Need vs. Fees

It's no secret that rehab providers have always faced some tricky reimbursement challenges. Finding the funding for technology advancements and quality-of-life improvements continues to be a dilemma. And now that the Centers for Medicare and Medicaid Services is revamping its mobility policies, those working in the sector are adopting a wait-and-see attitude regarding payment for the products and services they supply.

But the rehab industry is not standing still during the process. With a focus squarely on patients, both providers and manufacturers say it is smart business to pay attention to the needs of end-users by offering solution-based products that can still meet payer requirements.

Improving the System

“We realize as a company that you can't change the rules of the game unless you're in the game,” says Tom Rolick, vice president of sales and marketing for Permobil, Lebanon, Tenn. “I don't think anybody is selling out by trying to make a product that is fundable. The motivation behind product development is to improve the whole system — that opportunity doesn't exist if you're not in the game.”

One way product companies are looking to meet both patient and provider needs is with “mix-and-match” products. These can help avoid reimbursement denials for systems with components that are not medically necessary according to funding source guidelines.

Rolick says Permobil's new products are being developed with that concept in mind to ensure that consumers get the proper seating systems and mobility products, and that providers get reimbursed appropriately as well. It is a common-sense approach that enables rehab technicians to determine product needs independently in the same way they conduct evaluations.

“Oftentimes, the seating requirements are quite different from the mobility requirements — you can have very involved seating and minimal mobility needs, or vice versa,” explains Rolick. “So the goal is to be able to seamlessly match those two components together in a final mobility system.”

Such new approaches are what rehab equipment providers are seeking.

Provider Jerry Stevens of Advacare Medical Corp., Olathe, Kan., says manufacturers are doing their part in responding to coding challenges.

“They have revised almost all of their order forms to include the coding,” he says. “They have repackaged their products to respond to it, and that has given us choices we can offer our clients so that we can still have some decent contribution to the bottom line.”