Welcome to Cascade Orthopedic Supply, Inc.’s blog. If you are reading this, you are probably wondering who we are, what our blog is all about, and why we are here. 

Cascade Orthopedic Supply, Inc. was founded in 1975 and is distinguished as the single largest independently owned orthotics and prosthetics distributor in the nation. Cascade’s mission is to provide superior value and support on the products we source and the services we provide. Cascade has four distribution facilities located in California, Texas, Illinois, and Pennsylvania, allowing overnight delivery anywhere in the contiguous United States at published ground rates. Cascade’s 40 year reputation is built on a continued commitment to excellence, investments in technology, and operational efficiency. As the largest independent O&P distributor, Cascade is committed to helping customers build a successful practice and provide better patient care. 

Our blog will help us better connect with you, our customers. We are looking forward to filling you in on what is happening in the O&P industry in areas like innovation, technology, events, industry leaders, people, and more. Major developments and reform are occurring in the O&P industry and staying in front of the trends is top of mind. We want this to be a place for you to learn, grow, ask questions, and get connected.

Be sure to follow us on social media via Facebook, Twitter, or LinkedIn Groups.  We are excited to provide you with great content and make sure you know who Cascade is and what we are all about.

|Distribution How You Want It; Shipping Made Easy|

new-piktochart_23324074_4005d4275533b782cd93d73b2fbe4871a785c127We recently sat down with Cascade’s Director of Distribution Center Operations, Mark Hammans, to get an idea of the advantages our four warehouses provide to our valued customers.

Mark stated, “Cascade has always strived to have the latest logistics software, adhere to best shipping practices, and maintain a substantial number of inventoried products to meet a practitioner’s specific patient need. As Cascade has continued to grow, we have adjusted our distribution centers systems and logistical practices to continue delivering the best service possible.”


With four strategically placed Distribution Centers across the United States (Chico, California, Dallas, Texas, Chicago, Illinois and Lancaster, Pennsylvania), we can provide one day shipping at ground rates for a majority of customers. Our Customer Service Team is always ready and willing to work with customers to make sure we select the correct freight option to get packages delivered on time.

In November 2016, we moved the Texas Distribution Center from Grapevine to Irving, Texas which allowed Cascade to accommodate a larger volume of inventory. The facility went from a 15,000 sq ft warehouse to 22,000 sq ft space, increasing the area by almost 10,000 sq ft. Cascade also expanded the Lancaster Distribution Center, making our Lancaster location the largest distribution center at 32,000 sq ft.



Cascade stocks about 35,000 items in each of our warehouses with around 270,000 units available for purchase. By reviewing customer demand, we are able to stock a customer specific product mix in their default warehouse, this means stockable items differ from warehouse to warehouse. This allows us to ship, same-day from stock and reduces both transit time and freight costs for our customers.


It’s an exciting time here at Cascade, as we continue to implement new operating systems to increase efficiencies and provide added value to our customers. By the end of Summer 2017, all four warehouses will have all items weighed and measured using the Qubevue system. This system will allow customers to receive estimated shipping costs, prior to ordering. We will also be rolling out “scan to validate” by the end of the year. This will aid in packing shipments correctly and give customers access to see what items are in each package sent to them.

To learn more about additional resources Cascade has to offer, make sure to check out our website!

Cascade Website: Resources

Website ResourcesAt Cascade, we strive to provide you with easy and accessible tools to meet your everyday needs.  The Resource Section of our website is a great place to find additional information about industry updates, order forms, transit times and much more.  Have you had the opportunity to check this section out?

Let’s take look deeper into the Resource Section of Cascade’s Website.

How to get there:

  1. Go to www.cascade-usa.com
  2. On the left-hand column, towards the middle of the page, click the “Resources” link


What’s Inside:



PDF Catalog: Download the Cascade Catalog! Here you can download a PDF of the whole catalog, or just specific sections; i.e. fabrication, prosthetic, orthotics.


Custom Order Forms: Need a custom order form? If so, this is the place to look. We have order forms from all of our manufacturers that provide custom products.

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InsideTrack: The InsideTrack is a seasonal newsletter that provides Cascade updates, product improvements/changes, industry updates, and product picks. This is released four times a year: Spring, Summer, Fall, and Winter.

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Insiders:  The Insider is a newsletter that showcases the newest products that are available and provides an “Tip-In” (an editorial that covers the latest trends, ways to improve business, and other value added information).  This newsletter is released four times a year.

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MSDS Information: Material Safety Data Sheets (MSDS) or Safety Data Sheets (SDS) are a critical component of product stewardship, occupational safety and health, and spill-handling procedures. These forms include instructions for safety and potential hazards associated with a product.

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Credit Application: Credit applications are used by our AR Team to figure out a customer’s line of credit. If you would like to create a new account with Cascade or update your existing account, be sure to download this file!


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Transit Time: Cascade has four strategically placed warehouses to ensure your delivery will arrive via ground service in three days or less. Use the provided map to determine your specific transit time. *Times vary based on location

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Sales Territory Map: This resource provides you with contact information for our eight Territory Account Managers and provides a map of their respective territory boundaries. It also includes the contact information to our Inside Sales Account Manager, National Sales Manager, and Director of Sales and Marketing.

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Cascade Blog: The Cascade blog is a fun way to connect with you, our customers! In the blog, we will cover topics like innovation, technology, events, industry leaders, people, and more. You will also get a look into who Cascade is and what we are all about.


Industry Trade Show Organizations: This is a complete list of Trade Shows that Cascade sponsors and attends. Make sure to stop by our booth and say hello when we are in your area!

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OP Solutions: Solutions that Make Sense: Cascade has partnered with OP Solutions to provide independent providers of care the resources and tools needed to succeed in today’s uncertain healthcare environment. In this section, you can find more information about the available services and you can contact your Account Manager.

Make sure to check out our website to learn more about these amazing resources!

Where’s Jerry?


In the words of Jerry Schoendorf, our South Territory Account Manager, it was a “Mission Accomplished” trip to Antarctica.  From February 2nd-13th, Jerry visited Antarctica, adventuring to the seventh and final continent left on his list.  It has been Jerry’s long-term goal since a child to visit all 7 continents and he has achieved his goal!

Check out the details below to learn more about Jerry’s trip to Antarctica, some of his past travels, and where he is off to next!

  • Where in Antarctica did you go and what was your favorite place?

I went to the South Shetland Islands, Gerlache Strait, Weddell Sea, and all around the Antarctica Peninsula. My favorite destination was the Weddell Sea. I was fortunate enough to have a captain and crew (all Russian and Ukrainian) both skilled and willing to make the trip.  This area is known to have numerous giant tubular icebergs which make the area tricky to maneuver, so many captains won’t go.  Some of the icebergs are ten stories high and multiple city blocks wide!

  • What were some of the activities you did while you were there?

I toured inlets and bays that haven’t been touched by man in zodiac rafts. We visited centuries old whaling outposts that were littered with giant whale skeletons preserved by the cold climate. We also hiked among thousands of penguins with their newborn chicks and went whale watching. The Humpback Whales were so incredible and definitely the coolest animal I saw on my trip.


  • Since you were traveling alone, did you meet any interesting people?

I met a lot of people from the United States and Canada who share my same passion for traveling and a desire to see the world. I also met a professional nature photographer from Russia, a Marine Biologist from Australia, and an eight-year-old child prodigy classical pianist from China who were traveling with me.

  • What is the Antarctic culture like?

There is no culture in Antarctica because the only people allowed to stay overnight on the continent are scientists and researchers.  They stay at the various research stations located across the continent.  There are no permanent residents and no other structures of any kind.  The Antarctic treaty (signed by 53 countries as of 2016) protects Antarctica from any development and perseveres the continent for scientific research.  They only allow 100 visitors to be on land at any given time and there are strict procedures and protocols in place to protect the land:

  • All clothing worn must be rinsed and disinfected
  • All pockets must be emptied and vacuumed out to prevent the introduction of foreign organisms
  • No food or drink can be brought on land
  • Visitors are not allowed to “answer the call of nature” on land


  • Outside of your recent adventure, what has been your favorite place to travel?

It’s hard to choose just one place.  I like the unique traditions and rituals of Bali, Indonesia – the blend of Hindu and Buddhist cultural elements are fascinating to me. In Japan, I appreciate the order, integration of advanced technology, and respect for nature and elders.  In Italy, the attitude, zest for life, and food was remarkable and the severity, tenacity, and sacredness of Tibet was unparalleled.

  • Where to next?

I plan to travel to parts of Central Europe that I haven’t been including Southern Germany, Western Austria, and Luxembourg.

Stay tuned to find out more about Jerry’s adventures!


Contact Jerry Schoendorf

Cascade + OP Solutions: Providing You with the Tools

Welcome to Part III of the Cascade + OP Solutions Partnership

Learn more about the extensive Resource Tools that are available


The Resource Tools available to you through the Cascade + OP Solutions relationship will help guide your practice in product selection, clinical documentation requirements, and medical necessity.  For a limited time, you will have access to the following tools:

  • Socket Finder: A peer reviewed tool to show you the different types of prosthetic sockets, or interfaces. It allows the practitioner to educate and explain socket designs to a patient electronically.
  • Foot Finder: An easy to use tool to help patients and practitioners to find the ideal prosthetic foot for the patient by simply inputting the patient information. It includes every known prosthetic foot (besides SACH feet) from ALL companies. 
  • Knee Finder: An easy to use tool to help patients and practitioners to find the ideal prosthetic knee for the patient by simply inputting the patient information. It includes every known prosthetic knee from ALL companies.
  • Research Center: This APP has hundreds of articles that are relevant to justifying medical necessity in OP. The articles are provided in full when allowed by copyright, or condensed into one-page summaries with key bullet points.  The research center hosts a variety of topics organized by study type.
  • OTS Orthotic Finder: An APP designed to help practitioners quickly find an off the shelf brace that will fit the patient’s needs. The OTS Orthotic Finder sorts by brand, style and sizes. It currently only includes lower extremity.
  • Letter of Medical Necessity Writer: The LMN is a program that allows the user to quickly plug in a patient’s information and treatments generating a grammatically and punctually correct (non-template) letter, properly cited with appropriate references. This can be used by the prosthetist to provide the physician the required documentation generated from the MDs EHR.
  • Physician Documentation Resource: This template form considers and continually monitors and updates the many sources of Medicare Requirements to properly guide a physician through proper documentation, ensuring the most comprehensive guidance and compliance to limit audits.
  • Outcome Measures: Videos outlining how to perform various O&P outcome measures tests.

To learn more about the resource tools available to you, check out our test site or Contact your Cascade Sales Territory Manager. You can also email OP Solutions direct at opsolutions.us for for information!

The future looks bright with Cascade and OP Solutions! 

What Can Cascade and OP Solutions Provide You?

Welcome to Part II of the Cascade + OP Solutions content.

Check out the services our new partnership gives you access to…


Website Platform: The OP Solutions website platform was created to meet the specific needs of independent O&P clinics, by optimizing health engagements and care outcomes through information technology. The website is user friendly and features preloaded template pages, allowing you to customize content specific to your company (images, logo’s and page colors). OP Solutions maintains O&P specific content through a content management system (CMS), so you will always be current to the industry. The Responsive Web Design(RWD) ensures that your website will look great no matter what device it’s being viewed on; a computer, tablet or phone.


Resource Tools: These tools can help to guide your practice in product selection, clinical documentation requirements, and medical necessity. By taking advantage of this offer, you will have access to the following tools for a limited time:

  • Socket finder
  • Foot finder
  • Knee finder
  • OTS Orthotics finder
  • Research center
  • Letter of medical necessity writer
  • Physician’s documentation resource
  • Outcome measures

These tools are delivered through a state-of-the-art technology platform that will help you move towards building an evidence based practice.


Prosthetist Finder: This website app is a referral tool created by the Amputee Coalition to help amputees find a prosthetist in just a few simple clicks.  There are currently two types of listing; a free standard listing and an enhanced paid listing. Cascade customers will receive a Free enhanced listing until January 1st, 2018. The enhanced listing includes:

  • Names
  • Credentials
  • Facility name
  • Address
  • Bio
  • Photo
  • Email
  • Link to website
  • Affiliation badges
  • Google map
  • Office hours

To learn more about the website platform, check out the test site or Contact your Cascade Sales Territory Manager to schedule a personalized tour! You can also email OP Solutions direct at opsolutions.us for more information!

We are proud to be your partner and look forward to what the future holds.



Cascade and OP Solutions Partner to Support Independent O&P Facilities


Solutions that Makes Sense

Cascade and OP Solutions are teaming up to provide you, the independent providers of care, the resources and tools you need to succeed in today’s uncertain healthcare environment. You will have access to an advanced website solution, documentation, referral resources, and useful clinical tools.  These resources will be delivered through a state-of-the-art information technology platform that was created to help you build an evidence based practice. 

|It’s time to invest in solutions that make sense for the future.|

Who is OP Solutions?

OP Solutions is a company who is committed to providing clinical resources for the orthotic and prosthetic industry.  Their mission is to help the independent OP clinic succeed in today’s uncertain healthcare environment.  OP Solutions utilizes their extensive knowledge of the industry to offer strategies for growth, optimize health engagements and care outcomes through information technology, and provide you with the tools you need to build a better brand.

What will this partnership provide to me?

The opportunity to access the following awesome services:

  1. Website Platform – an advanced technology platform that utilizes extensive research and knowledge to help differentiate your business and support the future success of your practice by optimizing health engagements and care outcomes.
  2. Resource Tools – tools created to help guide your practice in product selection, clinical documentation requirements, and referral source information.
  3. Prosthetist Finder – an app created in part with the Amputee Coalition that increases your visibility in the amputee community by helping patients find the prosthetist they want in just a few simple clicks.

How do I learn more?

Ask your Cascade Sales Representative today for more information on how you can tour, play around, and test out these exclusive, independent O&P services!


Stay tuned for more information in the upcoming weeks as we detail each of these services and cover how you can invest in the future with a solution that makes sense!

The Cost To See Any Patient: Why It Matters

Written by Brian Gustin- President, Forensic Prosthetic and Orthodontic Consulting

Understanding the meaning of cost is the first step in objectively defining quality.  We must first understand what the term “cost” means, which varies according to the opinion of different stakeholders.  Cost, to politicians and policy wonks, is tied to reimbursement which has absolutely nothing to do with the cost incurred to provide a given service.  Cost, to providers, relates to the internal cost of delivering care.

As providers of care struggle with reimbursements and profitability, the O&P industry will need to develop a system to properly capture and measure their internals costs and compare this cost to the quality of the outcome.  This will be the first step in actively practicing comparative effectiveness.  Currently (in the absence of this system), we are seeing providers destroy the value of care by focusing on highly reimbursed items to replace their lost margin, often disregarding the clinical effectiveness of the service provided.

If we accept the new concept that value is measured in terms of patient outcomes per dollar spent and more expensive services do not necessarily create better patient functionality, then how does O&P create value by treating patients with a given diagnosis?  The answer is by considering the long-term costs of all resources consumed during the patients spectrum of care.

To properly understand these costs, it is assumed the providers have created a defined and measurable process for delivering care.  Unfortunately, many facilities do not have processes that are definable and repeatable. This problem is not unique to O&P and most healthcare models are inconsistent in the delivery of patient care throughout their spectrum of services.  Management will need to begin documenting the processes used to deliver service and define all aspects of patient care, like identifying who is needed to perform a process, how long the process takes, how much space is required for the process, and what supplies are necessary.

An Example

A patient consumes various resources during the process of delivering patient care. There are administrative costs like checking the patient in and completing the documentation, there are clinical costs to assess and deliver care, and technical costs to fabricate the definitive device. From this example, we learn the administrative staff spent 18 minutes (0.3 hrs.), the technician spent 24 minutes (0.4 hrs), and the practitioner spent nine minutes (0.15 hrs.) to provide the service.

From here, we calculate the cost of each resource consumed during patient care using the following formula:

  • Resource Cost Rate = Expense of all Resources/Available Capacity of the Resource (time)

The Expense of All Resources needed for care includes the sum of all compensation (including taxes, fringe benefits – i.e. health ins, pension or retirement plan cost, etc.) plus the cost of all other factors that make the resource available (such as a pro rata share of space cost, cost related to employee supervision, and any equipment or technology costs each may use to perform their job).

Thus, the Expense of All Resources for one of the individual involved in care of a patient may be as follows:

Annual Compensation – $65,000
Supervision Cost (10% of their Manager’s full-time cost) – $9,000
Space Cost (100 sq. ft. @ $25/sq. ft./year) – $2,500
Technology & Support – $1,800
Total Annual Cost – $78,300 or $6,535 monthly cost ($78,300/12)

The Available Capacity of a Resource formula is as follows:

Total Annual Days – 365
Less Weekend Days – 104
Less Vacation Days – 20
Less Holidays – 12
Less Sick Days – 5
Total Annual Days Available – 224 or 18.7 days monthly (224/12)

Hours per Work Day – 8.0 hours
Less Breaks – 0.5 hours
Less Lunch – 0.5 hours
Less Meetings, Training, Etc. – 1.0 hours
Total Available Patient Hours – 6.0 hours

Total Days Per Month x Hours Per Work Day = 112 hours per month

This staff member is available for direct patient care 112 hours per month (18.7 days x 6.0 hours).  Therefore, the monthly costs of the resource (calculated above) divided by the available time ($6,535/112 hours) gives us a total cost of $58.35 per hour for this one resource.  Complete this calculation for all people within the organization whose time is consumed by a patient.  Then simply add all the per hour costs and multiply by the total number of hours spent with the patient to arrive at the total cost of a visit.

This analysis is invaluable when identifying the true cost of providing care and is often overlooked when measuring the return on investment per patient.  In order to remain profitable, it will be necessary (and a good practice) for providers of care to apply the principle of comparative effectiveness.


About the Author: Brian Gustin is a 35 year, second generation veteran of O&P. He has owned and operated two different practices, selling one to the largest orthopedic surgical group in the country and the other to a private group. He has served as the President of AOPA in 2009 and is the senior member of the AOPA Coding and Reimbursement Committee. Today he serves as an industry consultant to many individual practices, manufacturers, insurance companies, law enforcement agencies, and private equity and venture capital firms.