feel that for most hospitals, monoplace chambers are the best choice. They are relatively inexpensive for the life span, easier to move, require less personnel to operate and offer an independent environment for each patient. There are a few monoplace chamber companies in the industry, however, Sechrist out of Anaheim CA is our preferred choice. (just a side note, the first chambers I installed at a wound center were Sechrist 25" chambers in the early 90's and I just recently found out that they are still operating!)
So now the question is do I buy it or have the company provide it? Well 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) A center should always start with a minimum of two chambers. In case a patient has an "issue" in one, you do not lose your whole day of patients while it is cleaned out. If you were to lease the chambers, a ballpark payment would be around $7,000.00 monthly on a 5 year lease for two 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. So, the average Hyperbaric, 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! The lifespan on these chambers can also be more than 20 years.
Now the flip side of that coin is that your hospital would be committed to that payment and the attractiveness of most turn-key models is that they provide the equipment with out much "risk". This also keeps $250,000 of cost off of your books, however, my opinion, is that if the program is under your provider number, you already have risk, and you should have the revenue that goes with that risk. Maybe overly simple, but that is our approach. One option that you may want to explore and we have done for clients, 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.
We have worked with hospitals to provide equipment and we have helped hospitals purchase their own. I feel the administration of each hospital needs to determine what issues are the most important to them, and then work with a company to develop the best solution. Either, way, now you have some idea as to the cost. My personal opinion, buy the chambers if you can. It will reduce your long term cost and makes the management company you are working with earn your business every year (rule #6 )rather than using the unspoken concern of losing your equipment as a reason to retain them.