I’ve fielded a number of calls in the weeks following a story about Merits Health Products entering the complex rehab market and a follow-up story looking at why we’ve seen two new entrants into this market in as many years (Merits, and Shoprider through ROVI Mobility).
I got a call this week from an industry stakeholder who raised a good point about what’s missing from the second story.
It’s true that complex rehab is an attractive market because it has been left largely untouched by Medicare’s competitive bidding.
It’s also true that complex rehab is an attractive market because Medicare still pays for complex rehab products, unlike consumer mobility products, in the first month.
There are very good reasons why this is the case, including that complex rehab products require evaluation, configuration, fitting, adjustment or programming to meet the patient’s needs, and to maximize his or her function and independence (that’s right from NCART).
But this stakeholder pointed out that the market for complex rehab is not attractive because it’s growing. That’s because it’s not growing.
Unlike other HME, complex rehab is not driven by the aging baby boomer population—rather, it’s driven by people with significant disabilities and medical conditions—and, therefore, isn’t growing at the same fantastical rate.
Overall, the number of Medicare beneficiaries who have received complex rehab wheelchairs (all of Group 3, K0848-K0864) has actually decreased to about 14,100 in 2014, according to this stakeholder.
Why is this such an important point? Well, when Medicare sees a market that’s “growing,” it tends to put it under a microscope and we all know nothing good comes from that, especially when stakeholders have fought long and hard to protect these sorely needed products and services.