Bariatrics: More than a marginal business

HME retailers who want to succeed in the bariatric product category need to treat it as a full-fledged business segment rather than a mere sideline, equipment makers contend. The obesity epidemic in the United States has fueled one of home medical equipment's biggest-ever product booms, with hundreds of new items now being produced for retail sales. Offerings go beyond the traditional heavy-duty beds and wheelchairs into walkers, rollators, orthopedic garments, hosiery and even shoes. This product plethora presents numerous sales opportunities for astute retailers who want to expand their inventories and allocate space in their showrooms for a bariatric section. Attracting bariatric clientele, vendors say, requires a commitment to learning about the nature of obesity, the challenges these consumers face and carrying the appropriate products to fit their needs. "We hear that a lot of providers are dipping their toes in bariatrics and not treating it as seriously as other business segments," said Michael DiFranco, group product manager for bariatrics at Elyria, Ohio-based Invacare. "This type of silo thinking needs to change. "If you are selling just beds, there is a great chance that the customer will need other bariatric products, as well," he continued. "You need to become a total bariatric solution provider." Providers already serving the diabetes and sleep markets may find bariatrics to be a natural business fit because obesity is a root cause of insulin resistance and obstructive sleep apnea, as well ambulation challenges. This situation creates synergistic cross-market sales opportunities, such as furnishing a reinforced bed to a CPAP patient or showcasing diabetic supplies next to bariatric mobility aids. Avi Weiss, director of home healthcare for Springfield, Ill.-based medical wholesaler H.D. Smith, agrees that many providers haven't fully committed themselves to bariatrics and, as a result, are denying themselves the market's full economic potential. "You can't be 'kind of pregnant' toward it," he said. "The hard part has been getting retailers to put products on the shelf. However, once they do, they are finding repeat sales from it. And this market will only continue to grow." H.D. Smith's bariatric product line has ballooned rapidly to meet escalating demand for the products. Some manufacturers like Mundelein, Ill.-based Medline Industries, now have more than 300 bariatric SKUs. Not only are there more types of bariatric products being produced, but also weight limits are going higher and dimensions are getting wider, said Dave Jacobs, president of Medline's Durable Medical Equipment division. "One area for growth has been extra wide wheelchairs," Jacobs said. "Ours go to 20 to 24 inches wide, with weight capacity in the 350- to 450-pound range. There has been a lot of interest in these." Eager to fill burgeoning demand, the number of manufacturers offering bariatric products has also swelled, but retailers need to carefully evaluate the merchandise that is now flooding the market, cautioned DuWayne Kramer, president of Kansas City, Kan.-based Leisure-Lift. "What we're seeing is a lot of suppliers jumping into the market that have no clue what they're doing," he said. "I call it the 'race to the bottom.'" In meeting with retailers, Kramer says, there are countless stories about how substandard products have broken or fallen apart. Well-made beds that meet 1998 FDA standards have undergone stress tests that include twice-the-rated-weight pressure for an hour and rated-weight pressure for 6,000 cycles. "The companies making cheap products are ignoring this," he said. As the bariatric market evolves, manufacturers are rethinking the way these products look and operate. Manufacturers like Invacare are soliciting consumer feedback in order to inject more innovation into product design, DiFranco said. "Up to now these products have been pretty utilitarian, so that means the market is wide open in terms of opportunity," he said. "It has to do with understanding how the bariatric patient functions and the product needs they have. It goes well beyond weight capacity." Likewise, Exeter, Pa.-based Quantum Rehab is looking at ways to improve its bariatric product line, said Scott Higley, vice president of sales. "The image of bariatric chairs is that they're big, with beefed up tubing and a heavy-duty motor," he said. "But people don't want medical-looking products. We want to enhance the look without sacrificing function." Leisure-Lift has found a niche with custom fitting. "I'd say close to 60% of our orders are custom seats and situations," Kramer said. "Even though they're large, these people come in all shapes and sizes and we want to accommodate them." As with other specialty markets, HME retailers need to learn as much as possible about bariatric clients' medical condition and how that translates to their living environment. "The level of expertise needs to go beyond the buzz words," DiFranco said. "We don't know everything about obesity, but we want to be a pathway for those seeking help in those areas." To increase awareness for its institutional clients in acute and long-term care, Medline has put together a "bariatric readiness assessment" checklist to evaluate doorway widths, waiting room furnishings, bathroom fixtures and staff sensitivity issues. This criteria could easily be applicable to HME, as well, Jacobs said. "The bariatric readiness assessment is a tool that can be used to assess [a provider's] ability to accommodate bariatric patients," he said. "This tool is not a prescription, but rather an evaluation of bariatric readiness."