Moving the HME Industry Forward


Success is Predictable for the Local Independent HME Provider

January 20, 2014

GRAND PRAIRIE, TX – The tsunami of change in the HME industry is nothing less than unnerving. On the bright side, these same changes that keep us up at night will soon swing in our favor.

Many bureaucrats and delegates in Washington recognize the value in home care. They understand that our industry keeps costs down and patients more comfortable, independent, and with less comorbidities. We also know that close to 10,000 baby boomers a day are enrolling in traditional Medicare.

If we stand in the sun long enough, we begin to see a solid future for small HME suppliers who manage themselves well within the ever-changing reimbursement world—especially for those who are able to differentiate themselves in this new market. The successful HME provider of tomorrow will have a position as the go-to source for clinicians and referrals on all aspects of respiratory and medical equipment in a home setting. 

They will be seen as health care professionals who are on the forefront of reimbursement and regulatory impacts to HME, product features and benefits, and ancillary items that may not be coded, but provide an additional level of independence and comfort. The new HME success story will be one that tells of a pro-active exchange of knowledge directly to the patients they serve as well as the referring entity.

Too often we fail to recognize who our customer is. Traditionally, we are an industry that promotes and grows our business indirectly.  Our sales efforts are in the hospitals, facilities, and clinics. We call on the social workers and case managers but we seem to be blind to the fact that we are walking into a building where dozens, maybe hundreds of people who actually use and need the products we offer are also residing.

It is ironic that we depend on referrals when there is increasingly strong evidence that the people who need and use HME want to know more about it. They search online and in print media but come up short on information and resources. Physicians and other clinicians are not equipment experts, so patients find very little information other than whether or not their diagnosis qualifies for equipment reimbursement. 

Sure, you can buy a wheelchair online, but that retailer is not educating the consumer on how important sizing, seating, and positioning are to maintain comfort and avoid negative impact to the patients’ condition. We are the only entities who understand this, and yet we are far under-represented online.

We carry this knowledge choosing only to share it with a frazzled discharge planner who is eternally busy, may be working double shifts, who does not have the time or incentive to educate patients on all of the available products that could make life at home so much easier. Don’t blame the discharge planner. We have a responsibility as health care professionals, too.

We need the referrals but we also need our patients to better understand who we are and how we can make their lives more manageable. Recent studies indicate that patients seem to agree. Most people have no idea where the hospital bed they sleep on came from.

Despite having 39 contributors, the Wikipedia page for “Durable Medical Equipment” has only a small, random paragraph description of who we are and what we do. The first item of DME that Wikipedia mentions is an iron lung!?

After reading the paragraph, one would assume that the “Secretary” of “Medicaid” prescribes DME. Despite this very misleading article, there were 2,694 page views in the past 30 days. Wikipedia admittedly pleas for more contributors to this article. They realize it needs professionals to update it. This is just one example of our industry failing to meet consumer demand for education in its present form.

For suppliers who don’t have a retail presence, internet marketing and social media can help fill in that gap. If the only thing you offer on your Web site is information, you’ll be one step ahead of the game. In my opinion, adding value to the referral source, and to the patient, are what sells our products and services.

But as the products are more and more commoditized, we can no longer hold the keys to the only vault containing medical equipment. Anyone can access it. Just take a look on to see how high the consumer demand really is in your area.

Now, more than ever, it’s the service aspect of what we do that we must promote. A large national company may have a well-known name and logo, but the best suited company to provide top notch service is the local guy. The small independent company who cares and depends on their patients as much as they depend on us will win in the end.

Let what you know be heard. Promote your company’s services where your patients are—in their homes, on Facebook, Twitter, Pinterest, etc. Start a blog and engage the questioning caregiver to help find solutions. Industry experts are telling us that the elderly population is highly active online.

We have a monopoly on HME-specific knowledge. We should maintain and constantly seek information and education on the issues that affect us and our customers, taking care to get that knowledge out to our communities.  The trouble with large corporate ventures is that key knowledge often remains in the upper echelons of their bureaucracy.

Rarely do you find a front line employee in a large corporation who understands as much as the smaller local outfit’s front line employee. A week prior to implementation of Medicare’s National Mail Order Program for diabetic supplies, I found myself in a Walgreen’s pharmacy. I was already aware that Walgreens did not secure a mail order contract under this program, but as retailers, they certainly would have some decisions to make about whether or not to accept assignment at the lower rates. 

I was curious about this and asked the lead pharmacist at that Walgreens if they planned to continue accepting assignment on high end test strips for Medicare beneficiaries. His brows furrowed and he shook his head apologetically. “I don’t know what you mean,” he replied. “I’m not aware of any changes.”

Why should he know about NMO? The answer is obvious to us—to best inform the patient and to protect our bottom lines. However, corporate leaders at Walgreens decided that their Pharmacists didn’t need to know. Likely because there would be no change in dispensing (they do accept assignment on all strips). This is a service-less model. We can and will do better than that.

How do traditional independent HME providers capitalize on the consolidation and commoditization of medical equipment in today’s market? Conscientious local providers will look to add value to patients and referrals.  After all, we are best suited to discover the challenges our clinicians are facing and offer a solution. We can be nimble and responsive to the demands of a single referral source if we so choose.

This flexibility is unique to the local provider. We should also shift our sales team inward. Instead of looking at referral activity and volume, take a look at the patients referred. What kinds of equipment did they receive? What is their diagnosis? Would they benefit from an in-home consultation?  What challenges are they facing now that they are discharged and settled back at home?

How much would it mean to the patient to have their HME Sales Rep contact them to see how they and their caregivers are adjusting? What can the HME Sales Rep offer by way of resources or information to the caregiver to make their life easier? What local resources will help with the Alzheimer patients’ quality of life?  Where are the support groups for people with a given illness? 

What home health agency has the best outcomes or expertise with their condition? When we understand the psycho-social reality of what occurs in each individual patients’ home, if we have educated ourselves, we can offer solutions; thus adding value. How much would it mean to be able to go back to the referral and give them an update on how their patient is recovering – physically and emotionally? This patient will certainly know who his/her HME provider is, and that HME provider will be securely incorporated into that patient’s continuum of care.

Laurie Bachorek is director of Human Resources, Sales, and Business Development at MetroCare, Grand Prairie, Tex.