Getting Your Foot in the Door

Doctors use continuous passive motion (CPM)
devices to help patients regain their range of motion
after a surgery that affects a joint. For providers,
CPM devices offer a unique blend of institutional
care and homecare that can be integrated into
service offerings as patients typically take the
devices home from the hospital (on a rental basis) for
two to three weeks as they recover from surgery.

“Once the CPM program is up and running and
you’ve got your system in place, it’s a nice business
to be in because it kind of takes care of itself.
As long as you’ve got the right people out there
working, delivering machines and you’ve got good,
dependable employees, it really is pretty easy from
that point forward,” says Kent Bishop, president of
OmniKare.

In order to get the machines into hospitals so
that the patient gets right on them after surgery,
providers have to make deals with referral partner
physicians and, in some cases, directly with the
hospitals.

It often helps if a provider is already in the market
with other products because it provides something
to piggyback on with established physician relationships.
Still, if CPM machines are a provider’s first
foray into the HME market, a good program can help
get appointments with busy physicians.

So, what is a good program? Bishop says it is one that helps generate
revenue for the physician, having a good reputation in the market with
very few patient issues or complaints, on-time delivery, willingness to
deliver at all hours if necessary and good, quality service.

“If you just get one physician that will use you, and put you on his or
her standing orders, then you just work hard from there. Over time you
should be able to get more and more referrals from other physicians via the
discharge planners,” Bishop says.

Assessing Advantages, Challenges

Like all products, integrating CPMs comes with both advantages and challenges.
One advantage is that since most doctors, nurses and physical
therapists are aware of CPMs, there is not a lot of selling that goes into it.

“It offers a revenue stream for the physician’s office,” Bishop says.
“Although it’s not a large revenue stream to them, it certainly is one that will
help offset their overhead. So any time you can do that with a physician they
are appreciative, and you do get their interest.”

On the rehab side, since physicians prescribe CPMs for post-op use,
bringing a machine into their office offers them more control, the ability to
set it up according to their instructions, and, if there is an issue, they know
who to contact right away.

A major advantage to the actual CPM devices is their long lifespan and
dependability. Aside from freak occurrences or extremely rare situations,
Bishop says a CPM machine should never need to be replaced.

“That’s a huge advantage. It’s basically a one-time cost to get in and then
maintenance as needed,” he notes. “Once the machines are paid off, it’s
just straight profit because basically you never have to replace one.”

In the past five or six years of ownership, Bishop can only recall his
machines needing minimal repairs or parts replacement.

“A machine probably goes out (to a patient) once a month, so that’s 11 or
12 times a year. Multiply that by five or six years or seven years. That’s a lot
of usage and to have one maybe malfunction once or twice—that’s a pretty
high reliability,” he explains.

The biggest barrier to entry a provider faces in integrating CPMs is cost.
There can be a steep capital outlay to get into the market that may require
a provider to start small with maybe a handful of machines for one account.
Once the initial machines are paid off, the profit (minus overhead and
delivery) can allow a provider to slowly add machines to build up inventory
and expand.

Other challenges, such as finding the right service person to deliver
and setup the machines and hiring other personnel, are typical in any new
startup, but also are important considerations in establishing a good CPM
program. Providers that are in-network with insurance providers and do
their own billing may face additional issues, but this can be avoided by
working directly with the physicians and hospitals.

Finding the Right Manufacturer

Finding a dependable CPM manufacturer that can quickly repair and turn
around malfunctioning machines is essential to running a successful CPM
program. Many manufacturers will provide technical support over the telephone
or the CPM device can be shipped in for repair work.

“That’s very important because obviously you don’t want machines sitting
around in your office or your storage facility because that’s just a waste
of money,” says Bishop. “Machines need to be on patients in order to be
generating revenue.”