Keeping Fingers Crossed

There is a popular song out that repeats the phrase, “Here we go again.” For mobility providers, that could be a mantra. Except this time, the challenges facing the industry are unprecedented.

Without a doubt, competitive bidding is the most ominous concern, particularly since the round one payment rates, announced March 20, are drastically lower than expected. But coding issues, accreditation, proposed supplier standards and the threat of additional reimbursement cuts also have left some providers stumped as to how to move forward — or even how to stay in business.

Although the outcome of these issues has yet to be fully determined, one thing is clear: Providers must tackle them all.

“The basic bottom line is how providers of mobility products can set a model in our industry that can operate profitably and at the same time service the needs of the clients, because these two are at odds right now,” states Tom Whelan, vice president of product management for seating products, Sunrise Medical, Longmont, Colo.

“Every day, providers are faced with choosing between giving the client what is the optimum solution that makes the best use of assisted technology or giving them what makes it profitable enough to stay in business.”

Whelan says that “bad coding” has set up a system that does not reflect the variations of assistive technology.

“As a rehab supplier, your job is to make an optimum relationship between the client's needs and the technical solutions. You have to use the code set to describe that and submit for billing, but the code set strictly is not robust enough to handle it,” he says.

David Jones, director of The MED Group's National Rehab Network, Lubbock, Texas, says competitive bidding and related consequences are affecting providers, patients and manufacturers alike.

The issues he ticks off include patient, physician and clinician education; gaining support for H.R. 2231 (which would carve complex rehab out of competitive bidding); price compaction; provider acquisitions; the power mobility device fee schedule; and accreditation.

“This is obviously the tip of the iceberg as it relates to the challenges our industry faces. However, I am optimistic that the opportunities presented today as severe challenges will be looked back on as a time when industry professionals collaborated and made progressive and positive changes,” he says.