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A guest post from Jeff Baird, Chairman of the Health Care Group of Brown & Fortunato, P.C.

Change is traumatic. This is true regardless of whether the change is positive or negative. Getting married is traumatic; so is getting a divorce. Starting a new job is traumatic; so is getting fired. Anything that takes us out of our comfort zone is traumatic.

As a durable medical device (DME) industry, we had a nice “run” from the late 70s until the first part of this century. We were lightly regulated; audits barely existed; competitive bidding certainly did not exist; the NSC was not particularly aggressive; the contractors were likewise not aggressive; and reimbursement rates were high. It was not terribly difficult to run a profitable DME company. There was enough money to provide great services to patients and to keep happy employees on board.

This has come to an end. Congress and CMS have forced a complete transformation of the industry. In many ways, has this been unfair? Sure. In many ways, has CMS been out of touch with reality? Of course. But this is what the government does. We have seen this movie play out in health care and non-health care industries alike.

And so we are having to “remake ourselves.” But so have other industries. Think of Xerox. What immediately comes to mind are copiers. Well, Xerox has branched out into so many other areas that copiers are now an afterthought to Xerox. Polaroid and Kodak were icons in the photographic film arena. This arena is now extinct. The list goes on and on.

What is an absolute is that we have 78 million Baby Boomers who will live to be 85 years old, whose bodies will break down, and who will need DME. The demand for DME will be overwhelming. What is another absolute is that Medicare will not pay a whole lot and it will take a lot of effort to get paid by Medicare.

Can we as an industry meet the demand? Sure. Do we have to be creative regarding the products and services we offer? Absolutely. Do we have to work our tails off to produce only a small profit margin? Without question.

What gives me optimism is to see new players coming into the market. Medtrade used to be like a high school reunion. I knew everybody. I saw the same faces every year.

This is no longer the case. During the past several Medtrades, I have not recognized most of the faces. They are new. I am seeing young, educated, entrepreneurial people coming into the market. They are willing to take the market “as is….warts and all.”

What they see is the huge demand. And they have the confidence that they will be creative enough to meet the demand…..and generate a profit in doing so. The “old timers” are burdened by knowing how “things used to be.” That is truly a burden. The old timers need to force themselves to forget about the past and rethink everything.

The creative DME supplier needs to think of itself not as a traditional supplier, but as a company that sells products and provides services to help people have an enjoyable lifestyle. If the supplier can set itself apart from its competition, if the supplier can find its own unique niche, then people will pay for the products and services. It may not be Medicare that is doing the paying. It may very well be the consumer that is more than happy to pay out of pocket.

I am a Baby Boomer. One day I will wake up and I will be 75 years old. When that happens, I will know that I will likely have about 10 more years left on this earth. Time will be my most valuable asset. I will not want to wait around for Medicare to agree to pay for something I want. Rather, I will pull out my Visa and pay for it. There are millions like me. We are the industry’s future customers.

Jeffrey S. Baird, Esq. is Chairman of the Health Care Group at Brown & Fortunato, P.C., a law firm based in Amarillo, Texas. He represents pharmacies, home medical equipment companies, and other health care providers throughout the United States. Mr. Baird is Board Certified in Health Law by the Texas Board of Legal Specialization. He can be reached at (806) 345-6320 or jbaird@bf-law.com.

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Peg Graham
improvecaregivingexperience.blogspot.comx
pgraham@quainc.com
HI Jeff: So happy that you are provoking innovative thinking within the DME sector. As a caregiver with 30 years of experience in healthcare delivery, I have been advocating for improved design of assistive equipment, specifically the old, reliable bedside commode that could sure use some updating, Would be great to see the industry attracting partnerships with Health Information technology and health systems, gaining respect for DME as a solution platform for improving the caregiving experience. Happy to share this article, just published today:
http://www.beckershospitalreview.com/hospital-management-administration/smart-durable-medical-equipment-an-investment-opportunity-flying-under-the-radar.html

Kalai
kckalai@ukm.edu.my
DME will be growing into more individual focus rather than medical service providers in current trend. The changing focus will cater to wider innovation in this industry since the needs may vary by many different factors. As such there will be different types of market segment from the very niche to general market. This new trend will open opportunity to more providers especially the the younger generation whom seems to be more creative and socially engaged. There are many different types of needs in healthcare that need mini and micro DME which was not a need earlier or event currently in many countries and communities. Let’s move together in providing the best healthcare service to the human kind globally.

Bill Weiss
ivorganizer.comx
bill@ivorganizer.com
Hopefully we only have 2 more years of this trash.

Tom KraMer
kablooe.comx
ideas@kablooe.com
Rethinking the way we do things is great. It hits at the heart of all innovation. Having to find new ways to eat lunch at school because a bully keeps stealing your lunch everyday can cause you to be innovative, but it is also a real bummer. The heart of the problem in this scenario is that the bully is too dumb and has too many issues to understand how to operate to best facilitate the betterment of the “whole”. Innovation by force is unfortunate, but it is innovation nonetheless.

Javier Cabrera LMS. FICS
biototalhip.comx
doctorjcabrera@gmail.com
Mr. Baird:
Osteoarthritis of the hip and other major joints are increasing worldwide. Total Hip Prosthesis surgery (THP) is very old, expensive, aggressive and not free from complications, due to device failures and patients health, especially when patients are older for Revision surgery.
The manufacture of hip prosthesis is unfriendly to the environment due toxic metals and energy needed in their production . The soil is contaminated when patients are buried with them.
We could prevent the deterioration of joints, if we resurface with biomaterials, stem cells etc. damaged articular cartilage of joints as soon as diagnosed, these lesions are generally undiagnosed or left behind without a radical treatment .
By resurfacing early damages in the hip joint, we will avoid the need of Total Hip Prosthesis surgery, as we will prevent rough surfaces in the joint to rub among themselves during gliding movements of the head of the femur.
I believed, that we should approach the treatment of osteoarthritis in the same manner as dentists do with dental caries, preventing the deterioration and removal of the tooth.
In Patent GB2344290 “A device for replacing or repairing a joint” an arthroscopic method is described to reach from behind the hip, avoiding puncturing the capsule, in order to reshape and resurface the damaged joint. Zimmer Co in the USA in 2009 tried to patent this method. They removed their application in 2011 after I claimed priority.
By using this method it is possible to patent new micro-arthroscopic devices and initiate a new era of treating osteoarthritis of the hip and other major joints in a biological and a more modern way.
In view of the costs of THP, and taking into consideration the worldwide increase of osteoarthritis disease, it is necessary to find a new way to prevent destruction of hip joints by wear and tear and the need of Total Hip Prosthesis surgery .
I am looking for partners to develop, licence or sell the patent.
Visit: http://www.biototalhip.com
I would like to hear your comments,

Regards,
Dr. Javier M. Cabrera LMS. FICS.
doctorjcabrera@gmail.com

Frank Winterroth
fwinterr@umich.edu
Mr. Baird:

Unfortunately, I will not be available at Medtrade, but you bring up some very critical matters that I would like to discuss. This is in particular to DME, namely biomaterials for implants.

Being a “baby-boomer” myself, I too have concern over the US population aging. New technologies for medical device design and services need to be implemented and be consistently evolving as new diseases, conditions, and outcomes are being discovered daily (with the current threat of Ebola looming, new methods for rapid treatment response and disaster preparedness are imperative).

Feel free to call or email me: 650-275-3068

Best,

Frank

Manas Kanungo
linkedin.com/in/manaskanungox
manask@aol.com
Nice, timely article, puts relevant thoughts together succinctly about what has been, what it will be in the future, and with an encouraging note about what one needs to do. Indeed, the potential market will be big … and the business model needs to adapt to make hay ….