3THE MED SUPPLY LINE

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Opening Remarks

s busy as we are today meeting the needs of our patients and the demands of man-aging our practice, it is always a welcome change when a vendor makes life easier— even better. One of our best partners is ACO Med Supply. They have met our

needs, exceeded our expectations, and worked collaboratively with our largephysician specialty practice. I am honored to provide the keynote message for this inau-gural issue of ACO’s The Med Supply Line.

Product availability, price, and service are the bedrock of a successful vendor relationship.But an extra measure of commitment by the vendor to understand customer operations,profitability, and shareholder returns improves the purchasing agreement and allows bothparties to profit from the relationship. ACO Med Supply has made just such a commit-ment to all its customers; we see it everyday in our relationship.

As a diversified medical supply house and distributor of internationally recognizedDonJoy bracing and support products, ACO Med Supply is uniquely positioned to meetthe high economic, quality, and service standards of orthopedic specialty practices.

This magazine is a great example of the company’s effort to tell its story and remind thehealth care community of some of the best reasons to look to ACO Med Supply as avalued business partner.

Sincerely,

James L. Perkins, MHA, CMPEAdministrator, West End Orthopaedic ClinicRichmond, Virginia

A

Volume 1, Issue 1 ContentsJoint VentureOA Braces Apply Support Where It’s Needed........................................................................................................4

A Decade of ExcellenceClient-Focused Business Ethic Puts Med Supply Company on Top .............................................................6

Brace Yourself!Innovative Technology Stabilizes Sprains and Prevents Recurrent Injuries .............................................8

Inventory Management SolutionsWeb-Based System Provides Quick Tracking ....................................................................................................10

A publication fromACO Med Supply, Inc.

2205A Distribution Center DriveCharlotte, North Carolina 28269

(704) 921-0116: Telephone(800) 351-8006: Toll Free

(704) 921-0117: Fax

Stuart Ross: PresidentJames Gray: Vice President

Richard Jacobson: Director of FinanceGreg Harmon: South Carolina Regional Manager

Tim Van Schaick: North Carolina Regional Manager

Sales Representatives:

Carl Bax: FloridaSandra Caldwell: AlabamaLoran DeFoor: South CarolinaDyan Effler: North CarolinaRod Ferguson: VirginiaToby Godfrey: North CarolinaAaron Gresham: VirginiaJohn Grubbs: North CarolinaGreg Harmon: South CarolinaMonty Jones: AlabamaAlan Livingston: South CarolinaJohn Muller: GeorgiaMike Osborne: North CarolinaCraig Paterra: FloridaTallie Pipkin: GeorgiaGrant Prescott: South CarolinaBrandon Pyper: AlabamaJim Reeks: VirginiaBob RoJahn: FloridaSpencer Sappington: AlabamaTim Van Schaick: North CarolinaKenneth Tucker: North CarolinaJeff Turner: Virginia

The Med Supply Line is an inside look at howorthopedic-related products are making a positive difference in the delivery of qualityorthopedic care. This bi-annual publication,produced by ACO Med Supply, is designed toeducate and inform orthopedic surgeons, prac-tice administrators, purchasing departments,physical therapists, and athletic trainers. Theinformation contained in this publication is notintended to replace a physician’s professionalconsultation and assessment. Please consultyour physician on matters related to your personal health.

4 THE MED SUPPLY LINE

Joint VentureOA Braces Apply Support Where It’s Needed By Diane M. Calabrese

inges simplify life. Instead of pryingopen a door each time we wantto enter and exit, we count on its

swinging motion. But when hinges eventu-ally deteriorate, they require restorationor replacement.

So it is with our joints, the in-body hingesthat allow us to walk, run, and throw withgreat fluidity. With so much activity packedinto a lifetime, joints are naturally wellcushioned with cartilage to withstandrepeated use.

Yet, an increased lifespan puts cartilage tothe test. When cartilage begins to lose itscapacity to cushion, the bone surfacesthat were once protected at the joint beginto rub against each other. The result is aspainful as it sounds.

Pain is not the only problem associatedwith osteoarthritis (OA), a progressivedeterioration of cartilage and bone.Swelling can occur, and the ability to movewith ease decreases.

OA affects 21 million Americans. The mar-ket for OA braces is growing at more than10 percent per year. The availability of OAbracing is one part of an integratedapproach to reduce the effects of OA onindividuals and the population as a whole.Although some OA cases are caused byrepetitive use in athletes, many are linked toaging. Consequently, as more adults livelonger and are more active, the incidence ofOA will continue to rise.

A Little Goes a Long Way

It’s possible to replace joints, and pain-reliefmedications are available. But if a noninva-sive method can improve mobility, it is gen-erally the first option physicians choose.

In fact, Alonzo Myers, MD, OrthopedicSurgeon at the Lewis-Gale Clinic in Salem,Virginia, selected the least invasive optionfor himself — a knee brace. “I use a DonJoyoff-loader brace when I play golf,” explainsDr. Myers.

According to Dr. Myers, an orthopedist canhelp a patient decide if a brace will help. Hisbrace redistributes weight so the portion ofhis knee joint most affected by OA does nothold a disproportionate amount of the load.

The angularity of uneven cartilage wear canexacerbate pain by pushing more loadtoward the part of the knee least able to tol-erate it. In some cases, explains Dr. Myers,individuals who have sustained a ligamentinjury benefit from a knee brace, as furtherinjury is prevented by the supportive prop-erties of the brace.

Dr. Myers has recommended braces topatients for at least 10 years but more so dur-ing the last four years, as brace technologyhas improved. Over the last decade, braceshave become lighter and less conspicuous.

Added Benefits

Dr. Myers sees braces as a beneficialoption for many patients. “Withincreasing concerns over use of anti-inflammatory medicines, this is a goodalternative,” he explains, “as it is inmy case.”

With angular degeneration of carti-lage, an individual’s effort to reducepain by using a compensating gait canactually put him or her at greater riskfor a fall. With the stabilizing effect ofmany DonJoy braces, fall preventionis often another advantage forpatients who utilize a brace. “To someextent, the stabilizing effect of thebrace probably slows the progress ofOA,” Dr. Myers explains.

A Good Start

To give patients the best opportunityfor success with a brace, careful evalu-ation and patient education are musts,says Jim Reeks, a representative forACO Med Supply. Beyond that, saysReeks, working to find a brace that isa correct match for the patientrequires attention to activity level,

lifestyle, body type, age, and severity of dis-ease progression.

In addition, knee-replacement surgery is notan option for many heart patients, Reeksexplains. The sales representatives at ACOMed Supply will work closely with the physi-cian or orthotist in understanding thepatient’s medical condition, special needs,and activity level.

DonJoy is so confident with the success of theirOA bracing that they have instituted a “TestDrive Program,” which states, “If any patientis not 100% satisfied after receiving a DonJoyOA product, they may return the bracefor full credit or refund within 30 days.” ■

If your patient’s quality of life hinges on anOA product, look to DonJoy for your brac-ing solution. To review DonJoy’s completeline of OA bracing, visit their Web site atwww.donjoy/arthritis.com.

H

Prescribe confidence. Prescribe DonJoy.Prescribe confidence. Prescribe DonJoy.

The market for OA braces is growing at more than 10percent per year.

5THE MED SUPPLY LINE

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6 THE MED SUPPLY LINE

CO Med Supply opened as anorthopedic specialty distributor inCharlotte, North Carolina, in June

1995 with a 2,500-square-foot facility, twoemployees, and nine sales representativescovering three states. The firm initially rep-resented three orthopedic lines: DonJoyOrthopedics, Procare, and Tecnol.

Stuart Ross, ACO Principal and Founder,decided to expand into full-line distributionof medical-surgical products, focusing onthe needs of orthopedic practices. Approx-imately a year and a half after opening,ACO doubled the size of its warehouse.

ACO Med Supply has focused on the busi-ness aspect of the medical practice so theclinical staff can concentrate on theirpatients. Customers soon recognized howACO’s knowledge of their business needscould maximize their office efficiency; theresult was continued expansion. A yearlater, another move heralded a 12,800-

square-foot warehouse. The most recentexpansion in August 2004 doubled itscurrent configuration to 26,000 squarefeet, making it one of the largest distribu-tion centers for orthopedic products in theSoutheast.

“We continue to focus on growth withinthe Carolinas and Virginia, adding per-sonnel and valuable customers,” saysRoss, who notes the firm is expanding inthe Southeast as far as Florida, Georgia,and Alabama.

Service and Personal Attention

ACO’s success stems from the firm’s dedi-cation to “the personal touch” and supe-rior customer service. According to Ross,“Most full-line medical-surgical distribu-tors don’t focus on orthopedics because ofthe technical and product expertiserequired, along with the significant com-mitment to orthopedic inventory.”

The dedication to fulfilling customerrequests has enabled the firm to grow froma distributorship of three medical-equip-ment companies to more than 500 suppli-ers. ACO has evolved into a market leaderin the four-state region encompassingNorth Carolina, South Carolina, Virginia,and eastern Georgia, with 23 sales andservice representatives.

To increase its product offering, ACOjoined the ABCO division of NationalDistribution & Contracting, Inc. (NDC),the largest organization of independentmedical, surgical, and dental supply distrib-utors in the world. “We benefit from theirhelp. Some of the benefits provided byABCO include lower pricing, nationalcontracting, and a private-label program,”says Jimmy Gray, ACO Vice President.“ABCO has a large warehouse in Nashvillethat acts as an extension of our own.”

The attention to individual customer needssets ACO apart from larger firms.Competition from large group purchasingorganizations and integrated delivery net-works does not daunt ACO’s sales force,which concentrates on customizing plans tofit unique customer needs. ACO’s philoso-phy reflects that notion: “ACO Med Supplyis a privately held business, not a policy-driven conglomerate. We run the system, asopposed to the system running us.”

The Extra Mile

Gray literally goes the extra mile to satisfyclients. “Our customers’ needs are para-mount,” he says. He recalls when acustomer requested a rush order on a pieceof equipment in a city more than two hoursaway. “We put it in our car and metthe sales rep half way,” recalls Gray. “Weensured it was delivered that day becausethey were in a bind and needed it immedi-ately. I can assure you that a large nationaldistributor would not jump in his car anddrive to his customer. He just can’t.”

At ACO, such instances are not isolated;they happen routinely. “Our customershave come to expect the extras; this sets usapart,” says Gray. “In the United States, we

A

A Decadeof ExcellenceClient-Focused Business Ethic PutsMed Supply Company on Top By Mali R. Schantz-Feld

ACO’s corporate headquarters in Charlotte Physicians appreciatedistributors that are smaller,

more flexible, and able to meettheir specific needs.

– Stuart Ross,ACO Principal and Founder

‘‘ ,,

7THE MED SUPPLY LINE

are privileged to have a great medical sys-tem. The physicians have more to say aboutwhat they are buying. They appreciate dis-tributors that are smaller, more flexible,and able to meet their specific needs, whilefocusing on reducing costs in their productsupply chain.”

Confronting Challenges in the Health CareMarketplace

Besides ensuring supplies are in stock, ACOkeeps tabs on everyday office tasks. Rossasserts that with the evolution of a moresophisticated payer base, orthopedic prac-tices are challenged to operate more prof-itably. Billing ancillary services takes timeand manpower. “As costs for other parts ofthe business continue to rise, running amarginally profitable business doesn’t makesense,” says Ross.

Challenges such as third-party billing,stock-and-bill programs, as well as just-in-time inventory pushes make orthopedicpractices turn to ACO for their office needs.“Because ACO is small and independentlyowned, we remain unencumbered by redtape to make changes and act quickly anddecisively within our market,” says Ross.

As a DonJoy distributor, ACO offers sever-al stock-and-bill programs to fit specificclinic needs. The OfficeCare program andthe Med Direct program for smaller offices

address numerous stocking and billingissues, such as:

(1) Streamlining office procedures andreducing overhead,

(2) Removing financial losses associatedwith billing and reimbursement ofsoftgoods,

(3) Transferring the responsibility ofinventory management to ACOand DonJoy,

(4) Removing the capital investment tiedup with durable medical equipmentinventory on the shelf,

(5) Reducing time spent with vendorsin the clinic, and

(6) Addressing compliance issues whenpatients are fitted at the point of care.

Currently, ACO has more OfficeCare cus-tomers than any other DonJoy distributorin the United States.

Vendor consolidation is another importantaspect regarding efficiency, explains Ross.Too much time and energy are expended onmanaging and ordering supplies, as well aschecking and stocking receivables. With thesignificant expense of generating aninvoice, it is often costly to do business withnumerous vendors. ACO’s relationshipwith more than 500 manufacturers makesvendor consolidation an easy transition.

In 2001, ACO began requiring its orthope-dic-specialty representatives to receiveboard certification as orthotic

fitters, which calls for many hours of fieldexperience, formal training, and earning arequired level of continuing education units(CEUs) annually (see “Fitting Credentials”sidebar). Orthopedic surgeons can feelcomfortable that their patients are fittedand trained on brace functionality by certi-fied professionals.

“Larger clinics have put us to the test to seeif we can handle their business,” says Ross.“We have an understanding of brand value,pricing, and delivery. Large or small, eachcustomer can count on the service andintegrity that has made ACO Med Supplywhat it is today. We’re 10 years and grow-ing, one account at a time.” ■The American Board for Certification in

Orthotics and Prosthetics (ABCOP) awardsorthotic fitters with the credentials of ABCRegistered Fitter-Orthotics (RFO) as anappropriate and meaningful recognition ofprofessional competence. For eligibility, thecandidate must have a certain amount ofhours of orthotic-fitter experience, success-fully complete an orthotic-fitter educationprogram, and have an orthotic-fitter licenseissued by a state orthotic/prosthetic licens-ing board.

Candidates are also required to take continu-ing education units (CEUs) designed to main-tain, develop, and increase the knowledge,skills, and professional relationships thatregistered fitters need to successfully provideservices for the public. ACO requires all itsorthopedic-specialty representatives toreceive these ABC credentials.

For more information on credentialing, visitthe ABC Web site at www.abcop.org.

Fitting Credentials

At this year’s DonJoy sales banquet, whichwelcomed 200 distributors and sales reps,ACO Med Supply and one of its representa-tives were honored with awards. Sales repre-sentative Greg Harmon, of Columbia, SouthCarolina, received the Pinnacle Award as thesales associate with the highest growth. ACOMed Supply won a Pinnacle Award as a prod-uct-growth champion distributorship. Theseawards recognize ACO’s continuing dedica-tion to offering the highest quality customerservice and variety of products to customers.ACO would like to thank its customers andsales associates for the company’s success.

A National Sales Award

VIRGINIA

NORTH CAROLINA

SOUTHCAROLINA

ALABAMA

FLORIDA

GEORGIA

Current Service Area

Expansion Territories

With its continuingexpansion, ACO has evolved

into a market leader.

8 THE MED SUPPLY LINE

veryday, approximately 25,000 peo-ple sprain their ankles in the UnitedStates. The “old-fashioned” method

of wrapping the injury with costly athletictape is time consuming and can result inlonger rehabilitation time and reinjury.

Athletes are turning to ankle braces toproperly stabilize sprains and reduce recur-rent ankle injuries. Physicians and patientshave braced themselves for a new innova-tion in ankle support and the evolution ofnew products therein. The Velocity repre-sents DonJoy’s new line of Rigid AnkleBraces. In March 2005, the DonJoyVelocity ankle brace garnered significantattention at its unveiling at the AmericanAcademy of Orthopaedic Surgeons’convention in Washington, D.C.

Innovative Technology

“This off-the-shelf ankle brace incorporatesmany features thatone would expectfrom a customankle-foot ortho-sis,” says RussHavranek, SeniorMarketing Managerfor athletic bracingat dj Orthopedics.“From footplate tocalf cuff, the Velocity

represents an evolu-tion in DonJoy ankle-brace technology.”

Developed using R3(Rapid-Rigid-Ratch-

eted) Technology,the Velocity pre-

vents abnormal

ankle inversion, eversion, and rotation,while offset, bilateral hinges allow for nat-ural, unrestricted dorsi-and-plantar flexion.While many rigid, hinged ankle braces arebulky and difficult to fit into shoes, theVelocity is low profile and lightweight.

“Some braces are universally sized, but thisis the only brace that comes in modularsizes, providing a better fit,” saysHavranek. He adds that the three footplateand two calf cuff sizes can be mixed andmatched to accommodate an individualpatient’s anatomy — further, this productincludes a left and right model, not just auniversal model as with many competitors.

The footplate is anatomically contouredand sized to mitigate foot slippage and isheat moldable for customization to eachpatient’s foot, matching insoles, ororthoses, Havranek says. “The Velocity’sunique features and technologies really setit apart from other braces,” he notes.

The Velocity design provides support to thecalcaneus and prevents extremes of inver-sion and eversion, the culprits of tradition-al ankle sprains. Selecting the appropriatebrace is a simple choice, which takes intoconsideration the amount of ankle protec-tion and support required as well as thepatient’s or athlete’s activity level.

Customizable by Design

Three different versions of the Velocitybrace are available, each with the same rigidcomponents but different softgoods thatafford various support levels.

The Velocity LS (light support) is the lowestprofile and lightest weight version.

The Velocity MS (moderate support) fea-tures SpeedWrap technology for securedjoint compression. The Velocity LS and MSversions are ideal for patients and athleteswho want to quickly return to daily livingactivities and noncontact sports.

The Velocity ES (extra support) also fea-tures SpeedWrap and incorporates an outershell to capture the calcaneus and anAchilles pad for added comfort and sup-port. The Velocity ES version is ideal forpatients and athletes who want to quicklyreturn to engaging in noncontact and con-tact sports such as basketball, volleyball,and soccer.

The Velocity is easy to apply and remove.The SpeedWrap technology incorporateslow-profile, no-tie laces with strap endsreadily attachable to each other or directlyto the outer shell. The adjustable tonguedesign on the Velocity MS and ES versionsensures comfort, fit, and proper alignment.The SpeedWrap is a low-profile option forbracing and was well received by patients.

Superior Support

“The brace’s fully rigid circumferential calfcuff offers superior tibia/fibula compressionfor high ankle sprains and prevents ab-normal inversion and eversion,” saysHavranek. The Velocity’s footplate is alsodesigned with unique posterior wings thatprovide calcaneus support.

For patients who wear orthoses, they canplace the Velocity footplate on top of theorthotic so the ankle joint properly alignswith the brace’s bilateral hinges. If thecontour of the brace does not match or sitflush on the orthotic, the footplate is heatmolded and/or trimmed.

For the color-conscious sports enthusiast,the brace is available in either black or

Brace Yourself!Innovative Technology Stabilizes Sprains and Prevents Recurrent InjuriesBy Mali R. Schantz-Feld

E

‘‘ ,,Some braces are universally

sized, but this is the only bracethat comes in modular sizes,

providing a better fit.– Russ Havranek,

Senior Marketing Manager, dj Orthopedics

Velocity. Born to run. Fast.

9THE MED SUPPLY LINE

white and has a customizable nametagsystem for easy owner identification.

Bracing Your Patients

The Velocity was field tested by many col-legiate and professional athletes and wasfound to provide superior support topatients recovering from high ankle sprainsor lateral instability. Use of the Velocityankle orthosis for prophylactic applicationsas noted by Rod Walters, Head AthleticTrainer for the University of SouthCarolina, is shown to reduce the cost ofstandard taping applications by more than40 percent.

Based on the reduction of cost per athlete,the elimination of staff time for tapingapplications, and the higher level of sup-port and stability provided by the Velocity,this is certainly the wave of the future. TheVelocity is now a bracing option for sportsmedicine patients. Athletic trainers note thereduced cost of bracing versus taping ona daily basis over the course of a season —a savings close to 40 percent. ■

10 THE MED SUPPLY LINE

ome see the supply cabinet half full.Others see it half empty. That’s a prob-lem in a busy orthopedic practice,

where time is scarce and proper supplies arevital. Orthopedic clinics can overcomeinventory challenges and save time andmoney with a little help from OrthoTrack.

According to inventory management spe-cialists, who build and market Web-basedsolutions for businesses, many health careorganizations are struggling to balanceinventory challenges. High order fill rates,high inventory turns, inventory shrink, andobsolescence drain a practice’s profits.

ACO Med Supply understands the multipletasks involved in a successful medical prac-tice. For patients to receive optimal care, theoffice must have the ability to access infor-mation quickly and efficiently handle supplyissues. In the past two years, ACO andDonJoy have researched inventory manage-ment software applications to address thespecific needs of orthopedic clinics.

As an orthopedic and medical-surgicalproducts distributor, ACO shares the frus-trations and realizes the value of managingthe durable medical equipment (DME)inventory. Among its services, ACO andDonJoy now offer the OrthoTrack solutionfor managing the myriad of products in anorthopedic environment.

“OrthoTrack is a Web-based tool that iseasy to support and is maintained by ourcompany,” says OrthoTrack ManagingDirector Steve Britt.

Works Like a Charm

Inventory poses a dilemma. Stockpiling toomany items on the shelf is costly, but toofew products on hand can affect patientcare. Supplies are often ordered, stocked,and used by several staff members, compli-cating coordination. Within the clinicalenvironment, supplies may require trackingbetween multiple locations, various supplyclosets, and individual vendors.

To maintain proper quantities, OrthoTrackestablishes and maintains par levels,tracks insurance billable products, andintegrates the ordering function into theaccounting process.

The system tracks inventory in a variety ofways — by procedure, doctor, and patient,notes Britt. The program does not allowreimbursable items to “fall between thecracks.” Certain supplies, such as wristbraces or walkers, are billable either to theinsurance or to the patient. SometimesDME products are issued to a patient with-out the patient or insurance companyreceiving a bill, or products are removedfrom the shelf and not replenished.

OrthoTrack establishes a simple way toquickly enter the information into the sys-tem. Scanning items avoids duplication andreduces paperwork. Hand-held barcodescanners with built-in laser scanners areportable and durable. The system also helpseliminate stock-outs and has the capabilityto automatically restock the supplies.

“The system knows what’s on hand,” saysBritt. “It maintains a perpetual inventory.Every time a supply is moved off the shelf,it’s tracked.”

All Systems Go

Many offices are reluctant to use a trackingsystem due to the implementation costs.For other inventory management systems,the purchase of new software and an updat-ed computer system, as well as the costs ofimplementation, training, and evaluation,can dip into the practice’s profits. Also,implementing a new office procedurerequires evaluation and training for physi-cians, administrators, and staff who arealready battling tight schedules, so learninga complicated new program can becomemore of a problem than a solution.

Since OrthoTrack is Web based, any com-puter that connects to the Internet canwork with this user-friendly application.Computers require no updating, and amonthly subscription replaces large upfrontcosts. To maintain security, a password isrequired for system entry, and users canturn certain applications on and off for pro-prietary usage.

Information is kept in a manner thatadheres to new privacy regulations as well.“The system supports HIPPA regulationswhile tracking patient data,” says Britt.If supplies are low, an e-mail alert informsthe proper office contact that it is timeto replenish and provides the vendor con-tact information.

The system also provides a detailed spend-ing analysis, tracks products to specificpatients or procedures, and provides anaudit trail for order monitoring, receiving,and paying for supplies.

Built to Order

ACO is one of the first distributors to under-stand the need to offer a spectrum of orthopedic products and a solution to managethe volume of specialized products required inthe orthopedic environment. In this way,ACO acts as a partner and consultant inaddressing product management needs in allaspects of inventory management. ■

Inventory ManagementSolutionsWeb-Based System Provides Quick Tracking By Mali R. Schantz-Feld

S

OrthoTrack estab-lishes a simpleway to quicklyenter the infor-mation into thesystem. Scanningitems avoids dupli-cation and reducespaperwork.

11THE MED SUPPLY LINE

3MTM Immobilization Products has a fullline of synthetic fiberglass casting andsplinting products, in a variety of sizesand patient-pleasing colors, as well ascompatible casting accessories.

ACO Med Supply, Inc.2205A Distribution Center DriveCharlotte, North Carolina 28269(704) 921-0116, Toll Free: (800) 351-8006Fax: (704) 921-0117