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ORLANDO, Fla. - Rotech created a buzz among respiratory providers recently when it announced a controversial drop-ship CPAP program that some feel could compromise patient care. While dropshipping is nothing new, especially with canes, walkers, medical supplies and blood pressure monitors, mailing CPAP units and a training video to patients raised a number of clinical eyebrows. Specifically, many respiratory therapists wonder how Rotech, without providing face-to-face instruction and education for this notoriously non-compliant patient base, can achieve positive outcomes. “With market leadership comes a lot of responsibility,” said an industry source. “I think the people at Rotech appreciate the fact that if they just drop ship and let it go with an instruction guide, there will be a lot of fall out with non compliance that gives a black eye to the industry.” In March, managed care giant Gentiva agreed to partner with Rotech to establish a new system for CPAP delivery in 48 states. Neither company returned phone calls. Other industry sources, however, have seen the program's training video, which apparently is shipped to patients along with the CPAP. In a release announcing the program, Rotech stated that under its special program, CPAPs will be shipped to patients within 24 hours of receiving an order. The release also stated that Rotech will provide “ongoing supervision and patient contact, including patient access to a call center with specially trained staff to answer questions 24 hours a day, 7 days a week.” While Rotech developed the program, it did so most likely to accommodate low reimbursement from Gentiva. What's more, as payors continue to squeeze reimbursement, look for additional, less expensive delivery models to develop, sources say. “At the end of the day, the payors pay for what they want, and if they want you to operate on a 15% margin or whatever, you do whatever you need to do,” said Don White, president of Associated Healthcare Systems in Amherst, N.Y. Because no “great data” on CPAP compliance exists, Rotech's model could work just fine, said a highly respected home respiratory provider. “Only time and outcomes will tell,” the provider said. “Part of me, however, says we are sending the wrong message that these technically complex products are simply commodity products that can be delivered via the least costly method.”