Accessibility not a 'pizza franchise'

Home accessibility—the business of modifying houses to accommodate mobility clients' physical challenges—is a category that has long offered HME providers the potential to build off sales of durable medical equipment. Surprisingly, it has been historically slow at gaining traction among those companies serving mobility patients, but in recent years has gained more interest, specialists in the field say.

“This market is doing well because for starters, the growth in the number of seniors over the past 10 years has been noticeable - they are everywhere,” said Alison Harper, business development vice president for Savaria in Brampton, Ontario. “We know that there are more seniors, we know they want to stay in their homes as long as possible and we know that stairs are one of the top concerns in order to realize that stay-at-home goal.”

Wade Lawrence, regional sales manager for Oakdale, Pa.-based Clarke Health Care, also sees heightened growth in the accessibility market for HME providers.

“I believe it has fared well and in the past few years I believe the trend is growing,” he said. “You are seeing more companies offer this service that have not offered it before. I think the HME industry is looking at ways to grow, and with funding cuts, many companies are trying to grow their cash business.”

To be sure, customer demand for home accessibility services is a robust market, said Robin Campbell, president of Billings, Mont.-based Accessible Home Solutions.

“We have approximately 11,000 people turning 65 every day—this is what's driving 'aging in place,'” she said. “The number of Americans ages 65 and older is projected to more than double from 46 million today to over 98 million by 2060, and the 65-and-older age group's share of the total population will rise to nearly 24% from 15%. The average life expectancy is increasing each year and is currently around 79.”

HME providers are perfectly situated to serve this market, Campbell said, because they are already seeing patients in the home and providing aids to daily living.

“Most are doing home assessments for oxygen safety, so they are familiar with the process,” she said. “Extending the services to home modifications makes perfect sense - providers already have relationships with industry vendors, referral sources, clients and their families.”

Key drivers

Harper says the demand for accessibility services has created a ready customer base, but cautions HME providers interested in entering the business not to tread too lightly.

“I think to be truly successful in HME, you need to be 'hands on,'” she said. “It's not a pizza franchise where you can hire a group of students. You need to be ready to listen to each client's needs, know your product and then know how to work with site considerations. We've seen great husband-and-wife teams where they can bring all those skills together to get started and generate success quickly. You need a wide variety of skills.”

Echoing that point, Lawrence maintains that “the best way to get into the business is to have a great team set in place so you can showcase the work. It's important to have skilled employees that understand the concept of producing quality work.”

Taking and showing photos of each job shows prospective customers the kinds of modifications that can be done to their homes, while home evaluations can give them specifics about the improvements, he said.

“There are many needs to be taken into consideration, such as what products from A to Z need to be looked at in order to achieve what the patient wants from the project,” Lawrence said.

Campbell adds that dealing with prospective clients can be a delicate psychological process because they are undergoing a traumatic experience with their health.

“Most people want to stay in their homes, but those homes don't support a safe environment for aging in place and most don't have a plan for it,” she said. “I can't count how many times I've heard someone say 'Yes, I know I need to do that, but I'm not ready yet.' Unfortunately, home modification requires money and time, which in turn creates stress and anxiety for patients and their families. But it's preventable with planning and preparation.”

Find a focus

Vision and focus are an integral part of any home accessibility project and it requires contractors to work closely with clients and their families to get everyone on the same page, Harper said.

“Cost questions inevitably come up, but education about the cost of alternatives is often helpful,” she said. “The might include costs associated with moving, staying in a senior living community or the cost of a fall if nothing is done. A fall is not only an economic cost, but is also a tremendous setback for the client's health.”

The scope of home accessibility services is wide and can present a challenge for small- to medium-sized HME companies to manage, Harper said, so it's important to focus on certain aspects, such as lift and ramp installation.

“Bathroom renovations and elevator installations may require more expertise or licensing, so you may not want to take that on unless you feel confident with it,” she said. “It is best to stick with what you are trained to do and what you feel confident about. We have to remember that clients are trusting us with their safety, so you need to know your stuff.”