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One Silent But Very Viable Area Of the WC System

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A Viable Area That No One In Workers Comp Discusses 

A very viable area of the WC system has existed for over 3o years and will continue to exist in the future.  I often do phone consultations for investment groups that are looking to invest in the Workers Comp “space.”  Over the last few years, one area of medical treatment seems to be unaffected by any economic upturn or downturn in any of the markets or claim counts.

Picture Of Watering Can Viable Area And Seedling
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This much-overlooked area is durable medical equipment (DME).   As I am a nationally based consultant, there may possibly be a state or locality where my following analysis does not apply overall.

DME’s have the advantages of:

  • Incredibly high markup value from manufacturer to end consumer
  • Offshore manufacturing where costs are much lower
  • Rare application of a state fee schedule
  • Almost impossible for an adjuster to deny if the treating Dr. recommends them
  • A very few networks to keep competitive price pressures in check
  • Locality being a large influence as shipping costs are prohibitive

 There are very few providers that deal with DME’s only.  The DME’s are usually a part of a network provider’s overall product offering.   Standalone DME companies are taking on a large risk of just one product line.  However, their ROI is amazing.

One of the possible upcoming competitive areas may be smaller-sized DME’s.   Shipping a cane or other smaller items are not centered on being a local provider.  This all depends on the prices of shipping and fuel.

2020 Update – More states started including durable medical equipment in their fee schedules.   The medical fee schedules should not become a deterrent for DMEs.  DMEs will be a viable area of workers comp for years to come.  They are still a great future investment. 

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Table of Contents

James Moore

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Mgmt Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications

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