Complex rehab: Greater investment, greater reward

Despite its reputation for being a market filled with tough reimbursement protocols, advanced clinical client demands and highly technical equipment, the complex rehab market is being explored as a business option by a growing number of HME providers, manufacturers say.

Despite the intricate maze of nuances that define the field, complex rehab is increasingly being seen as a viable alternative for HME companies that have been shut out of other markets due to Medicare's competitive bidding program. Because rehab is not included in competitive bidding, providers who didn't previously consider it are taking a fresh look at its potential, says Gabriel Romero, director of sales and marketing for Burnet, Texas-based Stealth Products. He cautions, however, that complex rehab is not like other HME categories and that practitioners need to make a bold commitment toward attaining a high level of clinical, financial and product expertise.

“If you aren't doing all that is required, high-end rehab is not very forgiving,” he said. “It requires a substantial investment to create a healthy balance of clinical, technical and financial knowledge.”

There is no such thing as casual participation in rehab, says Romero.

“It is a community filled with experienced professionals and most of the relationships are longstanding,” he said. “The 'new guy' may not be readily accepted in the beginning.”

Jay Brislin, vice president of Exeter, Pa.-based Quantum Rehab, also sees growing interest in rehab market expansion. To become a legitimate complex rehab provider, Brislin says there are myriad details to work through, such as implementing efficiency gains, improving service models, getting involved in client advocacy groups and learning the complexities of rehab funding.

“The companies that are willing to adapt and advance with the times, innovate, and develop creative programs and strategies will be the ones leading the complex rehab market into the next generation,” Brislin said. “The sky is the limit with regard to what innovations are the next big advancements to help improve the quality of one's life.”

To be sure, “there are significant considerations for a company considering a venture into complex rehab technology and it's not a decision to be taken lightly,” said Cody Verrett, president of Carson, Calif.-based ROVI Mobility. “As with any business, high quality, compassionate and dedicated personnel throughout the organization are paramount.”

Critical elements

Brislin notes that complex rehab providers must have a strategic plan in place, outlining short- and long-term goals as a foundation and business model.

“Large portions of this plan must include having a team that includes a strong ATP, rehab technician, customer service, and billing specialist that understands funding for rehab products,” he said. “With a strong foundation in place, it will still take time for this business segment to grow. The funding cycle takes time, so it is very important to allow for the rehab team to begin determining opportunities in the market, develop relationships, and build a book of business.”

The credibility of a rehabilitation provider starts with the ATP—the assistive technology professional, Verrett said.

“The quality and experience of this position is crucial to the business segment's success, but it does not solely rest on the ATP's shoulders,” he said. “The support team that surrounds them, including customer service and technical support, are essential in the ongoing client-provider relationship that is typical in the provision of complex rehab technology.”

Cultivating professional relationships with rehab clinicians is another key business tenet. Most referrals are generated by occupational and physical therapists, although nurses and physicians are integral members of the client's care team. From a marketing standpoint, Romero recommends using social media as a valuable platform for reaching potential referrals.

“There are a lot of heartwarming stories out there to post on Facebook,” he said.

Consolidation factor

The complex rehab industry has seen a wave of consolidation over the past decade, with companies merging to gain economies of scale. Romero sees the trend as positive overall because “manufacturers are trying to strengthen themselves, which makes sense as long as they don't lose their focus and direction.”

Verrett says he's “stood witness and (has) been an active participant in the consolidation and while there are many factors driving it, overwhelmingly catastrophic reductions in reimbursement are at its core.” As with other areas of HME, Verrett says legislators fail to understand complex rehab and as a result greatly devalue the industry's products and services.

Despite its challenges, manufacturers believe complex rehab has a bright future and they welcome more providers into the fold. Demand will continue to grow and more industry professionals are definitely needed, they say.

“There will always be clients in need of complex rehab products, so there will always be a need for certified, skilled and experienced rehab professionals,” Brislin said. “Based on these needs, it is essential for the industry to create more innovative and technological product advancements to further expand client functionality, environmental capabilities, home and community independence and overall quality of life.”