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One Size Doesn't Fit All

Bariatrics is a big growth market, but you've got to know — and show — the products.

A challenge for the bariatric market is to define what the term
means. Doctors may define an obese patient as one with a body mass
Index (BMI) of 30 or more, while Medicare may define a bariatric
patient based on weight. Neither definition accounts for body types
and other variables.

HME providers may also be discouraged by the capital outlay
required to provide bariatric products, says Phil Cunningham,
business manager for home care beds, Invacare. The equipment is
different — and more expensive — than standard home
care products. However, Invacare and other manufacturers now offer
financing plans that can help to spread out those costs and keep
them in line with monthly receivables.

"I would say the market out there is significant enough that in
almost any DME area, there's a bariatrics market, but the challenge
is to find referral sources and speak to them specifically about
bariatrics," says Cunningham. He encourages providers to bring up
the subject with referral sources: "Tell me about your bariatrics,
tell me about your obese patients."

According to Cunningham, the sector remains largely untapped.
"There are huge pockets in the country where they don't have
access," he says.

But it's a not a market for everyone. "I cannot stress enough
the sensitivity and compassion [needed] when working in bariatrics
as well as keeping yourself educated on the products available and
the needs of the patient," says Roberta Jacobs, national sales
manager for bariatric product maker Gendron.

Understand Consumer Needs, Put Quality First

The market for bariatric HME products is growing right along
with the country's waistline. More than a third of U.S. adults are
now considered obese, a number that has been trending up for two
decades.

That's something Elaine Latham, a bariatrics specialist at
Electropedic, sees first-hand. "I have been called 'an angel'
because I listen to people and help them," says the Burbank,
Calif., provider. Electropedic has two stores in California and one
in Phoenix, with about 60 percent of its bariatric business online.
Latham has a lot experience providing various bariatric products,
from lifts to scooters to beds, which has given her a good view of
the market.

She emphasizes the benefits of listening to bariatric patients
to figure out the products that can help them at home. Too often,
she laments, providers tend to favor a limited number of beds or
other equipment that may not work for these patients. "The bed is
the most important thing," Latham says. "When you bring someone
home from a nursing home, the first things you need are a bed and a
proper mattress."

She warns against the pitfalls of price sensitivity related to
bariatric beds. Buying a less expensive model of lesser quality is
unlikely to meet the patient's needs, she says. Latham also
emphasizes the importance of matching the right mattress to the
person. "It's very specialized," she says. The same concerns extend
to the assortment of available bariatric products, such as shower
chairs and toilet products. "The whole industry has bariatric
equipment," says Latham. "The manufacturers are out there.

"I try to help people with different kinds of options," she
says. Latham knows all too well the challenges of being homebound.
Her late husband suffered through a long illness and was confined
to a bed. "The last year was not easy, so I can sympathize," she
says. "I understand what people go through."

The government's rules need to change related to bariatrics,
contends Latham, but she doesn't expect they will. "They go by
weight [of the patient], not by the needs of the patient," she
notes.

For example, a patient must weigh at least 351 pounds to qualify
for a 42-in. bed, and more than 600 pounds to quality for a 60-in.
bed, Latham explains. She recalls a 37-year-old patient who weighed
557 pounds and had been in a flat bed for five years. "They wanted
to put her in a 42-in. bed, so I had the nurse measure her girth.
This woman is 51 inches and you want me to put her in a 42-in.
bed?" asked Latham. In that case, she appealed to California's
MediCal (Medicaid) program and convinced authorities to pay for the
larger bed — a successful outcome that happens all too
seldom.

Appealing to Medicare is less successful. "I can't change it,"
says Latham. "Unfortunately, a lot of people who make the rules
have not been in this position and don't know what they are dealing
with." Latham remembers another patient who was unable to get out
of bed, but Medicare didn't cover the electric lift she needed.
That means some bariatric patients whose caregivers may be frail or
elderly, or those unable to handle the patient safely even with the
help of a manual lift, are stuck, she says.

Choosing beds based solely on weight also presents other
problems, says Latham. "People lie about their weight, so if
someone says they weigh 350 pounds, I would never give them
anything close to 350-lb. weight capacity." Latham also notes that
certain medications can cause rapid weight gain that could make a
prescribed bed inadequate within weeks.

Latham's bottom line on Medicare? "There are too many rules and
regulations," the frustrated provider states.



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