“One thing we cannot suffer is the customer,” says Scott Higley, national sales manager for Quantum Rehab, a division of Pride Mobility. Other industry leaders echo this sentiment as they set aside their differences with Washington to take stock of what's really important in home health care — what drew most of them to into the business in the first place — the customer. “The value of what we're doing and why [we're doing it] is not to sell more, but to help more,” Higley says. “The selling part will take care of itself as long as we don't lose sight of the customer.”

But don't think manufacturers will accept consistently low Medicare reimbursement and complicated coding methods. In fact, most experts are frustrated by reimbursement and regulatory issues and are active in their pursuit of a solution — for the customer's sake.

“The sad part is that people who need [power chairs] are not getting them because there are so many hurdles to overcome,” says Mike Serhan, vice president of sales and marketing for Dr. K International.

“Insurance companies are trying to recoup their losses since Sept. 11 and the [resulting] general economic downturn,” says Tom Finch, president of Teftec. “They're pulling back, and everyone else has to compensate.”

To most industry leaders, the tighter, tougher constraints come as no surprise. “There was fraud and abuse — artificial inflation of the numbers that were very unreal — which led to intense scrutiny of the industry, and especially of dealers,” Serhan says.

However, manufacturers say they are less concerned about alleviating fraud and abuse — since most experts agree that stringent restrictions and the watchful eye of Washington have succeeded in bringing the fraud numbers down — and more focused on deciphering Medicare paperwork to determine which end of the page is up.

“The biggest challenge is a lack of clarification of products and broad coding practices,” says Mark Greg, product manager for Sunrise Medical. Understanding the intricacies of the business is difficult enough, “let alone understanding the funding for 50 states,” Greg says.

“It's not that the funding is so bad, but understanding what the funding is, [is difficult],” Higley says.

Given the situation, manufacturers are refocusing their efforts to ensure the dealer isn't alone in bearing the consequences of Medicare reform. “We need to provide a level of comfort so [dealers] don't worry about getting paid, but worry about providing the proper equipment,” Higley says.

So far, industry leaders are making the best of the reimbursement and regulatory situation and maintaining profitability. Experts agree that growth is steady in the power chair market. “We aren't seeing double digits, but we're still seeing 7 to 8 percent growth,” says DuWayne Kramer, president of Leisure-Lift.

The real work will be educating dealers, according to Higley, who says the challenges of funding require manufacturers to be more innovative. “Manufacturers have to be sensitive to specific coding, so that it's not just on the dealer's back,” he says. “There needs to be more education on understanding reimbursement, to help providers learn to cross their t's and dot their i's.”

Higley says Pride takes a “team approach” — involving the customer, the therapist, the provider and the manufacturer — to develop ideas to address reimbursement concerns.

Somehow, manufacturers are making the market work, as evidenced by the steady growth in the power wheelchair market and increased education. By dealing with what they've been handed, rather than running circles with Washington, manufacturers are able to bring their focus back to the customer.

For example, Higley avoids referring to buyers in the power wheelchair market as patients. “They're patients when they're in the hospital,” he says. As soon as they're doing business with Quantum Rehab, “they're customers, because we're meeting their needs in style and performance, and giving them something more.”

Manufacturers are “developing chairs on a customer level,” according to Higley, with an eye on a more simple design “so you don't look at a person and see a giant chair, you see a person.” Driving this development are the ongoing design goals of maneuverability, comfort, durability and size, combining to produce a chair that is “somewhere between convenience, want and need,” Serhan says.

Seating remains a primary target for innovation, says Mike Wade, national sales manager for Leisure-Lift. “It's the focus of almost 50 percent of our business,” he says. With so many options in fabric, style, size and positioning, there is a real “opportunity for choice — what [the customer] wants, not what Medicare wants,” Serhan says.

Leisure-Lift has even built an all-leather chair for a customer who is allergic to vinyl, Kramer says. Manufacturers are addressing customer needs with “a whole new generation of chairs substantially better in style and innovation,” he says.

“The most rewarding thing is that now customers are independently mobile because of a power device,” Higley says.

And, as Finch explains, “dollars can't give you that.”

Experts Interviewed: Tom Finch, president, Teftec, San Antonio; Mark Greg, product manager, Sunrise Medical, Longmont, Colo.; Scott Higley, national sales manager, Quantum Rehab, Exeter, Pa.; DuWayne Kramer, president, Leisure-Lift, Kansas City, Mo.; Mike Serhan, vice president of sales and marketing, Dr. K International, Monrovia, Calif.; and Mike Wade, national sales manager, Leisure-Lift; Charles Copley, sales and marketing manager, Golden Technologies, Old Forge, Pa.

Innovation With A Purpose

A lot of things are innovative, but the issue is whether they're useful,” says Tom Finch, president of Teftec. “The funding and dollars available are not going to pay for large expenditures in technology, so some companies are just making [power wheelchairs] prettier or putting new wheels on them instead,” he says.

By giving their power chairs a new look, some manufacturers attempt to give the appearance of a more technologically advanced chair, when no significant change has been made, Finch says. Even in recent cases of true innovation in the industry, many of the eye-opening advancements that have entered the market for power chairs are “intriguing but not practical,” he says.

According to Finch, the general trend in the power wheelchair market has been to draw technological innovation from the automobile and airline industries and implement those ideas into power chairs. “Manufacturers would take technology from the air and auto industries and adapt it to wheelchairs because they felt this was too small an industry to develop its own technology,” he says.

Other manufacturers also want to see an end to revamping the same old power chair, in favor of significant change — which some predict is just around the corner. “We're going to see another big jump [in innovation],” says DuWayne Kramer, president of Leisure-Lift. “Something revolutionary in six months to a year.”

“We're taking many small steps to be innovative,” says Charles Copley, sales and marketing manager, Golden Technologies. “Every day we challenge ourselves to take feedback and drive it directly into product development. It's something we welcome and challenge ourselves to get done.”

Vets Don't Sweat New Competition

Competition in the power wheelchair market has become more acute, according to Mike Serhan, vice president of sales and marketing for Dr. K International. While the market for higher-end products has been “diluted,” as manufacturers quickly learned how expensive customized power wheelchairs are to produce, “low-end products are becoming more competitive,” he says.

Most experts are confident in the market's current growth, and welcome the fresh perspective and energy of new power wheelchair players. Industry leaders agree that competitors who have something to offer the market will survive, and others — like many of the overseas competitors new in the power chair business — will taper off.

The challenge for overseas competitors, according to DuWayne Kramer, president of Leisure-Lift, is “to get the parts out as quickly as United States-based manufacturers, whose inventory is here,” he says. Dealers won't “wait a long time for parts from smaller, offshore firms, so these firms struggle to service chairs,” Kramer says. And, he says, it's more profitable for dealers to work with local or national manufacturers because the chairs are “built and stocked here,” he says.

Teftec President Tom Finch agrees. As dealers “try to reduce their selling price to outsell the competition, they end up down in the mud, cutting corners on the wheelchairs,” Finch says. The end result is the sale of poor quality chairs, meaning “there is a higher number of recalls than ever before in history,” he says.

Although Finch feels this is “indicative of a sick industry,” other experts say the flood of inexpensive imports hasn't hindered business as usual. Kramer says that it was “harder to do business at first,” but dealers who stray “come around again with service.”

“It comes full circle,” he says.