The New Mobility Market

Wendell Matas is down, but he's sure not out. Like many home medical equipment and rehab providers, the owner of Wheelchairs Northwest in Bellevue, Wash., is feeling the effects of legislative and regulatory changes that have rained down on the mobility sector of HME, dampening not only the market's business but also its spirit.

Matas is, he admits, having a hard time finding much good in the current market, which appears to be besieged from all sides. But he's not giving up. “At my soul, I love it,” Matas says. “I've been doing this most of my life. I have long-term, if not life-long, business relationships with many of our customers.

“We are very good at what we do, and there aren't many who excel at high-end rehab. It's hard to say the heck with it.”

Even so, he and other providers are reeling from the effects of new codes for power wheelchairs that were issued, rescinded and reissued again; from reimbursement that took a drastic hit; from increased government scrutiny that at times slowed payments to a trickle; from accusations of rampant fraud that involved only a small percentage of companies but tarred and feathered the entire industry; and from coming federal mandates like accreditation and national competitive bidding.

“It's death by a thousand cuts,” says Matas, who is also president of the Pacific Association of Medical Equipment Services.

Most recently, President Bush's 2008 budget proposal includes a 13-month rental period for power wheelchairs that would eliminate the current first-month purchase option and, say industry stakeholders, significantly affect beneficiary accessibility (see accompanying story this page).

That proposal, which has drawn vehement industry opposition, has contributed to an even greater sense of unease in the market, particularly in power mobility.

“I perceive the power mobility market as uncertain at the moment,” says Wallace Weeks of Weeks Group, a strategy consulting firm based in Melbourne, Fla. “Complex changes have been announced, rescinded, restated and implemented so fast that many providers have [hardly] had time to react.”

The effect has been that long-time providers find themselves questioning whether or not they should stay in the mobility business — or, for that matter, in the HME business altogether.