When Blackburn’s Medical Products, Tarentum, Pa, first entered the bariatrics niche in the early ’90s, principal Chuck Blackburn was not too impressed with the selection of bariatric beds available to him. In fact, he was so disapointed that he approached an established manufacturer and helped design a more reliable bariatric bed.

The experience of helping to create a more structurally sound bariatric bed was one of the biggest challenges, and one of the greatest satisfactions, of his career, he says. There was no financial reward—the manufacturer kept the rights to the product—but Blackburn would still do it all over again because it helped ensure that he could provide appropriate solutions to his customers’ needs.

The story underscores what it took then—and still takes today—to be a successful provider in the bariatrics niche: Total commitment.

“The bariatric industry requires maximum effort,” Blackburn says. “You have to have the desire and the dedication to do it right, every step of the way.”

Darin Robinson, sales director of Maximum Medical in Dallas, agrees. “Naturally, you have to offer reliable products, but all things being equal it is the intangibles that will set you apart,” he says. “It is all about consistent service and smart solutions.”

A Growing Market
According to the American Board of Bariatric Medicine, obesity affects some 58 million people across the United States and its prevalence is increasing. Approximately one third of adults are estimated to be obese. The latest studies report that the number of people in the United States that are 100 or more pounds overweight has quadrupled since the mid ’80s.

Rising obesity rates along with the proliferation of bariatric surgery are two key reasons the market for bariatric products has grown. “Many hospitals are now developing bariatric surgical wings and outfitting entire rooms with bariatric equipment,” Blackburn says. “This opens a whole new market for both sales and rentals.”

HME providers looking to enter the niche or expand their existing bariatric business might consider providing some of the essentials—bariatric beds, support surfaces, and lifts—Blackburn says.

Maximum Medical broke into the niche this way just 4 months ago. The company kept getting requests for bariatric products from the hospitals, nursing homes, and home health care agencies it services.

“We realized it was a market we couldn’t ignore,” Robinson says. His advice to those just starting out? Stay focused. Develop a plan for a few products, rather than try to be everything to everyone.

Know the Needs of the Customer
One of the challenges in serving the bariatric niche is that there is no single solution that fits every customer. “Different patients have different needs and different facilities have different needs,” says Bill Barr, owner of Sten-Barr Medical of Tampa, Fla. “Our job is to provide the right product for the right patient.”

For Sten-Barr, this means having a variety of solutions on hand, including beds with weight capacities ranging from 600 pounds for home settings to 1,000 pounds for institutional settings. Product features are equally important. Institutions look for bariatric beds that are equipped with built-in scales to monitor weight changes, integrated trapezes that provide stability as the patient gets in and out of bed, and multiple positioning features, which can assist in emergencies. An adjustable width is also key because it allows the bed to be narrowed to fit through a doorway or into an elevator.

Finally, aesthetics should be kept in mind. “Fortunately, many of today’s bariatric beds do not look industrial,” Robinson says. “Patient dignity was a consideration during the design process.”

Related Products
HME providers also need to be knowledgeable about the various types of support surfaces required for obese patients. For patients who are mobile, a pressure-reducing mattress is often suitable. An alternating pressure/low air loss mattress is a solution for patients who suffer from pressure ulcers, as many obese people do. Finally, there are a variety of bariatric turning or rotation mattresses that use air cells that inflate and deflate to gently turn patients from side to side. Such therapy can be critical to the obese patient with circulatory or pulmonary problems as the rotating motion helps prevent fluid build-up in the lungs.

Customers in both the institutional and home setting will expect providers to offer a full line of bariatric products, and lifts are often an important part of the rental or sale agreement along with the bed.

Manufactureres offer Hoyer-type lifts in both electric and hydraulic manual varieties that typically are reliable for the patient weighing up to 700 pounds. These lifts are movable and take up limited space. However, they usually require more than one person to operate them.

Overhead lifts can usually serve patients up to 1,000 pounds and be operated by a single person. However, they must be preset over the bed and require high ceilings, which can make them unsuitable for use in a home.

“You want to recommend a lift that’s easy to operate, features an integrated scale, and provides a wide range of motion should the patient fall and need to be lifted off the floor,” Robinson says.

Service Sets You Apart
For the bariatric provider, first-rate service is essential to success. Consider the issue of timely delivery of equipment. When a hospital admits an obese patient for acute care, it may not have a bariatric bed available. The provider must therefore quickly assess the patient’s needs, recommend the right solution, and immediately deliver the bed and accompanying equipment. “You must be able to guarantee same-day delivery,” Barr says. “Our average delivery arrives in under 4 hours.”

Ongoing follow-up is vital as well. Maximum Medical provides once a week service checks. “We don’t view ourselves as a vendor, but as an extension of the [health care] staff,” Robinson says.

And technical support is only half the challenge. Supporting caregivers is equally important. Blackburn’s company helps train hospital staff on the use of the equipment and teaches them to troubleshoot problems.

Bariatric patients at home also require unique service. Often, the patient will be released from the hospital and the provider receives the referral. However, the equipment the patient used in the hospital setting may not be suitable to the home. The provider must make a home visit and evaluate the structure. “You assess everything from the stability of the floors so they can handle the weight of the bed, to the width of the doors to the ceiling heights, which will affect the choice of lift,” Blackburn says.

Moreover, servicing the patient directly demands a great deal of sensitivity. It is critical to listen to the patient’s needs, be empathic, and maintain the patient’s dignity.

Daily Challenges, Long-Term Rewards
These bariatric product providers agree that the key to success is delivering on daily challenges and maintaining a long-term perspective. Providers need to be aware of the obstacles. First, the bariatric niche is capital intensive. In addition to maintaining an inventory of high-ticket equipment, there are delivery, maintenance, and training costs. “It’s a high overhead business,” Blackburn says. “You have to be committed to the investment and be patient with your return on investment.”

Moreover, cash flow can be an issue. Institutional contracts take time to be processed, and the provider may find himself on a 90-day payment cycle. To further complicate matters, insurance companies often lack knowledge about bariatrics. Frequently, they do not understand the special needs of obese patients or the high cost of bariatric equipment. “Convincing insurance companies to cover a greater portion of the costs often requires direct negotiation on the part of the provider,” Blackburn says.

Keeping pace with technology is another hurdle. Equipment that was cutting edge 5 years ago may be archaic today.

Finally, the bariatric niche is highly competitive. An independent provider may be up against some of the largest organizations in the business backed by a national network. Providers need to be extremely thorough and dedicated to stay competitive. Still, you can set yourself apart by excelling at the service end. That means cultivating staff who are knowledgeable about the products, an asset to caregivers and patients, and capable of solving unique problems.

It is a tall order, but bariatrics is a burgeoning market. If you have the staying power, it could prove a powerfully profitable market for you.

Marianne Matthews is a contributing writer for Dealer/Provider.