Accessibility market complements HME biz

Before Medicare came down hard on the HME industry with competitive bidding, getting involved with home accessibility just wasn't something that providers thought much about. Because the machinations are different enough, they didn't see it as a natural extension of their business.

Now in the days of waning Medicare reimbursement, HME providers are taking a fresh look at opportunities in home accessibility, studying its merits and potential application as a new, more commercially oriented model. Upon further review, the accessibility segment has gained a lot more appeal, says Fred Jensen, vice president of sales for Prairie View Industries in Scottsdale, Ariz.

“We've seen substantial growth in our business annually, with double-digit growth in ramps,” he said. “What's happening with competitive bidding is changing the HME landscape and there are two developments as a result of that—full-line accessibility companies are coming out of the construction industry and HME providers are getting into it because they don't want to lose the customers they have worked so hard to attract. They don't want to lose them to a full service company just because they weren't previously into home modification and accessibility. That's an expensive proposition.”

Providers are finding that the segment isn't as difficult as they imagined, Jensen said, especially for modifications using modular ramps.

“The sense was that you had to be a brain surgeon to do home accessibility and it's just not true,” he said. “We work on how to make our solutions simple and out-of-box ready. Modular ramps represent the biggest segment of our business. They are simple and easy to install, making it is easy for HME providers to enter the space.”

Detailed projects

Sarasota, Fla.-based Harmar started as a vehicle lift manufacturer and has since expanded into various aspects of home accessibility as demand has increased, said David Baxter, vice president of marketing.

“Our customers are evolving and as they do, we are here to provide the products they need to help patients with their life's journey,” he said.

When considering how to approach home accessibility, HME providers need to look at the different aspects of the process and what product and labor resources are needed for all projects, from simple modular layouts to more complex infrastructure modifications, Baxter said. Hiring or contracting with someone who has construction experience adds to the image of professionalism, though Baxter says “there is no one right business model” for providers to follow.

“Vehicle lifts can be done on premises, but home modifications have a whole other set of dynamics,” he said. “There can be all sorts of licenses and permits involved and every state has different requirements.”

While there might not be one right model to follow, Jensen says most of the HME setups he's seen involve subcontracting with local professionals.

“When the depth of a project goes beyond an out-of-the-box solution, it makes sense to work with a local partner for door widening, deck building and bathroom remodeling,” he said. “Unless you're located in a large urban marketplace, you typically won't have the capacity for a full service, soup-to-nuts shop.”

Progression of needs

As patients age in place at home, the accessibility business can bring continual returns for HME providers, says Baxter.

“Patients will have a progression of needs,” he said. “A scooter customer will eventually need a chair lift.”

Jensen estimates that spinal cord injury patients will inevitably need approximately $35,000 in home modifications over time and that those patients will continually contact their HME provider when the time comes for new products or home alterations.

“These are established customers—do everything possible to take care of them,” he said. “The last thing you want is for them to call somebody else.”