HME News

APR 2017

HME News is the monthly business newspaper for home medical equipment providers. This controlled circulation publication reaches 17,100 home medical equipment services providers, including traditional HME dealers & suppliers, hospital- and pharmacy-o

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Product Focus 18 / april 2017 / hme news By John Andrews, Contributing e ditor T he orthotics and prosthetics market is undergoing extensive review by c M s about who should furnish the products and who should qualify for them. i t could mean a change in the landscape and h M e provid- ers need to consider that, if they are cur- rently working in the field or contemplat- ing adding the category to their business mix. t he c M s initiatives have been met with both acceptance and pushback. A pro- posed rule in January that aims to establish qualifications and requirements for certi- fied o &P suppliers is seen as a generally positive development, while an attempt to restrict qualifying criteria for prosthetics has faced stiff opposition. i n a market that has its share of uncer- tainty, h M e providers need to consider whether o &P means " o pportunity & Profit," or " o ppressive & Punishing." Which definition applies is up to the pro- vider, industry analysts say. " i f h M e providers wish to enter the o &P space, this could be an excel- O&P: Opportunity and profit? lent extension of their current business model," said Brad r uhl, president of U. s . h ealth c are for o ttobock. " t his is not an uncommon practice in other parts of the world, in particular in Western e urope and especially in Germany. t hat said, it's not an easy decision to make as it may require significant capital investment and certainly the hiring and staffing of trained, licensed and certified practitioners to ensure qual- ity care and outcomes for their patients." Market projections point up in terms of demand and sales volume going for- ward. A market forecast from r eportstack predicts the orthotic braces and supports market will reach nearly $3.5 billion by 2021, largely driven by the aging popu- lation and patient preference for braces and supports as non-invasive treatment options. t he forecast concludes that the U. s . will dominate the global orthotics space, retaining over 50% of the market share throughout the forecast period. "Braces are increasingly being adopt- ed thanks to their dynamic therapeutic approach, especially in fracture treatment and post-operative rehabilitation," r eport- stack researchers found. "While the market is dominated by knee braces, upper extrem- ity braces are expected to grow at the fastest rate during the forecast period, at a com- pound annual growth rate of 5.1%." o & p certification eyed c M s published its proposed rule on o &P certification in the Federal r egister on Jan. 12. i t would establish qualifications and requirements to be considered a qualified o &P practitioner or supplier. i t would also amend the payment rules to bill Medi- care for prostheses and custom-fabricated orthoses and amend requirements an orga- nization must meet to accredit qualified suppliers to bill Medicare for prostheses and custom-fabricated orthoses. A qualified practitioner must be licensed by the state, or in absence of licensure requirements, certified by the American Board for c ertification in o rthotics, Pros- thetics and Pedorthics; by the Board for c ertification/Accreditation; or "creden- tialed and approved by a program that the U. s . Department of h ealth and h uman s ervices secretary determines, in consul- tation with appropriate experts in o &P." t he certification requirement has long been advocated by the h M e industry and has the support of o ttobock and other o &P manufacturers, Buhl said. " t he o &P field welcomes the accredi- tation requirement as it was originally intended to protect consumers and c M s against fraud and abuse," he said. "Legiti- mate providers of traditional o &P services are accredited, although this may not even be a requirement depending on the state they are practicing in." o ngoing r A c audits have permeated virtually all areas of h M e and o &P is no exception. t herefore, thorough documenta- Back/abdominal supports GF Health Products, Inc. ("Graham-Field") Grafco Supporto t ru SS ■ Athletic-type abdominal support with foam pads supports right, left, or double hernia. ■ Lightweight, comfortable, cool material with three-inch band for extra compression ■ Sized from S to XXL. Proudly made in the USA. ITA-MED Co. M a X ar Delu X e Bio-Ma G netic / f ar– i nfrare D Back Support Belt (BMS- 511) ■ Patent pending belt helps retain body heat and increase blood-circulation. ■ 25 front and six back magnets help create full torso 3D Bio-Magnetic field. ■ Drug-free alternative for pain reduction and rehabilitation after back surgeries/injuries. RangeMaster o ff-Your- n eck a r M Slin G ■ Patent-pending Off-Your-Neck Arm Sling by RangeMaster. ■ Places the shoulder strap in the proper place, off your neck and over your shoulder. ■ Sling weight remains on the shoulder, relieving neck weight and discomfort. tion is essential to keep the auditors at bay. "Audits have certainly been a challenge, but overall, the industry has faced this challenge and as a result are committed to being certain that claim documenta- tion requirements are met and that physi- cians are better at providing appropriate and more detailed prescriptions for their patients," Buhl said. Building on o & p e stablishing an o &P category might only be a small step for companies that already offer compression hosiery, cus- tom footwear, post-mastectomy products and off-the-shelf orthotics. t he keys are to have the expertise, certification and reimbursement knowledge necessary for each product. While retail sales are a front-burn- er focus for the h M e industry, o &P is a category that still relies mainly on reimbursement. " c ertainly there are instances where some patients that do not have insurance or adequate insurance to cover the cost of their prostheses or custom orthoses are willing to pay for them out-of-pocket," Buhl said. " h owever, in general, this is probably not a sustainable approach to the market on its own and would essen- tially be very opportunistic in nature for the average facility." Developing a reputation as a full-service o &P supplier requires outreach to refer- ral sources that are specific to the field, such as physiatrists, orthopedic and vas- cular surgeons. Physical and occupational therapists are also major referral sources due to their work in supporting amputees and those needing assistance with their mobility needs through the use of custom orthoses. " r eaching out to local amputee support groups would also be a good approach in connecting with key demographics," Buhl said. h M e c ate G or Y O&P a G rowin G fiel D ■ Burgeoning demand: The orthotics and prosthetics market is projected to reach $3.5 billion by 2021, fueled largely by the aging population and patient preference for braces and supports as non- invasive treatment options. It is a need that HME providers can fill with proper training and credentials. t he c MS factor ■ New landscape: Certification requirements for O&P suppliers are seen as a positive development, but will mean more capital investment in clinical and technical expertise. The agency is also considering more stringent coverage criteria for prosthetics, but it has temporarily shelved the initiative due to industry pushback. o & p referral S ■ Finding specialists: The best referral sources for O&P business are physicians—especially physiatrists, orthopedic and vascular surgeons. Physical and occupational therapists are also part of the referral community, as well as support groups for patients needing orthotics and prosthetics. ITA-MED Co. ita -M e D p o S ture c orrector for w o M en ( tl S o -250 w ) ■ 3-in-1 support for lower back, upper back and abdomen. ■ Highly breathable construction with cotton lining for all day comfort. ■ Other models include Posture Correctors for men and children. Orthozone, Inc. t her M o S kin h in G e D e l B ow with f le X ion & eX ten S ion h in G e ■ New product with PDAC Coding Verification Letter under L3760. ■ Brace includes two Flexion / Extension Hinges for maximum stability and control. ■ Lined with exclusive Trioxon Advantage material for heat and enhanced recovery. Off-the-shelf orthotics Bandages GF Health Products, Inc. ("Graham-Field") Grafco Me D icopa S te Ban D a G e ■ Zinc gelatin premium gauze bandage, optionally with calamine, aids in compression treatment. ■ Can function as a "flexible cast" in treatment of sprains, strains and dislocations. ■ Proudly made in the USA at our ISO 13485-certified facility. Other Swede-O, Inc. u niver S al Shoul D er w rap ■ Provides protection, heat therapy and support for the shoulder. ■ Keeps shoulder warm and flexible while playing sports or during rehabilitation. ■ Universal design fits right or left shoulder, sizes small-2XL. Sports medicine Core Products International, Inc t ri D ent oS teoarthriti S k nee Brace ■ Lightweight, low profile OA knee brace used for medial and lateral unloading. ■ Patented Dynamic Wedge System assists unloading the degenerative aspect on the knee. ■ One size fits most design is easy to put on and adjust for comfort and fit. Braces

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