Make pediatrics a relationship-driven biz

Tuesday, August 25, 2015

Perhaps more than any other HME category, pediatrics is more about the patients than the products. While a provider may specialize in mobility, respiratory or rehab for adults, the provider serving the pediatric market should offer a complete spectrum of products and services for patients, experts say.

Having one source for everything provides tremendous support for pediatric patients and their families, said Paul Banz, senior market development manager for Stevens Point, Wis.-based Ki Mobility.

“In general, it makes the most sense to own the relationship with the family and child, providing products for the majority of their needs,” he said. “That said, it also behooves providers to stay within their skill set to make sure they are doing what is right for the client. Overall, if the HME company does a good job, they have that client’s business for life.”

Carrying the full range of adaptive equipment is necessary because children usually need different types of products, says Stacy Clouse, North American market manager for Austin, Texas-based Ottobock.

“The family may come in needing a wheelchair, but after discussing their needs, they may wind up needing a medical bed, standing device, gait trainer, bath chair or other item,” she said. “While some products may have higher profitability than  others, when viewed as a package, the scale of economy means you get more return on your investment.”

Families are looking for holistic care for their children and want a provider who can address their physical, mental and emotional needs, says Scott Crosswhite, vice president of Matthews, N.C.-based Snug Seat.

“A true ‘full service’ provider fulfills that demand,” he said.

No Medicare, but…

Serving pediatric patients allows providers to avoid Medicare, but is Medicaid a fair trade off, reimbursement-wise? Market specialists say it depends.

“Some state Medicaid programs are currently better funded than others based on the health of the economy and values of the governing bodies,” Clouse said. “Some products may pay well, while others may mean a loss on providing a product. HME providers have to understand their state fee schedule to make the right choice for the business and by choosing the equipment.”

Crosswhite says Medicaid is a “reasonable funding source” for pediatric products, but “as with all healthcare, funding is a challenge.” Medicaid requires prior authorization, so providers need to have an understanding of the reimbursement schematic before providing equipment.

Even so, the Medicaid prior authorization can be an advantage in that it provides more certainty for payment, added Milena Rimassa, marketing communications manager for Torrance, Calif.-based Convaid.

Still, while providers don’t have to be concerned with the competitive bidding aspect of Medicare, the program does influence the pediatric market, she said.

“It is hard to avoid Medicare as many payers follow Medicare rules and in some cases, its fee schedules,” Rimassa said.

Thankfully, thr pediatric market does have retail-friendly product lines available, such as car seats, strollers and bathing chairs, Crosswhite said.

“Families are also interested in products and services outside the ‘medical necessity’ bucket,” he said. “That leads to retail opportunities for products associated with recreation or sensory integration.”

Reaching referrals

The list of potential referral sources for pediatric patients is long and diverse. Banz recommends starting with local school systems that offer programs for disabled children, along with rehab facilities with pediatric programs, and pediatric physiatrists and pulmonologists.

Crosswhite suggests children’s hospitals and specialty clinics, such as the Cerebral Palsy Foundation and Muscular Dystrophy Association, which want to partner with pediatric providers.

Networking with families of special needs children is an effective way of demonstrating compassion, involvement and capability, Banz said.

“Many of these groups hold local trade shows and educational events, in which HME providers can participate,” he said.

Occupational and physical therapists tend to have close relationships with patients’ families, so it is important for providers to seek them out, Clouse said. Moreover, families with a special needs baby will see a host of medical professionals who will direct them to a medical device provider.

“Build relationships with these referrals and promote your skill and experience with this population,” she said. “If you’re new to pediatrics but want to learn, seek out a skilled therapist and work with manufacturers’ reps for equipment   training.”