Medicare policy may change manual wheelchair landscape

Thursday, November 30, 2006

Will Medicare's 13-month capped rental policy for manual wheelchairs drive the category into extinction? Or will it create a double-tiered supply channel that features only low-grade K0004 versions and upscale cash-and-carry models?
The views of mobility manufacturers differ about the future of manual wheelchairs in the new Medicare environment, with speculation running the gamut between opportunity and futility. How HME providers respond to the challenge will be the determining factor, they say.
At least one manufacturer believes that Medicare's determination to turn mobility products into low-priced commodity items will signal the death knell for manual chairs.
"I predict that manual wheelchairs will all but disappear from the market in 10 years," said Steve McLean, sales manager for Orange, Calif.-based Eagle Health Supplies. "Basic power chair prices will fall further as the technology and offshore costs of manufacturing continue to get cheaper and cheaper."
The prevailing opinion, however, is that the product will continue on and perhaps find new momentum in the retail arena. Aside from deluxe sports wheelchairs, the manual wheelchair has traditionally had a reputation as a product that is provided through the conventional reimbursement channels and not a luxury item that end-users would be willing to pay out-of-pocket to acquire. But that could change if the dramatically lower reimbursement being proposed for basic chairs under Medicare becomes reality.
"We see the market splitting in two ways --shaving out costs for capped-rental chairs and creating premium chairs for cash sales," said Dave Jacobs, president of Mundelein, Ill.-based Medline's durable medical equipment division. "With the capped rental, providers are looking to lower their acquisition costs and manual wheelchairs are a big category for them. Longevity and durability are important because issues do arise in 13 months, so we are moving to find ways that take costs out in ways that don't affect the overall quality, such as removing pockets and using a powder coating as opposed to chrome plating."
Another area Medline is trimming: freight costs, Jacobs said. K0004 chairs are now shipped in two pieces, allowing for a smaller box and lower fees.
"On the other side, we have seen a lot of interest in higher-end transport chairs for cash sales," he said. "We've introduced an ultra-light transport chair made with better materials--aluminum and carbon fiber, and took about 4 pounds off, which makes it about 20% lighter. It is very strong, very light and easy to transport. We believe this product will be very attractive to baby boomers, who want something better than what is reimbursable."
Lightweight, high performance and attractive aesthetics are the elements that make a manual wheelchair desirable, said John Lescher, group product manager for custom, manual, seating and scooters at Elyria, Ohio-based Invacare.
"Invacare incorporates these requests into our designs for products such as the ProSPIN X4 ultra-light wheelchair," he said. "We also strive to incorporate anything that makes it easier for the caregiver or end-user to make adjustments in the field. The need for transport options is also increasing, whether it is through the chair weight or WC19 compliance."
John Vadeboncoeur, group product manager of IVC products for Invacare, is optimistic that retail potential for manual wheelchairs will grow.
"As America's older population increases, we are seeing higher demand for manual wheelchairs," he said. "Some of the volume is being driven by non-Medicare/Medicaid channels like retail or Internet providers. The increasing popularity of private insurance alternatives, such as health savings accounts, as well as rising insurance costs, are helping drive consumer choice. Overall, the need for independent mobility has and will continue to grow."
The market for bariatric wheelchairs continues to grow, as well, especially as society becomes more educated about the obesity epidemic and treatment options, Vadeboncoeur said. Although Invacare has had several bariatric wheelchair choices over the last few years, it added a 1,000-pound weight capacity option to the Topaz wheelchair line earlier this year.
Officials at Pride Mobility and Quantum Rehab are optimistic that manual wheelchairs will continue to be a viable product line, regardless of the external factors that come along. The Exeter, Pa.-based manufacturer offers a wide range of products in the category, with some emphasizing low price points and others showcasing advanced technology.
"Manual chairs is a great market segment," said Joe Mello, Quantum field sales manager. "It has a lot to offer consumers and is profitable for providers."
Pride also provides videos of actual users demonstrating their various models to help shoppers better visualize the products in action. Yet sales reps still need to be on top of their game when it comes to answering questions from a more educated client base, said Pride Product Manager Mark Smith.
"Consumers are more savvy today than they used to be," he said. "It is not uncommon for them to go online and Google wheelchairs before they go to the showroom. Once they get there, they are looking for more detail."