How Much Do Tracheostomy Tubes Cost?

When it comes to buying tracheostomy tubes, there are many factors to consider. Your patients wear their tubes every day — and some will need to for the rest of their lives. How do you find a high-quality trach tube that can help promote positive patient outcomes and stay within a budget?

As we explore this topic, there are two key questions:

• What is the cost of the trach tube itself?
• What is the cost of the trach tube over time?

In this blog, we will discuss factors that impact the cost of tracheostomy tubes. We’ll also explore what determines trach tube cost over time — including whether it requires an inner cannula — and the impact of maintenance requirements.

What Is the Cost of the Tracheostomy Tube Itself?

The type of trach tube a patient requires will determine its cost. A patient’s doctor writes a prescription for a specific tracheostomy tube based on each patient’s unique needs.

The cost of tracheostomy tubes can range from $50 to $243 each.¹ This depends on whether the tube:¹

• Is for adult or pediatric use
• Is with or without fenestration
• Is cuffed or uncuffed
• Is extended length or custom-made
• Has a dual or single cannula
• Uses a disposable or reusable inner cannula

The brand name of the tracheostomy tube can also impact its price.

This table outlines the average price of trach tubes depending on characteristics, including high-low ranges based on tubes currently on the market.

Tracheostomy tubes need to be changed every 29 days.² The first tube change usually happens between 7 and 14 days after the trach is initially placed.² This is important when calculating the annual cost of tracheostomy tubes per patient.

What Is the Cost of Tracheostomy Tubes Over Time?

Several factors can contribute to the cost of supporting patients on tracheostomy tubes over time. Including readmissions linked to:

• Stoma infection
• Accessories and supplies such as neck ties, heat and moisture exchangers, and suctioning equipment

This section will focus on two of the main factors that help determine the cost of tracheostomy tubes, including:

• The inner cannula
• Cleaning and maintenance requirements

The Inner Cannula

An inner cannula should be changed frequently — two to three times a day³ — because it can become occluded. If patients use a dual cannula tracheostomy tube, they will require regular inner cannula changes. There are two types of inner cannulas:

• Disposable
• Reusable (single-patient use)

Inner cannulas can cost anywhere between $0.90 and $6.59 each.¹1

Disposable Inner Cannulas

Prices for disposable inner cannulas are usually near the middle to low end of the range. However, they are changed more frequently than reusable inner cannulas — so you’ll need more of them. Your facility’s protocol may call for inner cannulas changed once or twice daily,³ every eight hours, or more frequently depending on each patient’s secretion level.⁴

Reusable Inner Cannulas

Typically used as spare inner cannulas during cleanings, reusable inner cannulas cost more per unit.¹ Reusable inner cannulas are single-patient use and last longer than disposable inner cannulas.

Some manufacturers recommend changing reusable inner cannulas every two weeks.³ Always follow your facility’s protocol because it may require more frequent changes based on the patient’s needs.

Cleaning and Maintenance Requirements

In addition to tracheostomy tubes and inner cannulas, you’ll want to consider the cost of cleaning and maintaining a patient’s stoma and trach over time. That’s an important part of maintaining a healthy tracheotomy and avoiding patient complications that can lead to readmissions or adverse outcomes later.⁴

Two important components contribute to the cost of maintaining a tracheotomy over time:

• Stoma infection
• Accessories and supplies such as neck ties, heat and moisture exchangers, and suctioning equipment

You may think these two components go hand in hand — and they do. But there are key differences in how cost can potentially impact your facility.

Infection Control at the Stoma Site

Healthcare facilities take measures to control infections. But they still happen. Twenty-seven percent of complications before the first [tracheostomy] tube change in pediatric patients is related to skin (stoma) breakdown.⁵

And in some facilities, when a patient gets an infection it’s harder to get reimbursement.^6,7 Readmissions linked to infections may not only impact reimbursement — your publicly posted star rating on the Medicare compare website is also at risk.^8-10

For more information on reimbursement and penalties applicable to your facility, check out our reimbursement and quality measure guides:

• Quick Reference Guide — SNF Quality Measures
• Quick Reference Guide — LTCH Quality Measures
• Quick Guide to Coding, Coverage and Payment — Tracheostomy

Your facility may use supplies such as gauze behind the trach tube to help mitigate stoma irritation or infection. Consider gauze or other supplies as you calculate the total cost of a tracheostomy per patient.

If the cost of supplies is substantial, you may consider a trach tube that can help mitigate infection at the stoma site. Some product features include clear, flexible flanges that are designed to reduce contact with the stoma site.

Cleaning Supplies

Cleaning supplies serve several purposes. Some facilities prefer using prepackaged trach care kits. Others purchase supplies a la cart. The cost of cleaning supplies depends on how they are used and where and how they are ordered. It is also a factor in the overall cost of caring for tracheostomized patients. ^†

Image taken at Five Towns Rehabilitation Facility in Woodmere, NY

References:
†Always reference the manufacturer’s Instructions for Use document and follow your facility’s protocol when cleaning your patient’s trach tube and inner cannula.
1. Based on internal analysis of GHX data from Q4 CY2017, Tracheostomy GHX market share. January 2018.

2. White AC, Kher S, O’Connor HH. When to change a tracheostomy tube. Respiratory Care Journal Website. http://www.rcjournal.com/contents/08.10/08.10.1069.pdf. Published August 2010. Accessed April 18, 2018.

3. Shiley tracheostomy tube with reusable inner cannula [instructions for use]. Medtronic; 2018.
4. Liverpool Health Service. Cleaning and changing of a tracheostomy tube inner cannula: corporate manual. 2006;12–13.
5. Carr MM, Poje CP, Kingston L, Kielma D, Heard C. Complications in Pediatric Tracheostomies. Laryngoscope. 2001;111:1925-1928.
6. QualityNet. Measures Hospital-Acquired Condition (HAC) Reduction Program. QualityNet Website. https://www.qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic/Page/QnetTier3&cid=1228774294977. Accessed April 25, 2018.
7. Medicare. Prospective payment system and consolidating billing for skilled nursing facilities for FY 2018, SNF value-based purchasing program. SNF quality reporting program, and staffing collection. Federal Register Website. https://www.federalregister.gov/d/2017-16256/p-135. Published Aug. 4, 2017. Accessed online on Feb. 28, 2018.
8. Skilled Nursing Facility (SNF) Quality Reporting Program Measures and Technical Information. www.medicare.gov/NursingHomeCompare/About/Short-Stay-Residents.html.
9. Medicare. Long-Term Care Hospital (LTCH) Compare. https://www.medicare.gov/longtermcarehospitalcompare/#about/whyCompare. Accessed December 20, 2017.
10. Medicare. Hospital Compare. https://www.medicare.gov/hospitalcompare/search.html?. Accessed April 25, 2018

TOPIC: Shiley™ Tracheostomy, Long-term Care and Homecare