The growing home infusion market is a golden vein that many prospectors in the home medical equipment field have considered tapping, only to be discouraged by clinical requirements and reimbursement concerns. Yet industry experts say HME providers can successfully add home infusion to their core businesses-but not without conducting significant research beforehand.

Before making the leap into unfamiliar territory, experts say, it is important to know your patient base, develop a niche and be aware of the clinical requirements necessary to operate a successful home infusion business. "Those who succeed in home infusion know their overall operational costs to the penny before they bid on a [managed care] contract," says Tim Redmon, a consultant on infusion for the National Association for Medical Equipment Services. "They know exactly how many days it takes a payer to bring an account current, and they're smart enough to turn down a contract that they can't handle profitably. The segment is clearly experiencing a growth spurt."

The ideal entry method into the market is for an HME provider to join or merge with a local infusion provider, says Richard Bulich, vice president of Pharmaceutical Buyers Inc. Another way to get a foothold is to open a business in an area where larger national providers are pulling out or closing a branch, experts say, or by serving rural or isolated areas outside the service range of larger providers.

"The trend is away from national companies because of the overhead," says Roger Klotz, president of Specialized Clinical Services. "As they exit, [they] create a vacuum, which is an opportunity for HME providers. Little independent entrepreneurs have a better chance of being successful in the business than the big nationals because they don't have Wall Street on their backs or the big corporate overhead."

Carving a Niche THERE ARE A NUMBER of niche markets to be found in the infusion therapy market, including chemotherapy, antibiotic therapy, pain management, therapy for hemophilia, human growth hormone therapy, and pediatric infusion therapy, Redmon says.

"The key to identifying a niche in your community is to communicate with hospitals, physicians and clinics and keep your eyes and ears open to new ideas," says Jean Bennett, director of clinical services for Home Care Medical, a provider of infusion therapy. Home Care Medical offers a variety of infusion services, including antibiotics, chemotherapy, main-line therapy and insulin, but Bennett says the money makers are total parenteral nutrition and specialty services.

"As our niche, we are trying to obtain a greater number of TPN patients, and we are being recognized as a center for pumps and supplies," she says. Bennett recommends forming relationships with associations that are affiliated with your target patients. Home Care Medical, for example, works with bone marrow transplant centers to get referrals.

Klotz says the HME provider has an advantage over others trying to start a home infusion business because it has established referrals and alliances and is currently providing those patients with other equipment and services. For example, many HME companies already provide supplies to diabetic patients, and those patients could be candidates for insulin pumps. An insulin pump, like the one used by Nicole Johnson, the current Miss America, is worn 24 hours and releases insulin through continuous infusion, says Pete Escallier, director of marketing for MiniMed Inc., an infusion pump manufacturer. MiniMed primarily sells its pumps directly to the end user, but says HME providers can, with proper training, get their share of the market.

While there are many benefits to entering the infusion market, there are some caveats, experts say. Prospective infusion providers must be aware of the implications, the procedures and the protocols before offering complicated therapies such as TPN, Klotz says. "You need to hire professionals who are experienced in the risks and dangers of infusion therapy," he says. "If you lose one patient, your company will go bankrupt."