Swimming Against the Tide

Frankly, it doesn't seem like the best time in the world to open up a home medical equipment company. Reimbursement is down and dwindling. Legislative mandates are becoming more onerous. And then there's CMS' competitive bidding project, which is set to roll out in 10 large MSAs around the country.

Despite the circumstances, however, at Lutheran Services in Iowa, it's about need. So early last fall, when Diana Hanner discovered a health need that LSI wasn't filling, the program administrator came up with a plan to do something about it.

Filling the Gap

For many years, the Des Moines-based non-profit agency has sponsored a home health care program that provides nurses, therapists, home health aides, social workers and even pediatric home health care specialists to residents, most of them low-income, in eight Iowa counties.

LSI also offers adoption and foster care services, early childhood programs, refugee resettlement help, residential treatment for those with behavioral and mental disorders and services for those with disabilities.

The question was, where were their clients getting their HME? “In this area, we don't have a national provider. Many providers have pulled out,” Hanner, a registered nurse, says.

It made sense to Hanner that LSI become an HME provider. “We were already in the home, we were helping with case management, and when you think of that, you think of continuity of care,” she says.

With a background as a consultant specializing in home care agencies, Hanner had a nodding acquaintance with HME (she also has a son who uses a wheelchair, which is what propelled her into nursing in the first place). Still, she didn't know much about the business side of the industry.

That didn't stop her. She studied up on the industry, worked with an accountant and came up with a plan for an HME division to present to the LSI board. That was in July. By August, the plan had been approved, and in November, Mobility Solutions opened, dedicated to the goal of providing “individuals and their loved ones with individualized care and equipment to help them lead active, healthy lives in their own homes.”

Like LSI, Mobility Solutions is a non-profit entity. It provides aids to daily living, walkers, wheelchairs, hospital beds, some modular ramps and most other HME except respiratory.

Already, the HME division has made a difference in client care. “It wasn't until we teamed up with [HME] that we learned how far we could take that care,” Hanner says.