There's good news and bad news for businesses in the power wheelchair market. The good news is that, the market is growing and the demographics are good. The bad news is that, competition is tight and Medicare reimbursement remains a struggle.

"Things are definitely changing," says Mark Greig, senior product manager for power wheelchairs at Sunrise Medical. "The market is becoming much more crowded, which is starting to drive prices down. It's becoming very competitive."

According to Sam Redman, national sales manager for Redman Power Chairs, every segment of the power wheelchair market is now crowded. And while this may not serve every manufacturer well, consumers are reaping at least one benefit, he notes. "The person searching for a power wheelchair today has more choices than in automobiles."

Unfortunately, things aren't going as well for home medical equipment providers, says Ron Weldon, director of sales and marketing for Leisure Lift. "The reimbursement environment is just beating these poor providers to death."

Many reimbursement problems center on the Medicare-coded K0011 wheelchair, a low-end chair that fits the needs of a wide variety of patients. "Medicare's definition of a K0011 wheelchair is so open that all it has to do is fit a certain number of specifications and have programmable electronics," says Jimmie Hall, national director of Chauffeur Mobility. But the popularity of the code has sparked close scrutiny of claims by Medicare, and HME providers sometimes wait months to be reimbursed-if they are reimbursed at all.

One of the options providers have found to the K0011 is the K0010, a chair that does not have a programmable controller and thus has a lower allowable. But these chairs may not be the best solution for the end-users, manufacturers say. "What the coding is doing is forcing something that's not natural. It's forcing people into products that are not the best-suited for them," Greig says.

This scenario is a symptom of an endemic problem with Medicare codes, says Hymie Pogir, Invacare Corp.'s vice president, marketing-power chairs. "The codes are very fuzzy," he says. "[Medicare] never really connected them well to clinical conditions, and that needs to be corrected."

Until it is, he says, the reimbursement problems will continue because the codes are unclear and confusing to manufacturers and providers alike.

Still, optimism about the market itself runs high. Most manufacturers say they expect the crowded playing field to thin out through consolidation. And market growth should continue. Theta Reports projects sales of power wheelchairs and controls to hit $290 million by 2000, up from $205 million in 1996. The aging of the baby boomers, growing longevity, and increased incidences of spinal cord injuries and diseases such as multiple sclerosis are driving demand for power chairs. Plus, manufacturers say, manual-chair users are moving over to power wheelchairs when they can no longer propel themselves.

As the market grows, so do patient demands, of course. Users want durability, flexibility, style and a variety of features. Providers want easy-service chairs. Already, these demands have prompted the introduction of foldable power chairs, mid- and front-wheel drives, and gearless/brushless motors. It's this level of responsiveness to providers and end-users that will pay off for manufacturers, experts say.

"We have three customers out there: the therapist, the provider and the client," says Scott Higley, Pride Mobility Products' national sales manager, rehab. Manufacturers who ignore any one of them do so at their peril, he says.

Bob Clarke, senior product manager, Everest & Jennings, Earth City, Mo.; Steve Cotter, vice president, Gendron Inc., Archbold, Ohio; Michele Eberle, marketing director, Wheelchairs of Kansas, Ellis; Tom Finch Sr., president, Teftec Mobility & Seating, Spring Branch, Texas; Mark Greig, senior products manager of power wheelchairs, Sunrise Medical, Longmont, Colo.; Jimmie Hall, national director, Chauffeur Mobility, Sewell, N.J.; Scott Higley, national sales manager, rehab, Pride Mobility Products, Exeter, Pa.; Larry Jackson, chief operating officer, Permobil, Woburn, Mass.; Hymie Pogir, vice president, marketing-power chairs, Invacare Corp., Elyria, Ohio; Sam Redman, national sales manager, Redman Power Chairs, Tucson, Ariz.; Brad Ross, director of sales and marketing, Theradyne Corp., Jordan, Minn.; Bruce Russell, president, Winmed Products, Cape Coral, Fla.; Rick Suddendorf, director of sales and marketing, Otto Bock Rehab, Minneapolis; Ron Weldon, director of sales and marketing, Leisure Lift, Kansas City, Mo.