Four Health makes best of opportunities

HIALEAH, Fla. - As HMEs struggle in the face of competitive bidding and consolidation, provider Leo Extramil has found a way to thrive.

Founded 20 years ago by Extramil's father, Four Health offers a mix of new and refurbished HME products, including mobility, sleep therapy and oxygen and supplies. 

“What we do is we buy closeout medical equipment from companies that are either downsizing or going out of business,” said Extramil, president. “Then we refurbish it (if necessary), make sure the equipment works and sell it with a warranty.”

While the provider offers its products to the public—it used to accept Medicare and Medicaid, but since competitive bidding started, it's adopted a cash-only business model—most of its sales are B2B.

“As Medicare cuts reimbursement rates, providers need to purchase equipment at lower costs, and that's where we come in,” said Extramil. 

Extramil stumbled upon this business model after his company was replaced by a national provider for a local hospice contract. 

“We were left with all this excess inventory, so we started selling it to the local market,” he said.

In addition to selling closeout equipment and supplies to other providers, Four Health has also found a niche in repairs for everything from scooters and patient lifts, to oxygen concentrators, CPAP machines and beds.

“There are other businesses out there that do that, but they only focus on one or two product lines,” said Extramil. “Whereas, we focus on all different types of equipment.”

Extramil credits his company's success to diversification.

“A lot of DME companies have closed down,” he said. “What's worked for us is being a jack of all trades.”