Ballard: ‘Right will win out’

Saturday, May 31, 2008

National Seating and Mobility, like complex rehab providers across the country, has made numerous changes over the past few years to respond to seismic shifts in documentation, coverage and pricing for power mobility devices. After reflecting on his numerous years in the business, however, President Mike Ballard believes the more things change, the more he stays the same.

“I’ve always had the same mission,” he said. “When I started out, I told everyone what I wanted to do and how I was going to do it, and I’m still doing it. Maybe I’m naïve, but I believe if you keep trying, you get the results you want, as long as your cause is just.”

All things considered, NSM had a good year in 2007. It celebrated its 15th anniversary and opened a handful of new branches in California, Arizona, Texas and Florida. HME News spoke with Ballard recently to discuss the rehab industry’s past, present and future.

HME News: Describe what the past few years have been like as a custom rehab provider.

Mike Ballard: It has been very frustrating. There have been so many changes under the guise of “reform” that it constantly changes the rules of engagement with Medicare and Medicaid. Up and down the line, everyone has had to do more work for less reimbursement. As we’ve adapted to changes, CMS has made more changes. They want to end the abuse in the consumer product and direct marketing categories, but they’re using a large fly swatter.

HME: What has been the greatest impact of recent changes like increased documentation and reduced reimbursement?

Ballard: The cost of processing prior approvals has doubled in the past few years. That has brought operating margins down very low and forced some companies to go out of business. No one is getting a fair return for what they’re putting into their businesses, in terms of money, intellectual capital and sweat.

HME: What’s an example of something NSM has done to try and compensate for the changes?

Ballard: We’ve tried to negotiate better purchasing agreements. One of the bad trends I’m starting to see as a result of the changes is that providers are looking to start cookie-cutting providing equipment.

HME: What does your crystal ball foretell for the HME industry?

Ballard: I see a period of consolidation. For small providers, with a few exceptions, it’s just going to become too tough to make the kinds of returns they need to make to stay afloat.

HME: What about national competitive bidding?

Ballard: Having complex rehab in competitive bidding is absolutely absurd. There’s no viable way that the industry can function and provide patient service under competitive bidding. We have to be confident that right will win out, because it’s going to be an unmitigated disaster.

HME: If you had one wish…

Ballard: I wish that the complex rehab industry would work like other industries in that we wouldn’t have an adversarial relationship with our payers. That there’d be some mutual respect.