Getting Started in the Mother-Baby Market

Published in Member Communities on August 24, 2022

By Nikki Jensen, VP, Essentially Women

Breastfeeding babies has been going on since the beginning of time. None of us would be here if our foremothers had not been able to breastfeed their children. That’s why it’s so strange to think of the “modern age” of breastfeeding to have only started in the mid-1990s. To clarify, we’re not referring to baby formula. We’re talking about breast pumps and a mother’s ability to pump at home—and what makes breast pumps such a great opportunity to diversify your business.

Background and History

The evolution of breast pumps dates back as early as 1854 when O.H. Needham patented the first hand-operated breast pump. It was good for extracting milk from the breast. However, it was not effective for emptying a breast for a feeding cycle.

The first electric breast pump was patented in 1923 by Edward Lasker. Mr. Lasker worked on dairy farms in Michigan, Minnesota, and Iowa. He was an engineer who was focused on making improvements on milking machines—intended for cows. He began working with Dr. Isaac Abt, a pediatrician from Chicago who was looking for a better way to help feed premature babies who were unable to latch or too weak to nurse.

The next notable advancement was when Medela introduced the first hospital and rental pumps. These quickly became a favorite of lactation consultants. It was 1996 when Medela introduced the Pump In Style as the first personal electric breast pump moms could purchase, no longer relying on the hospital-grade/rental pumps. This was the turning point we refer to as the modern age of breast pumps. The personal-use electric pumps allowed moms to return to work and resume more daily activities while continuing to provide breast milk for their child.

The Affordable Care Act (ACA), passed in 2010, changed the distribution model for breast pumps by requiring private health plans to provide breast pumps for new moms. While the ACA was passed in 2010, insurers started implementing in 2012. Prior to the ACA, if a new mom wanted a breast pump, she had to pay cash and the most likely place she purchased was directly from the hospital system through the lactation consultant, or through a retail outlet like Babies R Us, Target, or Walmart.

The increase in demand increased competition and innovation!

New Feature in Breast Pumps

With the increase in demand, there’s been a new era in innovation and attention given to help improve comfort and convenience for moms. Some of the new features that have most improved the breast pump market have been:•

• A closed system rather than an open system. With a closed system, breast milk and other contaminants are not able to get into the tubing or mechanical system of the breast pump. This helps keep breast pumps more sterile.
• Bluetooth enabled to track timing and quantity pumped
• Wearable breast pumps or nursing bras that help mom be hands-free while she pumps
• Battery operated
• Quieter operation
• Night lights
• Let-down and expression mode allow for a customized approach

Reimbursement

When billing breast pumps, there’s one billing code: E0603. The biggest factor in the equation will be knowing your local payers and what’s required when you bill for breast pumps. Some payers will require a specific bundle of products (e.g., bottles, tubing, and ice packs), while others will require a basic electric pump, minus any bells and whistles.

Another component of knowing your local payers is knowing when moms can obtain the breast pump. Some payers allow mom to obtain her pump up to 30 days before baby’s due date, while others require delivery before a breast pump can be delivered.

Lastly, when it comes to reimbursement, you should clarify with each payer when they allow mom a new pump. For example, if mom has baby number two 13 months after baby number one, is she eligible for a second breast pump?

Investigate your state Medicaid program because this may be an opportunity.

Market and Marketing Opportunities

Be sure to market your business to your local referral sources. You should consider all of the following for local referral sources:

• OB/GYN offices – doctors and nurses
• Lactation consultants
• Breastfeeding support groups

When marketing to these groups, make sure you educate them on the new advancements in the breast pumps you carry as well as the additional items you have that may make pregnancy and post-partum more comfortable for mom. Some of these items may be billable, while others are retail. These items include:

• Maternity bands (aka belly bands)
• Compression socks
• A second breast pump for travel or keeping at work
• Body position pillows
• Post-partum support garments
• Nursing bras
• C-section wound care kits
• Supplements for increasing breast milk supply

Don't Stop With Breast Pumps

In short, if all you’re providing mom is the breast pump, you’re leaving lots of opportunity on the table. Make sure local referral sources have a marketing piece they can give to their pregnant moms to educate them on what products you have available and, if applicable, bill to insurance.

If you have third-party insurance contracts in the DMEPOS category, chances are you can bill for breast pumps. Billing breast pumps does not require any special certification or designation. One thing we all learned over the past couple years: No matter what may be going on in the world, babies will continue to be born! Breast pumps can add a nice diversification for your existing business.

This article was originally featured in the VGM Playbook: Emerging Opportunities in DMEPOS. To read the full article and more like this, download your copy of the playbook today!

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