Is Mobile Wound Care Sustainable in Light of CTP/CAMPs Regulations? 

1    Sustainability Depends on the Business Model, Not the Market
Mobile wound care is viable, but only for practices built with realistic economics, adequate reserves, diversified revenue strategies, and acceptance of evolving reimbursement realities. 

2    People and Processes Are the Foundation
High-quality, engaged providers who are motivated by patient care—not just income—combined with standardized clinical practice guidelines, are essential for both compliance and financial durability. 

3    Operational Discipline Drives Long-Term Success
Practices must align productivity expectations, payer mix realities, technology adoption, and cost control (EHR, billing, compliance, staffing) to ensure margins that support growth, innovation, and patient care over time. 

Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text.  

Zwelithini Tunyiswa, BS: Simple question that many people have is, is mobile wound care sustainable with limited skin sub reimbursement and more regulatory oversight? I think people probably know what our answer's going to be, but maybe we can explicitly say what our answer is and maybe focus on some of the things that we think are opportunities for mobile wound care. 

Ryan Dirks, PA-C: I said this answer to somebody the other day and it was kind of on the fly and then I realized, oh, I might sound kind of like I'm demeaning or talking down on our field or whatever, but I'm just going to give the analogy. It's like, is the restaurant industry sustainable? Just curious, what do you think, Zweli? 

Zwelithini Tunyiswa, BS: People like eating. 

Ryan Dirks, PA-C: People like eating. Yeah, I love it. I love going out. I'm going out with a mentor of mine that was ... I knew him when I was in junior high. My wife and I were taking him and his wife out to dinner tonight. We're going to go and we're going to have great time and a great meal. And I don't think there's ever a shortage of people going to restaurants, but what is the failure rate of restaurants? 

Zwelithini Tunyiswa, BS: 70% in the first year or something like that. 

Ryan Dirks, PA-C: Yeah. Yeah. So I think the restaurant industry is sustainable. It just depends on how you run a restaurant. 

And so, and the way you look at how you serve your customers at the end of the day, that's the great thing about our healthcare system and great thing about our country is if I help enough people, I will be able to provide help for myself and my family, or in this case, all the people that work in our business and our practices. If you do the right thing, the bottom line follows. And so you can have the best intentions in the world, but if you don't have a business model that makes sense for your restaurant or your healthcare practice, it's just not going to work. And so the things that I've seen, and don't get me wrong, I mean, people will, and myself included, make mistakes in business all the time. I mean, you fail forward, right? If you don't quit. I mean, the mistake is quitting. 

That's the one thing what will end your wound care practice? You quitting. But it's kind of like if you're going to climb Mount Everest, you better have a lot of filled oxygen tanks stashed away along the way. You need money. And that's just the reality of it. And so what I think, to answer your question, is mobile wound care is sustainable after January when the camp reimbursement comes. I think it depends on how practices were built. And there's a psychological side of this as well, because some people were used to making more money than they're going to be able to make. And so that has things that affect it. Providers that are working for a practice might not have the same income that they were had before. I mean, Zweli, when I met you, and a lot of people don't know this, but Zelli reached out to me within a year or so of starting United Wound Healing, found me on LinkedIn, got my cell phone number, called me up and said, "I'm this person that you're not going to be able to pronounce their name, so you can call me Z." And even though I don't sound like it, I live in North Carolina and we just had this phone conversation. 

This was before we did Zoom and all that other stuff. And you said to me, "Hey, we've been doing this for a long time. We've scraped our knees. We've made a lot of mistakes. If I could just help you in any way, let me know. " And we probably talked every day. And then we became partners in OpenWood Research and you've been incredibly influential in our practice. So at the end of the day, what we learned is that we had to make sure that we had the, first and foremost, the right providers in our organization. And they had to be providers that absolutely love what they do. They love their patients, they love wound care, they're passionate about it, and it's more than just a paycheck. And this is not something where you're going to make an incredibly high amount of money with doing sustainable wound care. 

So we had to find a way, like we have our providers and then we have kind of the bell curve of where their typical industry norms of reimbursement would be. And you got to kind of start out in the middle of that bell curve. And as they perform higher and they're with you longer, then you got to kind of shift further and more aggressive on reimbursement. But you have to keep your providers. You have to keep them in your team. You have to keep them motivated, keep them excited, keep them growing and learning. And so first and foremost, you don't have good providers, you don't have a practice. I mean, that's just the bottom line. So there's going to be challenges where maybe providers are used to making a lot more money because of the economic system that the practice set up in the beginning. 

So that's going to be challenge number one. And then challenge number two is going to be able to figure out the basics of economics in a business. What am I going to make? What can I afford to spend? And how much am I going to have in sustainable cushion and reserves? I mean, for some reason, people don't like to use the word profit in healthcare. I think it's, again, because people have ... We don't want to be profiting off of people's suffering, but people suffering can't be addressed in a long-term way if there's not a sustainable income stream to pay the people that can make it happen. And as we talked about in a successful practice in today's world, there's a lot of costs. You have your EHR, you have your billing software, you have your billing team, you have your coders, you have all your compliance side of things, you have HR. 

I mean, we have all these costs because they're the minimum to play in the game and stay in the game right now. So it's going to take people to go back on the business and economic side, just like the restaurants, what can we afford to pay our people? How can we make sure we have some money in reserves? 

And then on the clinical side and on the revenue side, you have to decide what is good care. And we have clinical practice guidelines that have slowly changed and evolved as the science of wound medicine has changed, but that's what we teach and train our providers to do. And it is a lot of evaluation and management. It is sometimes sharp debridement when needed, but teaching them in the clinical practice guidelines, when is it needed and when is it not? I think that's really key. Diagnosing and making sure you have the right etiology of the wound. You have to have vascular studies done. You have to be able to do those. And if you can do those at the bedside yourself and not have to send the patient out or bring somebody else in, not only can you do that, if you use the right technology, you can be reimbursed for it. 

So it just takes, I think today in today's model, I'll speak about the future in a minute. It takes today just probably overhauling your business model. And I think in every business that's going to stay sustainable, that's just part of staying in business. Things change all the time. I was reading a book the other day, they were talking about Hewlett-Packard in I think maybe like the '50s or something like that. 

One of their largest accounts was the military and they lost that government account and it took away 50% of their income and profit overnight. And so it wasn't like, "Well, I just don't think we want to be Hewlett-Packard anymore." I think what they had said was, "I think we need to figure out a way to not have 50% of our revenue be tied to the government." It's what they did. And it took them 10 years. So their strategy was a 10-year process to be able to diversify their income and everything. But look, they're still around today and they're an industry leading organization because I think even in healthcare, every probably four or five years, there's some disruption, whether it's change in reimbursement for hyperbaric oxygen, whether it's change in reimbursement for debridement, it's going to take you a moment to go, "Okay, I need to modernize the economics and financial model of my practice." And now, I mean, look, we have things like AI that we can deploy and use that'll help cut down on the back office overhead costs. 

There's a lot that's coming out in the future. So clinical practice guidelines I think are key because then you can standardize what you need to do for your patients. And then the hard part, and it's probably another podcast for another day, is how do you ensure that your providers are seeing enough patients a day? We don't have an office where we have ... I have three exam rooms and I have two MAs and I have a person checking patients in. And so therefore, when I do the math, I can see X number of patients a day, a week, a month. It's a little bit different in the mobile setting, depending on if you're going to people's houses or you're going to a nursing home. So the way that you figure out, okay, and providers ask this all the time, it's like, "How many patients do I need to see?" And it's like, "That is a really, really hard question." And so it's kind of like, again, if you do the right thing, the bottom line follows, but the right thing also includes a good, healthy expectation of what a good full eight hours of work looks like. 

Zwelithini Tunyiswa, BS: No, that makes sense. And it's complicated, right? You can have same two providers seeing 20 patients each, but once payer mix is far superior than another's payer mix, right? So as an organization, you can't just say, "Well, this is what we're doing." No, we have to look at individual providers certainly, but we also have to adjust for those different payer mixes or settings that they go and see and come up with, to your point, a business model that makes sense for your organization and have a very clear idea of what that business model is. 
 
Zweli Tunyiswa is Chief Executive Officer and Co-Founder of Open Wound Research.  
 
Ryan Dirks is the Chief Clinical Officer and Co-Founder of Open Wound Research.