Incontinence supplies have long been a staple in the product mix offered by Home Care Medical (HCM) Inc, but today they are also a growing factor in the success this Milwaukee-area outfit is enjoying. “We’re the last HME enterprise in and around Milwaukee to still operate full-service showrooms,” says company president John Teevan. “We haven’t had to abandon showroom retailing like so many of our competitors because, in part, we’ve gone to great lengths over the years to balance our business lines. These are currently divided about evenly among supplies, equipment, respiratory, and infusion therapy. It’s in the supplies arena where incontinence products and services come into the picture, and they’ve been very helpful to us.”

Private meeting rooms allow Anita Lelford (right) and other Home Care Medical staff to answer customer questions confidentially.

Demand for incontinence items is rising in the Milwaukee market—home to an estimated 1.5 million people—thanks to an aging population and to the fact that more people than ever are undergoing various types of treatment that can induce incontinence, such as colostomies and prostate surgery, Teevan says.

Incontinence products carried by Home Care Medical include briefs, undergarments, liners, underpads, catheters (Foleys as well as the intermittent type), reusable plastic pants, pelvic muscle toning weights for Kagel exercises, and cleansers, says Patti Kelnhofer, manager of retail store operations.

BENEFITING FROM AWARENESS
Although HCM says it has no retail rivals of note among Milwaukee medical suppliers, the company does face mild competition for the most basic incontinence items from supermarkets, convenience stores, and discount mass merchandisers. “We don’t worry so much about that form of competition because those outlets do not—and, in fact, cannot—carry the range of incontinence products we do, and none of them offer service even remotely approaching the level of ours,” says Gloria Gerard, RN, ET, CWOCN, who manages the incontinence, wound care, ostomy, and sequential pump programs for HCM.

If anything, the availability of incontinence products in supermarkets has been a boon to HCM, since those operators and their vendors spend millions of dollars annually on promotions and advertising to stimulate purchases of the few incontinence goods they stock. The result is that a lot more people are thinking about incontinence than would otherwise, and HCM appreciates that. “The awareness those ad campaigns have generated are dovetailing with and benefiting our own incontinence marketing efforts,” Gerard says.

HCM’s highest-visibility marketing tool is television advertising. However, the commercials the company has run for the last 2 years are of a general nature, nothing dealing with specific categories of products—yet. “Our commercials at this stage are designed to build awareness of Home Care Medical and explain to viewers what sets us apart from the competition,” Gerard says. “Eventually, we will produce some commercials that call attention to individual product and service lines. Incontinence will be one of them.”

A large, attractive display of incontinence products in the center of the store can create good “word-of-mouth” business, says Gloria Gerard, RN, ET, CWOCN.

Currently, the big guns of HCM’s incontinence marketing strategy are newsletters, flyers, referral development, and dynamic in-store merchandising. “The newsletter we produce on a regular basis is a major tool for promoting all of our products and services, not just incontinence, but we do highlight incontinence on its pages,” Teevan says. “In addition, once a month we generate flyers to reinforce the messages of our newsletter, and we tailor these to different target communities.”

HITTING THE SPEAKING CIRCUIT
HCM also operates a Web site. Since last July, clients have been able to re-order their incontinence supplies online. “It’s very convenient for people, and it increases their privacy,” says Enid Asmus, communications manager. “Many people find it embarrassing to order these products by telephone from work or at home, where other people are around and within earshot. Because of the privacy of ordering over the Internet, we’re seeing a steady increase in the number of people using it.”

Educational materials HCM developed in support of incontinence products and services prove effective as well. Many of these end up in the hands of physicians, nurses, discharge planners, and social workers, which helps prime the pump for referrals.

HCM is also keen about in-services because of their value in reaching referral sources. The company conducts them at hospitals and clinics, in physician offices, and before audiences at community clubs, civic organizations, and disease-specific support associations. Currently, the company has a rotation of about 20 groups to which its representatives speak each year.

“We’re only too happy to make presentations to any group or agency that invites us, whether it’s at the mall or at a health fair or at a public meeting place,” Gerard says. The company encourages such invitations by letting it be known through mailings, phone contacts, and direct personal interactions with group officials that HCM is available and willing to send out its speakers.

Referrals also are attracted to HCM by the credentials held by company employees, many of whom are clinicians, says Paula Carlo, director of sales and development. “We found that enterostomal therapy nurses throughout our market area were very willing to refer patients to us because of our certified clinical specialists in incontinence,” she says. “Referral sources are comfortable about sending us their patients because they know that those suffering from incontinence will receive the quality of help that can make all the difference in the world.”

HCM has constructed several avenues for interaction with those enterostomal therapy nurses, along with other types of practitioners in a position to refer incontinence patients. One route is through direct sales calls. Another is by way of service agreements with local hospitals. “Right now we have contracts with five of the largest Milwaukee-area hospitals to provide those facilities with on-site staff to coordinate discharge planning and care planning,” Carlo says. “This provides an excellent means by which we can help guide the discharge planners and social workers in ordering the products and services that will be most appropriate for their patients, whether it be incontinence supplies or something else. We’re the only home care company in this market that has this kind of relationship with the hospitals.”

IN PLAIN SIGHT
At HCM’s two retail stores, attractive shelf displays help shoppers quickly find the incontinence products they need. The products have their own section, which is easily visible to all customers who enter the store. “We didn’t want to hide the incontinence products and make the section something you have to ask the store personnel for help in finding if you’re a first-time customer,” Gerard says. “Many people who come to our store don’t have incontinence, but they know someone who does. By making the section visible to everyone, it encourages those who aren’t incontinent to pass the word along to those who are that Home Care Medical is the place for incontinence care.”

—Gloria Gerard, RN, ET, CWOCN, Home Care Medical Inc, Milwaukee

A small conference room is available near the incontinence section so that customers with questions about incontinence and the products available for it can speak privately with one of the clinically trained specialists on duty and view product videotapes specific to the condition. The specialist often remains in the room with the customer during the showing of the videotapes. “We don’t consider it a waste of employee time to do that,” Gerard says. “We’re totally service-oriented; that’s our mission, and that’s why we stay with the customer while the videos are playing, so that we can be there to answer questions on the spot as they arise.”

An effective technique for moving incontinence products is to offer vendor-supplied samples to customers, Kelnhofer says. “This way, the customer can go home, try the products in private, and make a decision based on what works best for him or her,” she says. “The samples cost us nothing if they’re provided by the vendors, and, fortunately, the vendors have been very generous in keeping us supplied with those. But if we don’t have any available, we’re perfectly willing to take samples from our own stock.”

HCM further ensures success with its retailing of incontinence products by allowing the person in charge of the incontinence department at each store to participate in the making of purchasing decisions. “In many companies, purchasing decisions are made entirely by the purchasing department based on transaction history reports and pricing considerations,” Gerard says. “But we find it invaluable to have our department managers provide input to the purchasing department before any such decisions are finalized. The department managers have a better sense of what’s available in the market and what might do well in their stores because they’re the ones down in the trenches, so to speak, and know the needs of their local clients.”

HCM also benefits by belonging to a group-purchasing organization, The MED Group. HCM has used group purchasing for about 2 years now, and this has made it possible for the company to source and procure various incontinence products at significantly volume-discounted prices.

Among the incontinence products HCM sells, only briefs, underpads, and catheters are covered by Medicare, Medicaid, and private insurance. Thus, with about 40% of HCM’s incontinence volume tied to third-party payment, the enterprise has had to scramble to find ways to offset the drain on revenues resulting from downward pressure on reimbursements. What HCM came up with in response was a strategy of using a drop-shipment service to drastically pare the need to maintain a product inventory. “Now, we have almost no incontinence inventory other than emergency levels in the retail store and warehouse,” Teevan says.

The drop-ship company is about 20 miles away and receives purchase and delivery information via computer connections. The product usually ships the same day. At the end of the week, HCM receives a bill from the drop-ship company and then processes its claims. “In addition to protecting our margins, it enables us to afford to continue employing those higher-educated and better-trained staff, so we can keep building our business,” Teevan says.

By making smart expense cuts that do not impact service or efforts to reach referral sources, HCM is guaranteeing itself a bright future in incontinence supplies and HME.

Rich Smith is a contributing writer for Dealer/ Provider.