Growing Your Business in Today's Environment: Getting Started in Women's Health

Published in Member Communities on October 05, 2021

Originally featured in “VGM Playbook: Growing Your Business in Today's Environment" by VGM & Associates, Nikki Jensen discusses how to grow your women's health business. You can access the full playbook here. 

The women’s health market can be a rewarding, profitable, and worthwhile business. While there are many different paths to define women’s health, in this segment, we define women’s health as serving the post-mastectomy patient.

Checklist to Consider When Providing Post-Mastectomy Products

• Does your state require licensing as a DMEPOS supplier?
• If you’re planning to bill Medicare, enroll as a DMEPOS supplier and obtain a Medicare surety bond.
• Accreditation through a Medicare-approved organization.
• Mastectomy fitter courses through American Breast Care.
• Compression courses through media.

A DMEPOS provider can help make the post-surgery days of recovery more comfortable and continue to offer services for women who choose breast prosthesis as an option for breast replacement, as well as compression garments for women who may develop secondary lymphedema due to cancer treatment. No two patients will be the same based on their individual journey, but for those seeking post-surgical comfort and services, you can be the trusted resource within your community.

Preparation for Mastectomy Surgery

Items that are beneficial for women to assist with recovery after mastectomy surgery include: body pillows, seat cushions, post-surgical bras, recovery robes, drain management support belts, and wound care. After mastectomy surgery, there is limited range of motion of arms, which will limit the ability to get in and out of bed or stand from a seated position. The Contour Flip pillow is an example of a retail item that can help provide support for women during the first few weeks after surgery.

Post-surgical bras may be supplied by the hospital, but most women will want more than one as they recover from surgery. It’s beneficial for women to obtain a post surgical bra prior to surgery. Consider each of the steps in a woman’s post-surgical journey and research products to help them along the way.

Breast Replacement Options

Following mastectomy surgery, the options for breast replacement are off-the-shelf breast prostheses, custom breast prostheses, or surgical reconstruction. While most people are familiar with surgical reconstruction, some women do not wish to have additional surgeries, and others may be advised by their physician they’re not a candidate for surgical reconstruction. Off-the-shelf breast prostheses come in different shapes and size, so they do require some inventory on hand in order to properly fit patients. Off-the-shelf breast prostheses are held in place with a pocketed mastectomy bra. Mastectomy bras are a billed item that require inventory on hand for sizes and are eligible for resupply.

Another prosthetic option is the custom breast prosthesis. A custom form is a prosthetic created to match the unique contour and skin tone for the woman. Manufacturers use proprietary scanning software to map the woman’s chest wall and create a unique mold. This technology is beneficial for women who have a contoured chest wall, women seeking to match skin tone, or for women with one remaining breast following unilateral mastectomy. Finding symmetry with an off-the shelf prosthesis after a unilateral mastectomy surgery is very challenging.

Breast prostheses, both off-the-shelf and custom, are eligible for resupply every two years as durable medical equipment unless there is documented medical necessity from her physician with a prescription. Examples of medical necessity would be extreme weight loss or weight gain.

Medicare does not currently allow coverage for custom breast prostheses; however, many private pay and state Medicaid plans do allow coverage. Contact local payers to determine coverage eligibility.

Essentially Women is working on legislation that would allow women the option to choose custom breast prosthesis. Follow our efforts and take action to ask members of Congress to support this bill at letherdecide.org.

Compression Garments

As many as 40% of women who have experienced breast cancer will develop lymphedema. Lymphedema is the build-up of fluid when there is damage to the lymphatic system. Breast cancer patients are at higher risk due to cancer treatments. This can be due to lymph nodes that need to be removed from under the arm during surgery, chemotherapy, or radiation.

Lymphedema develops over time and may not become apparent until years later. Most commonly, lymphedema will occur in the arm of the woman on the side she had cancer, but it can also develop in her hand, breast, trunk, or abdomen.

Gradient compression therapy is recommended to help move the protein-rich lymphatic fluid away from the extremities. A prescription for compression garments is necessary, and most garments are recommended for resupply every six months to maintain therapeutic compression levels. Some patients may be prescribed custom-fitted or night compression for added relief.

The reason diligent, daily therapy is needed for patients with lymphedema is the risk for infection. Patients who develop an infection can quickly escalate to the need for hospitalization for treatment. The protein-rich lymphatic fluid is a breeding ground prone to infection.

While Medicare does not currently allow coverage for compression therapy, many other payers do allow coverage. Be sure to check with local payers to determine whether coverage is allowed.

There is also proposed legislation that would allow Medicare to cover compression garments for lymphedema patients. Follow lymphedematreatmentact.org for more information and to take action.

Being a Resource

Each of the examples above are great ways to get started in women’s health. To truly succeed in the market and fully realize the potential for recurring revenue, focus on becoming a resource. There isa host of other women’s health products that are beneficial to carry. Examples include skincare for sensitive skin, wigs, hats, turbans, and swimwear, to name a few. To find out where to start, all you have to do is listen. Your patients will tell you what they’re looking for.

For more information about the women's health industry or Essentially Women, contact Essentially Women at essentiallywomen@vgm.com or 800-988-4484.