Diabetes opens door to new referral sources

With its myriad co-morbidities, diabetes is a market that can offer HME providers access to a referral source stream they never considered before. A company established as a full-service diabetes supplier can access a wide range of specialists, including endocrinologists, podiatrists, ophthalmologists, dermatologists, orthopedists, hematologists and vascular specialists.

To start, as they are with all other markets, primary care physicians are the gatekeepers for diabetics and research shows they have regular contact with these patients. The Centers for Disease Control and Prevention's National Center for Health surveyed more than 34,500 people in 2013 on healthcare encounters, including more than 3,500 diabetics.

Access to health care is especially critical for diabetes patients, CDC officials said, because of its multiple co-morbidities.

The survey showed that diabetic respondents reported having contact with a physician or clinical professional within a six-month time frame. Specifically, respondents said they had encounters with eye and foot specialists within a 12-month timeframe, survey authors said.

More than one-third of adults aged 18-39 with diagnosed diabetes (35.9%) had contact with an optometrist, ophthalmologist, or eye doctor during the past 12 months and diabetics aged 65 and over were 1.5 times as likely (28%) as those aged 40-64 (18.7%) and 2.5 times as likely as those aged 18-39 (11.1 %) to have had contact with a foot doctor during  a 12-month period.

The frequency of physician visits offers HME providers a great opportunity to connect with a referral source base they may not have had before, said Robert Heglin, product manager for Mequon, Wis.-based Dr. Comfort.

“Podiatrists are a good referral source—we're partnering with providers to connect with them,” he said. “Of course, referrals start with the primary care physician, but there are a number of specialists available for diabetic patients.”

Strong cash potential

With a wide array of products and waning Medicare reimbursement, the diabetes market shows great promise in becoming a strong retail category, said Brandon Noble, director of sales for Vionic Group in San Rafael, Calif.

“We are seeing a lot more interest in the market from HME providers looking to expand into diabetes care,” he said. “There is an abundance of products being sold for cash—glucose monitors, compression hosiery, toe separators and even diabetic slippers.”

To become a one-stop retail shop, Noble recommends carrying multiple brands because “no one brand has the profile.” Even so, “you don't need to carry all the brands on the market—two or three is ideal.”

The diabetes category can be cross-marketed in various ways, touching on established HME lines in mobility, respiratory, rehab, wound care, aids-to-daily living, bath safety and health and wellness products. In fact, this versatility dovetails perfectly with a holistic approach to keeping diabetic patients healthy, Noble said.

“Our inserts work in conjunction with the diabetic shoe,” he said. “We understand the market's move toward cash, so it's worth tapping into the market for that. Our primary focus is foot health and wellness.”

No biz like shoe biz

Although therapeutic footwear is closely associated with diabetes, offering a custom shoe line benefits patients with a number of mobility, vascular, orthopedic and dermatological issues, Heglin said. Shoes are also an attractive feature product because he said, “people can relate” to a well-positioned shoe display.

Adding therapeutic shoes to the HME business is not a complicated process, Heglin said, though there is a learning curve and training period involved to become proficient. Clinically nuanced shoe fitting gives HME companies a competitive advantage against shoe mass marketers, he said, as does having a certified pedorthist on staff.

“The large chain shoe stores don't size correctly, only measuring the length of toe to heel,” he said. “But the length from the heel to the ball of the foot should also be measured because of how shoes flex when you walk. If the fit isn't correct, it can cause a lot of pain.”

Working with a vendor like Dr. Comfort alleviates the need for excessive inventory because each customer is a special order. The therapeutic footwear business also forges close working relationships between providers and vendors, so services are at a premium, Heglin said.

Vionic also works closely with customers, which helps them operate their footwear segment efficiently, Noble said.

“Footwear is not a difficult business if you have the proper support,” he said. “Seek out manufacturers who can consult you on the process. The good companies will give that to you. If they don't, look somewhere else.” HME