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time greatly reducing costs, essentially all this new growth is limited to the use of hyperbaric treatment chambers for outpatients with chronic wound-healing problems. Acutely ill patients for whom hyperbaric treatments have long represented a vital standard of care are now, in many cases, out of luck.

So why is this growth in hyperbaric medicine causing long-standing 24/7 facilities either to stop providing

urgent care or close altogether? In a word, it’s money, or an increasing lack of it. As hyperbaric programs open with these new business models, they compete with existing programs for the same pool of well-insured outpatients, those who are clinically easy to manage. This reduces revenue generation at the 24/7 facilities, while the costs of care continue to increase.

Given that this crisis is based largely upon revenue shortfalls, efforts are under way to alter how hospitals are paid for the provision of hyperbaric medicine. It would seem reasonable that the greatly increased costs of providing emergent 24/7

care (e.g., more highly trained health-care practitioners, ancillary equipment requirements, on-call fees for physicians and staff) should be considered within the health insurance payment process. It is traditionally difficult to convince insurance companies to pay higher fees, but we at the Baromedical Research Foundation suggest that non-24/7 outpatient-only programs have their payments reduced by a modest amount, passing on these savings to 24/7 programs. This would represent a revenue-neutral process. As there are many more non-24/7 programs than 24/7 programs, the proposed modest reduction could mean a significant revenue increase to those facilities providing 24/7 care. It might even be sufficiently rewarding that those facilities that have stopped providing 24/7 care might reconsider their decision.

Fortunately for divers, DAN keeps track of the availability of chambers around the world. If you have symptoms after diving, avoid confusion and call the DAN Emergency Hotline (+1-919-684-9111). AD

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