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
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
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
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
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
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.
Make the Right Choices
Drive Medical also recognizes the challenge of identifying what
is considered "bariatric," according to Ed Link, vice president of
marketing. The manufacturer offers a full line of bariatric
products targeted to bath safety, mobility, beds, patient room
pressure prevention and powered mobility. The company recently
introduced a 22-in.-wide transport chair that can accommodate 450
pounds and weighs only 33 pounds.
Drive includes a BMI index in its catalog to help determine the
extent of obesity, but Link recommends better training for staff to
identify specific bariatric needs.
"If you are providing equipment for a specific patient to use at
home, many measures should be taken to ensure you are getting the
proper equipment," adds Jacobs of Gendron. "Wheelchairs are not
one-size-fits-all, and a patient should be measured for their
chair. The same for the bed, depending on the patient's size and
ability. The bed should be selected that best meets the needs and
functionality of the patient. This may require a
width/length-adjustable bed, a low-height bed or both."
When selecting a bed for a specific patient, Jacobs says, it is
important to look at multiple choices "to ensure the patient is
getting the proper product." Gendron's bariatric beds can meet the
needs of patients up to 1,000 pounds. The company's Model 3807 is
an ultra-low bed designed to meet the needs of the patient when
fall prevention is important. With a weight capacity of 500 pounds,
the three-function electric bed can be width-expanded up to 48 in.
The company also offers wheelchairs, walkers, recliners and bath
safety products, and last fall, moved its assembly operations
— for the second time in five years — in response to
the growth in its bariatric business.
Jacobs adds that HME providers should be educated on the
equipment that is available, be aware of the geographic market they
serve and create relationships with referral sources for bariatric
products. "Value-added service is also a key factor in establishing
a solid bariatric business," she says.
Let Customers Know You've Got the Products
Because bariatric equipment is not a high sales category,
providers tend not to stock these items, says Brad Goodman, vice
president of ConvaQuip. But he also believes that even "carrying
one or two items in the better-selling categories can enable
consumers to get a hands-on look at the product, which would help
In ConvaQuip's wide-ranging line of bariatric products,
including a single-point cane to a fully electric bed, products
have weight capacities going from 350 to 1,000 pounds. One of the
company's products is a freestanding trapeze with a 1,000-lb.
capacity that folds up and has wheels so it can be moved from room
Goodman contends the bariatric market is about more than just
providing equipment. Bariatric equipment can aid safety by
preventing injury to a patient or caregiver. He recommends that
providers' websites include a specific "bariatric" category. They
should also educate employees about the manufactures and
distributors that deal in bariatric products, and the types of
products that are available, he says. "Many times we get a call
from a company looking for an item and wondering if they could set
up an account, only to find their company already has an account,"
Cynthia Counts, director of homecare sales and marketing for GF
Health Products, agrees. "The bariatric market is sometimes
overshadowed by the standard products out there," Counts says.
"While the volume for DME products is larger with the standard
options, some providers are doing very well with the category
because they understand the need for it, which increases when
consumers are informed of their options."
Counts says HME providers can increase business in the category
by researching their local areas and targeting rehab centers. "Many
places that are working with bariatric patients are often not aware
of the different product options available to them," she says. She,
also, recommends showcasing bariatric options on the sales floor.
"Some retailers show the standard items and are unaware that they
could be missing opportunities for someone to see an item that
could benefit themselves or someone they know," Counts
Last month, Graham-Field introduced its Lumex Bariatric Folding
Commode to accommodate the growing bariatric population. The new
product offers both a greater weight capacity and more seating
surface to provide the same level of user comfort as a standard
commode, and is easier to store, transport and deliver to the
patient, the company says.
The Time Is Right
Invacare's Cunningham sees some utility for bariatrics-directed
equipment among non-bariatric patients. He gives the example of a
patient whose spastic body movements, including tensing up and
pushing on the footboard, were destructive to his standard bed. The
patient was put in a mid-level, stronger bariatric bed, which was
Cunningham says Invacare is seeing significant growth in
wide-bed sales (39-42 in.) in the long-term care market, largely
for safety reasons among patients likely to roll out of a 36-in.
bed. While he notes that home care trends tend to follow those in
long-term care, a challenge is that Medicare will not pay enough to
supply a wider bed, and the difference often makes the approach
In addition to beds, Invacare's bariatric line includes sleep
surfaces, wheelchairs, walking, bathing and patient transfer aids
and is targeted to patients from 350 to 750 pounds.
One of the company's key bariatric products is its BAR750 bed
with a split frame that is expandable for various height and weight
ranges. The bed is used both in long-term care facilities and for
home care, so a patient going home from a facility can use the same
bed he or she is familiar with.
Jeff Hollander, sales and marketing director of scooter maker
Ranger All-Season, says his company, too, has "seen an upswing" in
provider interest in bariatric products. The company offers several
bariatric models, including the Solo HD in three- and four-wheel
models with a weight capacity of 450 pounds, and the Solo XT550, a
four-wheel scooter with a weight capacity of 550 pounds.
According to Hollander, he's seeing an increasing number of
providers who are putting higher weight-capacity scooters on the
showroom floor so that bariatric clients can test drive an
appropriate model on the spot. Displaying bariatric devices
"increases the probability that a sale can be made," Hollander
says, adding that too many providers are overlooking an important
source of new revenue by not providing bariatric products for the
client base in their local areas.
He points out, however, that customer service reps should be
knowledgeable about bariatric products from various manufacturers
and about each product's history of safety, reliability and
longevity. (His company, he says, has begun to catalog the number
of Ranger scooters that have demonstrated exceptional longevity,
including some scooters that are 19 and 20 years old and still
Hollander says providers should become known as the bariatric
experts in their locale and communicate to consumers that expert,
caring hands are waiting to serve them, that they have working
models on the showroom floor and that friendly representatives can
fully explain the benefits and use of the products.
ConvaQuip's Goodman thinks providers should consider becoming a
"one-stop shop" for bariatric items. "Typically, if the end-user
needs one piece of equipment, it's likely they need other items as
well," he points out.
With more demand for bariatric products among the burgeoning
baby boomer population, he advises, "It is a good time to promote
and position yourself as a provider of bariatric equipment. Get
that message out now. State that in all of your literature and on
- Cynthia Counts, director of homecare sales and
marketing, GF Health Products, Atlanta
- Phil Cunningham, business manager for home
care beds, Invacare Corp., Elyria, Ohio
- Brad Goodman, vice president, ConvaQuip,
- Jeff Hollander, sales and marketing director,
Ranger All-Season, George, Iowa
- Roberta Jacobs, national sales manager,
Gendron Inc., Bryan, Ohio
- Elaine Latham, bariatrics specialist,
Electropedic, Burbank, Calif.
- Ed Link, vice president of marketing, Drive
Medical Design and Manufacturing, Port Washington, N.Y.