Know your coverage criteria for better cash flow and educate staff members and referral sources about the clinical benefits of the profitable and growing beds and support surfaces niche.

According to industry research, the annual bill for the treatment of pressure ulcers by all means and methods is more than $1.3 billion and the specialty bed market is estimated at approximately one third of that total. Add pressure-relief products like special mattresses, overlays, and other devices and it looks like a pretty lucrative market for today’s providers. In fact, one market research company—New York City-based FIND/SVP—estimates compound annual sales growth of pressure-relief products to be at least 11%.

If you are a provider of beds and support surfaces, you may believe that statistics like these mean you can rest easy. The truth is, the bed and support surfaces niche is highly competitive. Experts agree that the best way to remain profitable is to educate yourself, your staff, and your referral sources.

Profit Begins at Home
Specialty support surfaces are used to treat approximately 2 million American patients in hospitals, nursing homes, and private residences. So for providers serving this niche, where is the best place to begin? Start at home. If you begin by educating yourself and your staff, you will have a leg up on the competition.

Gloria Gerard, RN, CWOSN, manager of clinical support at Home Care Medical, New Berlin, Wis, says that providers who plan to be profitable must first understand the products and the Medicare coverage criteria. After all, ensuring timely reimbursement is the fastest way to predict cash flow.

Gerard advises providers to familiarize themselves with the published Medicare Part B coverage criteria information on certification of medical necessity for beds and support surfaces. “Providers should be looking at this carefully and using the guidelines when they provide in-services,” says Gerard.

Her advice makes sense. After all, it is not uncommon for a private insurance company to reject a claim, especially for support surfaces. If you understand—in advance—what Medicare considers fair and reimbursable for specific conditions, you are apt to have far fewer problems with private carriers.

Gerard offers an interesting piece of advice to providers who do run into trouble collecting reimbursement. “Take a photo of the patient’s wound and send it to the insurance company if you are having difficulty getting paid,” says Gerard. The bottom line: Make sure you and your staff understand the Medicare guidelines. Then, you can not only recommend the right products, but also use Medicare’s standards as a benchmark when dealing with private carriers.

Know the Emotional Impact
Understanding the products and the reimbursement issues is only half the battle. Educating your staff about how to deal with patients and caretakers is another key to success. Your people should be well prepared to ease the emotional impact of bringing a bed into the home because it often signifies an end-of-life scenario. “Our home care technicians receive sensitivity training from hospice groups in the area, and because of that they are prepared to go into the patient’s home and deal with both caretakers and patients,” says Gerard. Indeed, educating your staff about sensitive issues, family dynamics, and the grieving process can be beneficial in building relationships and gaining trust and confidence.

“I’ve found that physicians have no clue about what a gel foam mattress pad can do. Very often in their minds, a support surface is a support surface.” —Jennifer Wyatt, QS/1 Data Systems, Spartanburg, SC

Jennifer Wyatt, marketing representative at QS/1 Data Systems, Spartanburg, SC, thoroughly understands this crucial issue. Before her current position, she worked for a provider of beds and support surfaces. Wyatt says that easing the trauma is essentially a matter of using common courtesy and kindness. “Make sure you call the patient’s home and talk with the caregiver about where the bed will go,” says Wyatt. “It gives them a chance to decide in advance where the bed will be located.”

Moreover, discussing the situation beforehand can be of psychological and emotional benefit to the caregiver. It allows them to envision—and begin to mentally prepare for—a major life change. “Providers should train their technicians who deliver a home bed to introduce themselves, assess the setting, talk quietly with the caregiver, and be cognizant of the person’s home and décor,” says Wyatt. “For example, you don’t want your technician to chip the paint on the wall as they are moving the bed into the home.”

Naturally, your technicians should be well prepared to work with patients as well. Technicians should help patients familiarize themselves with the new bed and test it out for ease and effectiveness. The key to a smooth transition is to make patients comfortable while easing the trauma for all family members.

One thing you should never allow is an impersonal bed delivery. “It is absolutely unacceptable to leave a bed sitting on a front porch in five pieces,” says Wyatt. “That is just a perfect opportunity for another provider to take your business and do the job the right way.”

Delivering a bed and/or support surface directly to a residence does not necessarily signify an end-of-life scenario. As Gerard sees it, providers should also keep in mind that there is an upside that signifies hope for many patients. “A support surface is a treatment as well as a prevention. For example, a low air loss replacement mattress might be needed until the wounds heal,” says Gerard. “It does not necessarily mean an end-of-life scenario.”

Even so, sensitivity is always vital to building a bond. “If you handle the situation with grace and dignity, you will get referrals from that family,” adds Wyatt.

“Take a photo of the patient’s wound and send it to the insurance company if you are having difficulty getting paid.” —Gloria Gerard, RN, CWOSN, Home Care Medical, New Berlin, Wis

Educating Referral Sources
“Most doctors are not very knowledgeable about the specifics of support surfaces such as overlays, replacement mattresses, or bead beds,” says Gerard. “On the other hand, they are pretty familiar with hospital beds because they’ve been dealing with them since they began training, and because there are very limited options in beds.”

No doubt, educating physicians is one way to boost referral business. But since doctors are often busy with patients and hospital rounds, how can a provider help? With physicians, it is often best to reeducate at the time of the “sale.” “When we fax an order to a doctor, we include a copy of the manufacturer’s literature that highlights the features and benefits of the product,” says Gerard. “This way, the physician has immediate information to write the most accurate letter to order the kind of support surface a patient needs.”

Wyatt agrees that when it comes to support surfaces, physicians need support. “Most doctors do not understand the benefits of support surfaces,” says Wyatt. “It is a good idea to remind physicians about what it’s like to be in a bed for many weeks or more. For example, the skin breakdown that can occur is a real problem.”

It is also wise to equip your salespeople with visual aids. When salespeople do get an appointment with a physician, it is often brief and interrupted by phone calls and other urgent matters. Remember the old adage, “a picture is worth a thousand words.” Make sure to provide your sale representatives with visual aids from manufacturers that distinguish the difference between surfaces ranging from foam to air-loss mattresses.

Doctors do not always know the difference between various kinds of support surfaces. For example, doctors can specify a cushion amount for an alternating-pressure mattress. But very often, say experts, they do not understand that there is quite a variance between two and four inches. “I’ve found that physicians have no clue about what a gel foam mattress pad can do,” says Wyatt. “Very often in their minds, a support surface is a support surface.”

Another thing to keep in mind is that physicians may have misconceptions about support surfaces. A common misconception that Gerard encounters has to do with cost. “Many physicians feel support surfaces are very expensive, but actually the costs have become quite reasonable over the years,” says Gerard.

It is a good idea to train your salespeople to deliver that message to doctors. If doctors knew that surfaces were not cost-prohibitive, they might write the prescription more readily for prevention’s sake instead of waiting until it becomes a matter of treatment.

Wyatt believes physicians have misconceptions about beds as well. She says doctors do not always understand that Medicare and private carriers tend to pay for semielectric beds for the home. Patients leaving a hospital are accustomed to a fully electric bed. Doctors should know what the patient will be receiving at home. This way, the patient will know, too. Then they can emotionally adjust to what they will not get, namely, an easy transfer from bed to floor, which is a unique feature of the fully electric models.

Doctors are key, but there are other important referral sources who need to learn from your experience as a provider. To boost referrals, providers need to spread the word and the knowledge. “Let nursing staff who see patients at home and discharge planners in hospitals know about your services,” says Gerard. “RNs treat pressure sores at home, and if they are not seeing enough headway with the patient, they can request a support surface as a treatment option.”

Wyatt concurs. “Education and reaching nursing staffs and discharge planners, it’s all key,” says Wyatt. “Your team should take in good samples and explain the Medicare coverage guidelines. It’s a real eye-opener for your referral sources.” Moreover, says Wyatt, once RNs are familiar with products that get results, they can help educate the doctors they work with.

Finally, it is a wise move to provide in-services for newly trained home care nurses. At Home Care Medical, the company walks new nurses through the various support surface products and lets them know that the company has the administrative staff to help them get the documentation needed to expedite the order. Moreover, the entire in-service program is dovetailed with Home Care Medical’s Medicare wound care program orientation, so it is all about education. That is the kind of informational, knowledge-based context in which you want to present your bed and support surface product offerings.

In the beds and support surfaces business, as in life, a little bit of knowledge is a dangerous thing. It is up to you to make sure your own staff and all of your referral sources fully understand the products, the reimbursement issues—and most of all—the difference these products can make in a patient’s healing process and quality of life.

Marianne Matthews is a contributing writer for Dealer/Provider.