Manual wheelchairs remain viable
Despite reimbursement pressures and higher costs driven by fuel prices, the manual wheelchair category remains viable, manufacturers say. An expanding demographic base, consistently strong demand, higher quality products and an abundance of cash-oriented accessories are seen by vendors as positive factors for an assured future.
"The market for basic chairs in general is growing, but it has been a tough 12 months," conceded Tom Tucker, vice president of sales and marketing for Houston-based Attentus Medical Sales and American Bantex. "Providers and manufacturers have both been buffeted by reimbursement pressures, high delivery costs and high manufacturing costs, regardless of source. We hope that the huge pressures on manufacturing costs will at least stabilize over the next six months."
Tucker expects demand for basic chairs to grow, "but for our clients to increase margin, we will focus on helping them provide retail cash accessories to fit each patient's needs." The cash accessory segment has great potential, he said, because consumers want more features and are willing to pay for them out-of-pocket "if they are packaged correctly."
Atlanta-based Graham-Field has seen sales of its manual standard and manual lightweight chairs rise, despite an increasingly competitive marketplace, said Lawrence de la Haba, senior vice president of homecare business development.
"Despite tight competition over price, the basic wheelchair continues to be the one most people encounter and use," he said. "For Graham-Field, it is a very viable business."
The most significant opportunities, de la Haba says, are in the following segments: bariatric and heavy-duty wheelchairs; and add-on products like oxygen and IV holders, wheelchair cushions, patient alarms, scales and replacement parts. Transport wheelchairs, although technically not part of the manual classification, are attractive add-on products for people with the ability to travel who want an extremely lightweight, portable chair, he said.
There are also opportunities in the long-term care and acute care sectors, de la Haba said.
"Many facilities utilize wheelchairs as their transport chair for patients being moved within a facility or during admittance and discharge," he said. "In long-term care facilities they are used for a wide variety of purposes. In both markets, the wheelchair is the basic 'product,' and then a wide variety of add-ons are used to customize the wheelchair for the specific use it will see."
Jesse Keirn, president of Strongsville, Ohio-based Roscoe Medical acknowledges "an increasingly difficult" business environment due to rising costs for raw materials, labor and oil, along with unsettled exchange rates and other factors.
Even so, Keirn remains optimistic about the continuing success of manual wheelchairs.
"We feel it is still a viable business, simply from a demand standpoint," he said. "The opportunity is with those companies that can manufacture well, manufacture in high volume and have the resources and capabilities to import from overseas in order to be competitive. Opportunity also lies in being able to offer cost reduction alternatives to our customers, reducing non-essential cosmetic features on products in order to save costs."
To illustrate how Roscoe is approaching the issue, Keirn explained that the company has replaced the once-popular chrome-plated finish with a powder coat or silver-vein finish.
"With Medicare's tightened reimbursements, these small changes can add dollars to our customers' pockets," he said.
Similarly, Kennewick, Wash.-based TiLite is providing lower-cost options on its custom chairs, offering aluminum as a less-expensive alternative to titanium. But with proposed coding changes and lower reimbursement rates looming, mobility providers also need to sharpen their clinical and policy skills, said Marty Ball, the manufacturer's vice president of sales.
"There remains opportunity in custom-fit chairs but the therapists and RTSs need to stay ahead on studies and changes that directly affect independent mobility," he said. "There also needs to be more emphasis on teaching wheelchair skills and proper techniques."
To assist providers in training and education, TiLite is offering the services of a veteran physical therapist and seating specialist. Gaining more knowledge about how to approach payers on funding issues can make a difference on the coverage front, Ball said.
"Reimbursement is difficult, yes, but not impossible," he said. "If the client is appropriate for a custom manual wheelchair and the therapist is willing to fight the battle to get the chair and the payer offers to cooperate, it is many times possible to get funding. That said, the level of funding may be less than complete coverage--but at least it will help at the bottom line."
While Medicaid does not allow clients to contribute out-of-pocket to their mobility device, most other payers will, Ball said.
"In some cases we now see users who want better mobility shopping for a better performing chair using their own savings rather than accepting something inferior," he said.