Animal O&#038;P and Solvency

Kevin Carroll, MS, CP, FAAOP(D), vice president of lower extremity prosthetics, Hanger Clinic, Texas, suggests that if you plan to open up a clinic, you’ll want to be well prepared, as in any other profession. “I would say maybe take baby steps first, then move more into mainstream animal care—but understand that you really need some training and experience to be able to succeed at what you’re doing.” Frank Snell, president, CEO, Snell Prosthetics & Orthotics, Arkansas, notes that while it isn’t something his practice advertises, he’s not opposed to handling pro bono veterinary O&P cases, as a special need arises. “While some experts in the O&P field would rather refer such cases, all of our experiences in this area have been pleasurable—and educational.” Is starting an animal O&P practice a good business decision? “That question is asked a lot,” says Jim Alaimo, CPO, co-owner, My Pet’s Brace, Pennsylvania. “There’s obviously a need out there. There’s not a lot of people that do what we do, but I caution people who think, ‘Oh, I fit human orthotics and prosthetics, so I bet I can fit a dog or other animal.’ “You probably have the skills. My tagline is ‘anatomy is anatomy and biomechanics is biomechanics; if you understand anatomy and biomechanics, you can do both.’ But the reality is, to do it properly, you can’t see dogs in a human facility. Just can’t do it. There’s hair everywhere. “We vacuum three times a day in our facility—literally,” he says. “Every room has to be cleaned up after an animal leaves, and we shampoo the carpets every week because I’m particular about the way the place is cleaned, because animals leave hair everywhere. A lot of them live outside all the time. “I think orthotists and prosthetists have the skills. They just have to use them in the right environment.” Ben Blecha, CPO, founder of Hero Braces, Nebraska, agrees that while the biomechanics may be similar, fitting animals can be different. “The hurdle is the fur. Plastic adheres well to human skin, not so well, however, to the animal’s fur.” As far as starting up a new animal O&P care business, he warns, “You’d be pretty hard-pressed to start it as a stand-alone business. I’ve been doing it for 18 years now, and we still borrow money to make things work. But I also live in a rural area, so my overhead is much lower than if I were living in Denver or something. “The other established players in this field continue to look for ways—some of them have been acquired to try to have more capital to make it work. So I think having it as an add-on to your current practice, if you’re in a metroplex, could be a viable solution. “OrthoPets and Hero were among those first four animal O&P care business to start up in 2004-2005, and I think they’re probably the most recognizable names in the veterinary space,” Blecha says. “But we’ve dropped literally hundreds of thousands of dollars into marketing to get to that place. Just starting up, there’s a much larger cost than most people might guess. I don’t want to be negative, just helpful and realistic.” Bobbie Adams, RVT, CCRP, MSPO, LPO, veterinary O&P strategy and development coordinator, OrthoPets, Colorado, advises that this is a field that can be lucrative because of how billing is done, very differently than human O&P. “With vet O&P, insurance authorization and coding is all left behind. The pet parent expects to cash pay, and that is a complete change from the form used in human O&P. “Pet insurance is available in the vet O&P field, and some insurance companies, including Trupanion , Pumpkin, Figo, and Nationwide, will reimburse the pet parent for veterinary orthotics and prosthetics. The pet parents pay the bill, then they submit a claim, and depending on the policy parameters, the pet insurance will reimburse the parent whatever the policy states.” Snell notes that the pet business is a billion-dollar industry, and people are known to do things for their pets as much as they would do for their children. Considering the cost of a brace or prosthesis, which doesn’t get any cheaper when it’s made for an animal, insurance would be a wise idea. “If I were doing vet O&P, I would not accept assignment, however,” he states. “I would want cash money. The first thing the insurance company is going to do is regulate your prices, and then take six months to pay you—and require documentation. You know, all the stuff we’re dealing with now [in human O&P].” Alaimo agrees that the income is not what one might expect. “We do a lot of work, but the reality is that this is all out of pocket for most people. Some pet insurance will pay for this, but we get reimbursed much less than we do on the human side. From Medicare you’d get maybe $7,000 or $8,000 for a below-the-knee prosthesis on the human side. We’ll be lucky if we get $1,500 or $2,000 for an animal. “You’ll get a couple thousand for a [cranial cruciate ligament] brace on the human side. On the dog side you’re only going to get $700 or $800. So the reimbursement isn’t nearly as much, but you can’t charge the same amount of money because people couldn’t afford it. “At the back of the issue is, can I afford a $120,000 orthotist or orthotist/prosthetist to come and work for me? Does that make fiscal sense? “So you have to match up the labor with what you’re doing,” says Alaimo. “We use vet techs. They have a lot of experience working with dogs, so we train the vet techs. We have biomechanical engineers, mechanical engineers who are used to working with their hands and understand biomechanics; but for us to be able to go out and afford $100,000 or $110,000 orthotist/prosthetist, is that economically feasible?” “I think it comes down to a love of what you do,” says Angela Boncz, CTPO, Specialized Pet Solutions, Washington. “In human O&P you’re battling L-Codes and insurance issues, and a lot of people think animal O&P care would be easier since you’re not dealing with insurance companies so much. But then again, people don’t have thousands of dollars to put into a brace. Maybe they’ll just let the dog go without a brace, or they’ll have the animal put down. So it’s tricky trying to find the right price that’s fair to everybody so that the animal gets care, because not everybody has pet insurance, or the money for the premiums. “People love their animals—more people are having dogs than kids now. In most cases they’re regarded as family members. But there are still parts of the country with a 1920s mentality [about] how they take care of their animals.”

Animal O&P and Solvency

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Animal O&P and Solvency

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Surgery Versus Bracing for Canine CCL

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