Business Spotlight: Made with Care

For most health care sectors, time is of the essence. At Therapy Support Inc., the pace of response to patient needs is quickened by technology and a small army of field technicians.

“It’s not scheduled when patients get sick or need care, so we have to be there when that happens,” says Therapy Support CEO Cliff Stepp.

To that end, the durable medical equipment company operates a fleet of 165 delivery vehicles to furnish rented beds, wheelchairs and respiratory equipment to patients the same day orders arrive. That’s no small task considering hospice and long-term care clients are in seven Midwestern states, mostly concentrated in Missouri and Ohio.

Founded in 1997 by brothers Dave and Brian Pavlin, Springfield serves as headquarters for its 21 branch offices. Cincinnati, where Brian Pavlin is based, is home to Therapy Support’s call center and dispatch offices with representatives on-call 24/7. Dave Pavlin works in Springfield.

The Pavlins started the business in their respective homes, and Stepp says Therapy Support has grown to 240 employees serving 12,000 patients.

“It’s been quite a journey,” says Stepp, who’s been on board seven years.

Last year, Therapy Support generated $24 million in revenue, and two acquisitions in the Kansas City market earlier this year are expected to boost the top line by $2.4 million.

While the company already operated an office in Lee’s Summit, it strategically purchased medical equipment competitors Prime Source in February and Town and Country Medical in March.

“This really helped us gain some market share there, particularly in hospice,” Stepp says.

Therapy Support primarily delivers equipment to residences, ordered through the patient’s hospice provider, while a smaller portion of its drop-offs are made to nursing homes.

“It’s difficult sometimes for nursing homes to maintain their own equipment,” Stepp says. “We will change it out if it needs servicing. When a patient no longer needs it, we’ll go pick it up and bring it back to be cleaned and maintained.

“It’s very demanding from a time and delivery perspective.”

Key to the recent growth curve is an investment in technology.

Stepp says a few years ago, the company committed to developing an online ordering portal that communicates with handheld devices used by field technicians.

“When I came, we were doing everything by paper,” Stepp says.

After about $150,000 invested in development, the portal sends orders in real-time to the call center, where email acknowledgements are delivered to customers and dispatchers send the data to the handhelds in the field. The proprietary software, developed by independent programmer Mark Bauer, who earned himself a full-time job with the company in the process, is GPS-enabled, allowing dispatchers to monitor driver routes and delivery speeds.

Once delivered, the service techs capture electronic signatures of the patients or caregivers, and an e-ticket appears in the online portal for view by the hospice representatives.

“We’ve made that full circle without a piece of paper,” Stepp says, noting the programming included security features to meet Health Insurance Portability and Accountability Act standards.

The next step, he says, is considering whether to market the software to other medical equipment companies. A  sister company called I-Heal Co. LLC  formally launched two months ago.

I-Heal was created to manufacture an immersion foam mattress and specialized wheelchairs under the Posture-Mate line designed to help prevent and treat wound development.

“One of the things that tends to happen when you lie in a bed for extended periods of time is the increased potential for development of wounds,” Stepp says, noting Medicare is becoming more stringent on hospital for treatments of wounds developed during patients stays. “(It’s) become a real big issue, particularly in the hospital setting.”

Through the Affordable Care Act, the industry is moving toward evidence-based payments for qualifying care. Company officials turned a key corner when a clinical study on the I-Heal mattress was published in the August edition of Ostomy Wound Magazine. “This is evidence,” Stepp says of the clinical study.

With reimbursement rates in question for caregivers, Therapy Support Chief Financial Officer Michelle Kimrey says the medical equipment seller is working on behalf of their clients. “As they are impacted, we are indirectly impacted,” she says.

While over 1.5 million patients received hospice services in 2012, according to the National Hospice and Palliative Care Organization, Kimrey says among Therapy Support’s clients, uncertainty with Medicare has made hospice companies more careful to take on patients.

On average, each patient uses 10 to 15 items. A standard package includes a hospital bed, foam mattress, wheelchair and shower chair, while end-of-life care brings into play higher-end respiratory items and advanced mattresses with air.

With an aging population in mind, Stepp rattles off key statistics that will impact the future of Therapy Support: 75 million boomers coming into the system and 10,000 people turning 65 years old each day.

“There is a likelihood the Medicare model may change somewhere down the road,” Stepp says. “We think we’re positioned well for whatever may come because we have so many vehicles and service techs running up and down the road every day.”