Faced with unpredictable funding requirements and a market described as volatile at best, manual wheelchair manufacturers may adopt a new industry-wide policy of using No. 2 pencils instead of ink pens. For when it comes to planning product release dates and adding new competitors to the Rolodex, industry professionals are finding they need a writing utensil with a bit less permanence.

While most experts agree that the manual wheelchair market is steady, many companies' product development calendars are smudged with eraser marks. “It's a moving target with funding,” says Christy Shimono, senior product manager for Sunrise Medical, who says manufacturers are pressured to develop products more quickly. “Instead of having two years to develop a product, you have six months,” she says.

Manufacturers also must consider not only what the funding is today, but what funding will be tomorrow — and plan product development accordingly.

Wary of potential changes in Medicare practice — including the possibility of competitive bidding programs in some states — manufacturers are hesitant to get too comfortable, even if the current market is strong. “There is so much turmoil out there with the indecision about competitive bidding,” says Bob Crabtree, national sales manager for Nova OrthoMed.

Manufacturers have only a limited amount of time to speculate on the potential effects of competitive bidding, however. It's enough of a challenge to keep your name in the business, experts say. As fickle as today's manual wheelchair market is, permanence is elusive, and tight competition commands the attention of even the most seasoned industry veterans.

“The turnover in American companies is really high,” says Mike Hoepner, president of Essential Medical. “Companies can be gone in three to six months.”

Fueling this high turnover rate is the continued growth of manual wheelchair manufacturing in Taiwan and China. “The market is changing drastically because America is turning to Chinese- and Taiwanese-made products as an alternate source,” says Winston Anderson, president of Merits Health Products.

Industry leaders say it's hard to keep track of what company is manufacturing which product in which country. But there are definite manufacturing trends attributed to Asia and the United States. These include a shift in the manufacturing of commodity wheelchairs to the overseas markets. “Even the majors are now going overseas for the basic manual chairs,” Crabtree says.

Meanwhile, industry experts say the high-end wheelchairs, especially those made of aluminum and titanium, require too much specialization to be efficiently manufactured outside the U.S.

“It's nearly impossible to manufacture custom-made wheelchairs overseas because of the detail [required] to make a person comfortable in that chair,” Anderson says. “It's not cost-effective.”

Market erosion — in the form of a decline in the overall base price of manual wheelchairs — is attributed in part to overseas manufacturing, according to Crabtree. “It's a challenge to maintain a high quality level in a product when [you're] up against imports,” he says. “You can only reduce the price so much before it affects the product, so the issue is drawing a line between acceptable quality and low price.”

Competition from Asian manufacturers has driven down prices for manual wheelchairs, says Darrin Horst, president of Lifestyle Mobility Aids. “It's easy for dealers to lose sight of customer service and quality because of price,” Horst says. To compete, he says, manufacturers have to diversify. “They have to be a one-stop shop.”

Keeping up — and keeping on top of funding changes — has led many to view the future of the manual wheelchair market with uncertainty. Manufacturers agree that there's a lot of noise within the industry, and people are getting stirred up about what's to come. “It's a strange atmosphere,” Crabtree says.

Despite the commotion, most manufacturers aren't expecting an overhaul of the status quo anytime soon.

“There are plenty of doomsayers who are waiting for the end of the world to come,” Crabtree says. “There's a lot of talk and nothing is happening. The industry is in an uproar right now, but I don't think we're going to reinvent the wheel anytime soon.”

Building on Brand

LEADING MANUAL WHEELCHAIR manufacturers say dealers shouldn't be starry-eyed over some of the low prices in the marketplace. Focusing on price alone ignores two other components of the products that experts say are essential to completing the home care package: customer service and quality.

According to experts, there are two ways to sell in the manual wheelchair market — by price and by brand — and customer service and quality are what make a brand.

“It's important to provide value, customer service and quality all in one place,” says Darrin Horst, president of Lifestyle Mobility Aids. To achieve this, many manufacturers are infusing every stage of the manufacturing process — from the factory floor to the end-user's home — with quality.

According to Mike Hoepner, president of Essential Medical, the focus on quality begins even before product assembly, with an inspection of every factory a manufacturer intends to use. Leading manufacturers conduct what Hoepner calls a “quality audit” of the factories they use by visiting each factory and checking that they meet standards imposed by the U.S. Food and Drug Administration.

“If [the factories] don't meet the standards, we don't work with them,” Hoepner says.

Even with federal regulation, it's the responsibility of the manufacturer to review the factory's records to ensure the quality behind the brand name, he says. “If you don't qualify a factory, you're nuts,” Hoepner says. “We even go to the ongoing factories we use to see their records — not because we don't trust them, but because we're the ones putting our name on the product.”

These types of efforts are often, but not always, reflected in the price of the end product, experts say. Horst points to Pride Mobility Products as an example. “They sell their products at higher prices, yet they still do as well as a leader in this industry because they're built on brand, not on price,” Horst says.

Horst hopes manual wheelchair providers will recognize the importance of brand. “I hope this mindset will trickle down in the industry, and dealers will realize the value that's built into the quality of the products.”

Experts Interviewed: Winston Anderson, president, Merits Health Products, Cape Coral, Fla.; Bob Crabtree, national sales manager, Nova OrthoMed, Gardena, Calif.; Mike Hoepner, president, Essential Medical, Winter Park, Fla.; Darrin Horst, president, Lifestyle Mobility Aids, Seminole, Fla.; Christy Shimono, senior product manager, Sunrise Medical, Longmont, Colo.; Merv Watkins, president, Convaid, Palos Verdes, Calif.

An Open-Door Policy

THERE ARE DIVERGENT trends in the manual wheelchair market when it comes to product education, according to industry experts. While manufacturers award credit to end-users for the strides they've made in learning about the products available to the marketplace, they are disappointed in the effort — or lack thereof — that funding sources have made to educate themselves on the same.

“People are wiser about their products,” says Christy Shimono, senior product manager for Sunrise Medical. “They're more understanding and they ask the right questions.”

According to Shimono, the average end-user is becoming more involved in the purchasing process and is demanding to know the differences between the available products.

At the same time, manufacturers are concerned that funding sources still don't understand the differences between products and how those differences impact the end-user. The difference between a manual wheelchair for an independent end-user and one used by an end-user in assisted living is one difference funding sources still may not fully comprehend, Shimono says. And, it is up to manufacturers to enlighten them.

Shimono says she asks herself, “Do we as manufacturers explain that well enough?”

Many manual wheelchair manufacturers are proactive in closing the knowledge gap that exists between the manufacturer and the end-user and funding sources. “Manufacturers are pushing and helping to drive funding sources to understand these differences,” Shimono says.

“We have welcomed and opened ourselves up to educating them about what these differences mean to consumers.”