Business Solutions

Getting a Toehold in Compression

This important category can help providers broaden not only their revenue, but their referral and patient relationships, too.

rock climberAs providers work to ramp up alternative revenue streams, compression has become a tantalizing target for many. Providing compression products an opportunity to reach a variety of existing and new patient groups with a cash sales product. Better yet, the compression market is poised for significant growth.

Growing populations of diabetic patients and elderly patients with venous diseases will foster significant growth in the global market for compression therapy, according to findings from research and consulting firm GlobalData. The group’s report, “Compression Therapy Market to 2019,” says the worldwide compression market will swell from $2.4 billion in 2012 to $3.4 billion in 2019, at a compound annual growth rate (CAGR) of 5.1 percent.

Better yet, in 2012, the United States was home to the largest market for compression therapy, with 49 percent of the market revenue. GlobalData’s report forecasts the U.S. compression market will grow from $1 billion in 2012 to $1.6 billion in 2019, at a CAGR of 6 percent. The report expects the European and Asia-Pacific regions to have smaller shares of 35 percent and 13 percent in 2019, respectively.

In addition to the high incidence of venous diseases, such as deep venous thrombosis, among elderly and diabetic populations, the adoption of compression therapy in the treatment of lymphedema and amputations will also help drive market growth, according to the report. Similarly, so will the compression products themselves. As the textile technology used in compression stockings and bandages continue to advance and improving patient comfort, those innovations are expected to drive future growth, as well.

And that’s just the healthcare market. As providers look to diversify their revenues, they must also look at related customer markets that could help drive new income, and where compression products are concerned, the sports therapy/rehab market is tough to ignore. Compression plays a big role in sports therapy/rehab, so providers already supplying those items can leverage their inventory and existing staff expertise to reach a whole new market, provided they employ the right marketing and sales.

Suffice it to say, compression is a tough category to ignore. Here are some guidelines on approaching this important market opportunity.


Let’s start off with some basics: how does compression help patients? In the most basic of terms the tight fit of compression garments helps provide support and increase circulation for the limbs and areas of the body suffering one condition or another. More serious conditions require heavier compression. For wound care, it can help direct the flow of nutrient-rich blood to an affected area. For patients with diabetes or poor blood flow, it can help overall circulation in an extremity. For patients with lymphedema, compression can help reduce edema and direct lymph fluid away from the affected limb. In short, there are as many compression applications as there are conditions.

Since compression is essentially providing pressure, it is measured in millimeters of mercury and can range from 15-50 mmHg. Lighter compression products start out at 15-20 mmHg, which are for tired, achy legs, mild edema, varicose veins and foot swelling. This level of pressure can also help to prevent vein thrombosis.

Higher levels of pressure such as 20-30 mmHg is for severe varicosities, for open face ulcers, moderate edema and post-surgery. This level of compression also helps to prevent the recurrence of venous ulcers, moderate to severe varicosities during pregnancy and thrombosis. For people who have ulcers, lymphatic edema and varicosities, they typically need 30-40 mmHg. Once you go beyond 40 mmHg, you’re getting into customization.


The key for any provider of compression comes down to expertise. A provider can have the best product selection in the world, but if it doesn’t have the staff that know how to use it, that provider won’t be able to help referral partners or patients. The provider must have staff who understand the various types and grades of compression products, as well as their applicability for difference patient conditions.

And that goes beyond understanding product basics. The provider should have key team members should have proper training in compression. Fortunately there is training available from the various compression vendors. Select your in-house experts and sign them up to become certified compression fitters. Certified fitters receive training by going to different classes and seminars that are typically put on by the manufacturers of compression product.

Once trained, the fitter will be able to review a patient’s history and ask important questions that will help determine the right type of product and level of compression. Fitters will also help ensure patient compliance, which isn’t always easy to instill.


Education plays a critical role in compression provider success, because, like a lot of the home treatments HME providers help facilitate, successful compression outcome hinge on compliance. A compression provider with educated, expert staff that can help foster compliance through attentive patient care and education will help ensure patient success, and thusly secure referral partner confidence.

While successful outcomes for compression hinge on patient compliance, compliance can be tough to achieve. That’s because, at the end of the day, compression garments can prove troublesome for many patients to wear. After being given a prescription from a doctor, some patients will come in to a provider get fitted for compression wear, and still not wear the compression garment. Why? Because compression garments can be hard to put on and take off, especially for older patients and patients with joint stiffness, or for parent caregivers working with young patients.

Educated, certified fitters can show patients how to don and doff compression garments, especially hosiery, and avoid common mistakes. For instance, one mistake patients will make is that they will put on compression hosiery as though it were a typical sock; by bunching the compression sock up on their hands at the point above its heel. Then they’ll try to pull it up over their toe area and then their heel, which is very hard to accomplish.

Providers can help them by training patients on the different methods for fitting compression socks. For instance, in the “heel pocket out” method, the patient puts his or her hand into the sock, grabs hold of the heel and turns it inside out, in order to more easily get move the sock over the more challenging portions of the patient’s foot. Then the patient slowly smoothes the sock up around his or her leg.

Also, using rubber gloves can make the process go much more smoothly, by providing traction to help grab hold of the sock. Or, a patient can use a donning and doffing device that provides a frame that holds an open toe sock in position and lets the patient step into it. If a patient uses an open toe sock, a plastic sack can be placed over the foot, the sock slipped over that, and then the sack pulled out from under the sock. (And those devices are also a sales opportunity, of course.)

Ultimately, staff that can help patients understand what compression garments and products do, how they benefit the patient, and how to use them is the heart of compression therapy. Patients who understand what stockings do and how they work are much more motivated to overcome the other compliance issues to get the health benefits the products provide.


Remember that most compression products are garments. Patients wear them on a daily basis, and for many the prospect of being attired in the same “orthopedic brown” stockings, sleeves and other garments isn’t’ all that enticing.

Your patients might want a good therapeutic outcome, but for many appearance will still top the list in terms of their purchasing criteria. In winter time the concern is less of a concern, because compression stockings are fairly easy to hide under pants and boots, but they are not so easy to disguise in warmer weather. (And usually legs tend to swell more in warmer weather.)

But regardless of weather, at the end of the day compression patients are like everyone else: they want clothing that helps them feel good about themselves. And that’s a concern that has been magnified as the Baby Boom generation has retired in increasing numbers.

Fortunately, vendors have really started to respond to these needs over the past several years. Now compression stocking, sleeves and other garments come in a wide array of colors and patterns to fit your clients’ sartorial sensibilities. The key is for providers to stock an equally broad selection so that their patients feel more connected and in control of their care.


Like expanding into any new practice or category, it’s critical that providers work to educate existing and new referral partners regarding their compression offerings. Try to create educational opportunities such as in-services that can give certified fitters an opportunity to educate medical professionals on the different levels, uses and benefits of compressions.

The goal is to establish an effective referral relationship that ensure that, when the physician sends a patient to the provider, the fitter can examine the diagnosis to determine what level of pressure will work best for the patient. Furthermore, because the provider established a good relationship and provided education, the doctor will be able to provide more precise guidelines about what he or she wants to achieve in terms of treatment, and the fitter can help accomplish that.

Similarly, ensure you position your business as an expert solution provider to various client and patient groups through a combination of marketing and educational events. For instance, see if local assisted living centers will let you offer an on-site seminar regarding the benefits of compression. Those kinds of efforts will help familiarize patients with what’s available, help reinforce your reputation for expertise in the category, and hopefully start creating some friendly, long-lasting relationships.

Ultimately, compression represents a ripe care and business opportunity for providers to crack into. The learning curve isn’t all that steep, but it does require providers getting a solid footing in terms of product knowledge. Once they have the right expertise on staff, the will be able to make their services a perfect fit for referral partners and patients alike.

This article originally appeared in the March 2017 issue of HME Business.

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