The winds of change are beginning to rustle the sheets of the beds and support surfaces market, according to industry experts. While reimbursement rates continue to force dealers and manufacturers to operate within tight margins, a renewed focus on quality and reliability is prompting innovation in a market that, until recently, was driven almost entirely by cost.

“Three or four year ago, there was much more focus on price,” says Abbey Daniels, chief executive officer of Sentech Medical Systems. “There was an influx of Taiwanese products that achieved much success because they were inexpensive and received the same reimbursement as products that cost two or three times more. But during the past year, there has been much more focus on therapy, outcomes and reliability.”

Even hospital-bed manufacturers, who have been reluctant to invest in innovation in a climate of plummeting reimbursements, are beginning to update comfort- and design-related features.

“The standard design has been out for more than a decade,” says Henry Lin, vice president of American Bantex. “We're trying to give it a more modern look. Right now, the [standard] bed looks like a piece of painted metal designed for sick people, but we're trying to make it look more [aesthetically pleasing].”

Lin attributes the recent push for innovation to the fact that growth — fueled by longer life expectancies and a growing aging population — is overshadowing reimbursement woes.

In fact, most manufacturers report having introduced a new product or feature this year — or that innovations are in the works.

In the support surfaces market, recent innovations include air/foam combinations for pressure relief; non-powered mattress overlays designed to provide complete ventilation; and mattress overlays available in customized shapes and thicknesses.

Lionel Walpin, founder of Roloke and a physician of physical medicine and rehabilitation, rheumatology and pain management, says educated customers will continue to drive innovation in this market. “As people become aware of the importance of proper support — not just what feels comfortable — they will become more selective as to what they sleep on,” he explains.

But nowhere is innovation occurring faster than in the bariatrics segment of the beds and support surfaces market, the experts agree.

Big Boyz owner Leonard Feldman attributes bariatrics innovations to doctors' growing awareness of the U.S. obesity epidemic. “Physicians and hospitals are realizing that they have to better care for bariatrics patients,” he says.

This realization is fueling rapid growth, which, in turn, allows manufacturers to invest in product improvements without raising prices significantly, Feldman explains. “In July, we'll be coming out with four new units that have more features and are less expensive.”

Another fast-growing segment of the beds and support surfaces market is the luxury beds segment, according to Sandy Thomas, national sales director for Flex-a-Bed. “The majority of our beds are sold to folks [age] 50 and over, and the baby boomers are in that group now,” she says.

The fact that baby boomers want functional beds that do not look like hospital beds is good news for home medical equipment providers, because cash sales can generate “a nice profit,” Thomas explains.

Despite these signs of new life in the beds and support surfaces market, third-party reimbursement rates still are forcing manufacturers' and dealers' attention to the bottom line, Sentech's Daniels says. In this market, “it's almost a given that it has to be a cost-effective product.”

Consequently, in some cases, reimbursement rates are stifling innovation, according to Susan Wilson, director of research, design and development for Supracor. “Because the HCPCS codes are based on a product's characteristics rather than its performance,” she explains, “[some] types of innovations are not encouraged. This is unfortunate, because the end user is the one who suffers in this climate.”

For the support surfaces market, the reimbursement climate may get tighter before it gets easier, says Erik Larsen, senior product manager for KCI. “Support surfaces is one area that is just beginning to be looked at more closely,” he says. “Medicare spends a lot of dollars annually for support surfaces, so it simply makes sense for Medicare to look more closely at the manufacturers to ensure that [end users receive] clinical benefits.”

But such increased scrutiny could provide an opportunity to educate third-party payers about the value of beds and support surfaces, Larsen and Anthony DaCosta, president of Mellen Air, agree.

“I remain confident that reimbursement will improve if our industry polices itself better and communication improves between all the parties,” DaCosta says.

Broadening third-party payers' perspective to include pressure-ulcer prevention is another reason to improve communication between manufacturers, providers and third-party payers, says Ingrid James, executive vice president of James Consolidated.

“My field is public health, and our company has demonstrated time and time again how millions, in fact billions, of taxpayers' [dollars] could be saved through prevention of pressure sores and pulmonary complications,” James says. “However, nothing will change until our elected officials change the laws governing reimbursement.”

But communication cannot occur without a common language, many experts say. To address the need for performance standards, the National Pressure Ulcer Advisory Panel, based in Reston, Va., has planned a series of meetings to “prepare and present uniform terminology, test methods and reporting standards for support surfaces,” according to Mellen Air's DaCosta.

Experts Interviewed: Anthony DaCosta, president, Mellen Air Manufacturing, Long Beach, Calif.; Abbey Daniels, chief executive officer, Sentech Medical Systems, Fort Lauderdale, Fla.; Leonard Feldman, owner, Big Boyz, Huntingdon Valley, Pa.; Ingrid James, executive vice president, James Consolidated, Walnut Creek, Calif.; Erik Larsen, senior product manager, KCI, San Antonio; Henry Lin, vice president, American Bantex, Burlingame, Calif.; Sandy Thomas, national sales manager, Flex-a-Bed, Long Beach, Calif.; Lionel Walpin, founder and director, Roloke, Inglewood, Calif.; Susan Wilson, director of research, design and development, Supracor, San Jose, Calif.