These cash-sale items can boost profitability and support new business
by Larry Anderson
March 25, 2014

Consumers are driving greater demand for orthopedic soft goods sold through DME/HME providers, especially demand for off-the-shelf items that can address minor strains or sprains. Cash-sale items in the orthopedic category can boost profitability and support new business approaches to offset reimbursement challenges. Increasingly, consumers are managing a large proportion of their ailments without consulting either a doctor or pharmacist. HME providers can help customers make informed self-care choices by acting as a communicator, rather than just as a supplier, says Matt Garver, Brownmed’s director of marketing. “An HME provider can engage the consumer by asking key questions to address a patient’s condition appropriately and then passing relevant information to him or her,” Garver says. “Establishing trust forms a valuable relationship, which is a foundation to help consumers undertake appropriate and responsible self-help treatment or, when necessary, to refer them for medical advice.” Consumer advertising is supporting the market, too. Brownmed drives consumer awareness of orthopedic soft goods products by advertising in popular magazines and newspapers, including Prevention, Ladies’ Home Journal, Arthritis Today and local newspapers. The company has also advertised on boomer radio stations and increasingly uses search engine optimization techniques to get educational resources into the hands of consumers searching for it on the Internet. Alex Orthopedic’s national account manager, Mike Murphy, says he has recently seen consumer television advertising for orthopedic soft goods, using a familiar pitch along the lines of “available at no cost to you through Medicare and Medicaid.” The direct-to-consumer plea featured an inflatable lumbosacral support as well as knee, ankle and wrist braces and an offer to “take care of the billing for you.” The TV ad did not mention a specific condition and promoted general pain relief as the major benefit. Such ads could increase general awareness of available products and their benefits, says Murphy, although the specificity of a patient’s need for an orthopedic soft goods product would argue against such a general approach. It’s also difficult to communicate the benefits of orthopedic soft goods if product claims are limited to generalized pain relief. Overall, Murphy sees the market dividing into two factions—one related to HME providers and a generally older populace, and the other specific to treating sports-related injuries. He sees the two markets as totally separate and doesn’t see opportunity for HME providers in the retail sports category because of most providers’ demographic mix.

Keeping People in Motion

Knee pain and osteoarthritis (OA) affect 40 million Americans, and too often the solution is a pill or surgery. “We are working to change that by offering a continuum of products, all recently introduced, to help keep people in motion,” says Joe McClung, senior vice president and general manager, Vascular Business Unit of DJO Global. DJO provides orthopedic rehabilitation and prevention, including the Bell Horn brand in profitable packaging for the home care market. Changes in reimbursement have institutions and consumers placing more emphasis on prevention and delaying surgery. Based on the premise “Motion is Medicine,” DJO focuses on providing non-invasive, simple and economical solutions designed to keep patients in motion. Products include the Flex-OA shoe for alignment, the Reaction Knee Brace with an elastomeric web design for stability and the Fast Freeze topical soothing agent to alleviate pain. Product designs are improving by focusing on key areas of pain and providing simple, easy-to-use solutions that will get customers back in motion and out of the house, says McClung. The additional coding extension for non-fitted orthotic bracing will change the channel, price and products being provided today. It is yet to be seen when and how those changes will manifest, says McClung. “Make the product an experience the patient wants because of the relief and mobility that it can provide, not simply a product they have to wear.” HME providers can generate more cash sales by implementing a plan-o-gram of commonly recommended products, he adds. Customer-facing merchandising and marketing materials provide effective choices at their fingertips, says McClung. DJO offers a wide breadth of products that can be combined to provide unique outcomes to patients and referral sources. “We strive to provide the proper education and outreach to help our providers understand how to position this unique service,” he adds. As for any other segment HME providers are looking to expand, they should consider the referral base, merchandising and marketing (for retail expansion) and payer profiles (for non-cash products).

Cash Items in Retail Packaging

Swede-O provides an extensive line of ankle braces, lower extremity orthopedic soft goods and a line of thermal supports for upper and lower extremities. With competitive bidding and other health care changes, providers are looking for ways to 
increase their revenue/cash business. Swede-O continues to provide reimbursable items and has added to its cash sale offerings, including updated retail packaging. One of Swede-O’s retail sale items is the Plantar F3 Foot Roller for plantar fasciitis/heel pain, a condition that affects many. Anyone who doesn’t have heel pain likely knows someone who does, and the cash item is easy to use and sell, notes Barbara Mauss, sales manager of Swede-O. Competitive bidding, audits and constant changes to Medicare have hit the market hard. “We have seen many businesses close their doors, although there are a number of businesses that are flourishing,” notes Mauss. “The lesson learned is that businesses must be able and willing to change. Diversification is important.” Successful HME providers are committed to the product line and value what it adds to the bottom line, according to Mauss. “Presentation is key and they see the opportunity.” Swede-O provides an extensive line of both reimbursable and cash items. Plan-o-grams of the most popular products make it easy for providers to get in the business. Swede-O has also developed online learning tools and selling tools to educate referrals. “There must be a commitment to adding this component to [an HME provider’s] overall business,” says Mauss. Murphy of Alex Orthopedic suggests providers should in general stick with non-technical, elastic-type products. Alex Orthopedic’s products include neoprene knee braces that provide both stability and pain relief, thanks to the neoprene that holds in body warmth. Orthopedic soft goods are one of six major product lines provided by Alex Orthopedic, which has been in business 26 years and began operations out of a house in Dallas. A mistake Murphy sees some providers make is overreaching in the products they offer and, for example, displaying a product on a wall that really should be fitted. Not all products are conducive to a self-selection approach. If they aren’t, a provider either shouldn’t carry them or they should employ someone with the expertise to fit them, says Murphy. Certification requirements for fitters vary by state. Speaking of fit, Murphy says providers should be sure to stock a variety of sizes, not just medium and large but also small and extra-large. “If you don’t carry enough sizes, you are inviting customers to go somewhere else,” he says. “Advertising is all well and good, but it boils down to the basics of going to your referral sources,” says Murphy. “You should have your name there. The store should provide literature in the physician’s office. Keep your name in front of the prescriber, including occupational therapists (OT), physical therapy (PT) clinics and orthopedic surgeons. If you don’t, customers wind up in Walgreens, CVS or Walmart, where the selection is really bad.”

Varied Product Choices

Since 1965, Brownmed has manufactured quality, innovative orthopedic products, including SEAL-TIGHT cast and bandage protectors, Plastalume finger splints and IMAK Arthritis Gloves, which have received an Ease-of-Use Commendation from the Arthritis Foundation. Other popular products include Nice Stretch night splints for plantar fasciitis, Soft Stride visco-elastic shoe inserts and a line of dynamic vibration therapy products called Intellinetix. A recent study from the World Health Organization (WHO) highlights that one out of three people above age 65 falls each year, and 15 to 20 percent of falls result in serious injury. Bands and braces can provide stability, enhance balance and promote confidence, thus solving an enormous patient need within a demographic that has significant capacity to buy. To fill the need, Brownmed introduced the Intellinetix Step Sensor, which works for people with peripheral neuropathy or other forms of nerve impairment resulting from multiple sclerosis, diabetes, stroke or advanced age. “It harnesses the power of vibration to let the user know when the heel has struck ground, improving gait patterns, enhancing balance and increasing confidence among those who may have difficulty walking,” says Garver.

Understanding Consumer Needs

FLA Orthopedics, a brand of BSN medical, offers a full line of off-the-shelf orthopedic soft goods designed for chronic and acute orthopedic conditions, including sprains, strains, fractures, arthritis and plantar fasciitis. Product development in the market is driven by research and development and a keen understanding of consumer need, says Kim Burgess, product manager, orthopedic soft goods, FLA Orthopedics. Retail cash sales continue to be a buzzword, and orthopedic soft goods expansion is an excellent way to attract and keep cash customers. Last year FLA Orthopedics partnered with Powerstep to distribute “the #1 podiatrist-recommended” line of prefabricated orthotics to the HME and independent pharmacy market. With at least 60 percent of the U.S. population over-pronating, the foot care device market is growing exponentially. Over-pronating involves the foot rolling excessively inward with each step. Many times, the patient gets their first orthotic from a podiatrist and then goes to retail for the next. Carrying Powerstep is a great cash sales opportunity to meet this need in the market, says FLA Orthopedics. Some orthopedic soft goods are still reimbursed; however, as part of the new CMS guidelines, providers will need to determine whether to bill items as off the shelf (OTC) or custom-fit orthotics—the same fee schedule applies in either case. Orthopedic soft goods are used by people of all ages, so advertising to younger consumers increases the lifetime value that patient can bring to an HME store directly or indirectly, because many purchasing requirements are handled by individuals with older parents. Attracting the younger patient can be rewarding for various reasons, says Brian Kletch, senior marketing manager, compression therapy and orthopedic soft goods, FLA Orthopedics. Providers should also consider carrying products that set them apart from the big-box stores. For example, the FLA for Women line of maternity, lumbar and posture control products allows the HME provider to offer a unique line of products designed specifically for women that can only be found in the HME market. To sell more orthopedic soft goods, HME providers should actively promote and bundle them with synergistic product lines. For instance, a pregnant customer who is already in the store to buy compression stockings or a breast pump should be educated about maternity belts and vice versa. BSN’s medical sales representatives partner with HME providers to help them succeed in the orthopedic soft goods market. They start by helping select the best product mix for a location, providing staff training and assisting with marketing efforts. The breadth and depth of the FLA product line ensures that the HME/DME industry can meet the orthopedic soft goods needs of their customers.