Hospital bed referral market still durable

Monday, September 30, 2002

The hospital bed has long been a staple of the durable medical equipment industry product portfolio, along with wheelchairs, walkers and canes. And while some providers have abandoned bed provision to focus on new ventures, those who have stuck with it say it is a reliable market with consistent growth.

Although hospital beds still carry the old institutional DME image with many referral sources, successful providers say innovations are being made and that it's their job to convey the new relevance to referral sources.

For instance, Greg Kaylor, director of Pleasant Valley Home Medical in Point Pleasant, W. Va., says he's seen a spike in requests for bariatric beds, designed for obese patients. The beds, rated for 500 pounds and having heavy-duty frames, are becoming a common choice for referral sources, he said.

"The key has been to educate referral sources about these beds and that they are available," he said. "We've made that a priority in our marketing."

Mark Bragg, president of South Hill, Va.-based Atlantic Medical, says his company has done the same thing with hospital discharge planners and that it has led to a rise in demand.

"They've only been available for a couple of years, so it's up to us to let people know we have them," he said. "It has worked so far, because we're getting more referrals for them."

Finding the right referral source for a particular type of bed is also a way to generate orders, Kaylor added. For instance, a bed specifically designed for Alzheimer's patients is perfect for skilled nursing and assisted-living facility residents, he said.

"The frame is about eight inches lower to the floor, so if the patient rolls out, there is less chance of injury," Kaylor said. "As a result, we're getting rental and sales inquiries from long-term care facilities as well as social service organizations such as the Ohio Department of Aging and the West Virginia Community Action Agency. It has opened up a whole new market for us."

Ralph McBride, vice president of Advanced Home Care in High Point, N.C., has also established solid contacts with long-term care referral sources for beds – mainly SNF administrators and directors of nursing.

"This market makes sense for beds because that's the first thing residents need when they move in," he said. "It has been a great opportunity for us to develop relationships with them."

One product that interests long-term care referral sources is the pressure-relief mattress. Because decubitus ulcers are one of the most common health problems among nursing home residents, clinicians want to know more about how the mattress works, McBride said.

"These mattresses have been a very good marketing tool for long-term care," he said. "Home health agencies are interested in them, too."

Pressure-relief mattresses have helped Lebanon, N.H.-based Keene Medical boost its bed sales volume by approximately 20% in the past two years, said Gary Robbins, director of purchasing. But while manufacturer advancements on mattresses and standardization of parts are positive developments, Robbins believes more attention needs to be paid to the aesthetic design of the beds.

"They're still pretty institutional-looking," he said. "The beds should be made more attractive."

Referral sources seem to be upgrading when it comes to bed models, however. According to providers, the days when hard-to-crank manual beds were the predominant choice are all but over.

"They're pretty much obsolete at this point," Robbins said. "Most everyone wants an electric or semi-electric."

Despite public payers' policy that still favors manuals, Kaylor says the semi-electric has become "the standard of the industry" for hospital beds and that "if Medicare downcodes, they downcode."

Qualifying a patient for a fully electric bed is "extremely difficult," admits Tony Rollins, manager at Boaz, Ala.-based Med-South. But, he adds, payers seem to have loosened their coverage for the semi-electric models.

"They must see it as a happy medium," he said.

Versatile bed models, such as those with full-, semi-electric or manual controls, have contributed to Advanced Home Care's bed business growth, which has increased at about 12% a year, McBride said.

If bed designs have remained staid and traditional, so have referral source channels, providers contend - especially in rural areas.

Med-South, located in a remote part of Alabama, is one example of that. Rollins said that approximately 60% of the company's hospital bed referrals come from hospital discharge planners, while another 30% come from general practice physicians. The remaining 10% are listed as "other" sources, such as hospice, HHAs and the county health department.

Likewise, small independent providers in thinly populated parts of such states as Indiana, Missouri and Texas tell the same story.

"Referral sources have remained the same for a long time - physicians and hospital social workers," said Shanetta Dowen, DME manager at North Side Pharmacy in Vincennes, Ind. "But in small towns like ours, a lot of business comes from word of mouth."

Indeed, providers in small towns may even find that they have an advantage in name recognition and an established reputation among the public, compared to larger operations. King Pharmacy in Albany, Mo., is one.

"We've been here a long time, so people know us," said HME Manager Peggy Stooksbury. "If a clinician in town needs to refer a patient for a hospital bed, they know where to come."

The local grapevine also feeds referrals to Red Oak (Texas) Drug and Home Medical Equipment. Even with a strong local referral base, though, DME Manager Teresa Walton says the company still needs to maintain a high profile through regular advertising.

"Our pharmacy is well known, but a lot of people still aren't aware of our medical equipment business," she said. "We're not that far from Dallas, so we try to keep them here instead of going to the city." HME