Manual wheelchairs keep rolling

Saturday, January 31, 2009

Did manual wheelchairs dodge a bullet by avoiding a 9.5% nationwide reimbursement cut? Yes, but no one in the industry is popping any champagne corks. With a new administration coming in, an economy in the doldrums and manual wheelchair coding still an unknown, the status quo remains in flux and the future uncertain.

Because it wasn’t one of the 10 product categories put out to bid as part of national competitive bidding, manual wheelchairs are safe from the 9.5% cut. In fact, the product category has seen a 5% increase, said Judson Cummins, product manager for custom manual wheelchairs at Elyria, Ohio-based Invacare.

“Accessories (for manual wheelchairs) received the increase, too, so that’s a good thing,” he said. “If I’m a provider, I look at manuals and see a 5% margin instead of a 9.5% cut. I have to look at that as an opportunity. If I’m doing more than just fleet chairs and offering accessories, that is another opportunity.”

Whether manual chairs get snagged by cuts in the future is outside the industry’s sphere of control, industry sources say.

But there is something more concrete about the market: “Consumer demand and the need for manual wheelchairs will continue to grow regardless of rates,” said Larry de la Haba, senior vice president of strategic accounts at Atlanta-based Graham-Field Health Products. “What will change is the industry’s focus on improving efficiency and streamlining costs to maintain the bottom line of providers.”

Because Medicare is the primary driver in the market, there is no single fix for reimbursement erosion, industry sources say. Maximizing market potential, they say, means considering new approaches.

“We need to look at all potential markets and product opportunities and change who we are and how we market ourselves,” de la Haba said. “For example, the children of the elderly, nursing home administrators and directors of nursing are all key potential customers. We’re experts in that area and we just need to market that expertise and service potential to new markets.”

Graham-Field has been actively seeking new opportunities for providers in the long-term care and acute care markets, de la Haba said.

“Both of these markets utilize large numbers of manual wheelchairs for transport and patient care,” he said. “Hospitals purchase and maintain fleets of manual wheelchairs and many long-term care facilities utilize wheelchairs as their primary source of resident seating due to their flexibility.”

Coding contemplation

The industry is anxious to see a new, improved set of manual wheelchair codes, though no one seems sure what to expect or when they’ll come out due to the recent shift from the SADMERC to the PDAC.

“It’s in the PDAC’s hands now,” Cummins said. “We’re preparing like they’ll be announced tomorrow because it’s important to be ready. We can anticipate and boil down various possible scenarios and work toward that, but it’s really up to the PDAC at this point.”

Industry sources expect a greater subdivision of codes that recognize varying styles and modifications based on a patient’s age, diagnosis and weight. That could mean greater emphasis on specialty chairs for geriatric, pediatric and bariatric patients, Cummins said.

“If I were a mobility provider and had a pediatric facility in my territory, I’d absolutely focus on them,” he said. “Across the country clinicians want to partner with a vendor who is an expert and will definitely use them as a resource.”

Product planning

While a cautionary Medicare environment is a concern for Minneapolis-based Otto Bock HealthCare, company officials say it hasn’t deterred them from launching new products. In fact, the recently released Motus folding manual wheelchair will help providers meet current market pressures by combining quality, durability and affordability, said Nicole Muehlenhaus, marketing manager of mobility solutions.

“We are continuing as normal despite the absence of new codes for manual wheelchairs,” she said. “We anticipate that manual wheelchair demand will remain strong now and in the future.”