2011 Editorial Round Table

In Their Own Words: What’s on Their Agendas for 2011

Q: What issues are you personally tracking or watching right now? What are your major concerns for 2011?

Julie Jackson, Invacare Corp.

I’m focused on the separate benefit for complex rehab: understanding the key elements to the “decision tree” and ultimately driving towards the implementation.

Cody Verrett, ATG Rehab

Remaining viable amidst significant pricing pressures and funding cuts for complex rehab equipment, as well as developing significant resources to audits for justified, approved and authorized equipment transactions.

Amy (Meyer) Morgan, Permobil

Coverage of standing wheelchairs and seat elevation systems: Because clinicians and consumers continue to ask for and demand standing wheelchairs and seat elevators, third-party payors are starting to see the medical and functional benefits of incorporating these features into one’s wheelchair base. In 2011, I am anxious to see national and local policies evolve in response to the clinical research and evidence which supports coverage for these devices. I know that Permobil is on the front lines of seeking to obtain appropriate coverage policies for these necessary features by challenging the Medicare Local Coverage Determination (LCD), which currently states that wheelchair standers and seat elevators are not covered because they are not primarily medical in nature.

National response to the growing body of evidence supporting power mobility for young infants and children: The news is spreading that kids need to be able to move independently and explore for appropriate development. I am excited to see therapists’ eyes being opened to using power mobility as a therapeutic intervention and means of functional mobility for their clients who lack the ability to move on their own!

(Ed. note: Congratulations to Amy, who got married Thanksgiving weekend and will now be known as Amy Morgan.)

Rick Graver, Medtech Services

My major concerns for next year are primarily regulatory issues. While our company continues to work on improvements that are within our control, there are a number of external factors that are outside our control, primarily relating to work funded by government agencies.

Patrick Boardman, Active American Mobility

Reimbursement reductions: In Texas our TXRPC organization successfully defeated an attempt to reduce Medicaid payments for complex rehab by 9.5 percent. This is only the first in many funding reductions we anticipate from funding sources. Further reductions from Medicare and other payors will present access-to-care issues for patients and business failures for many complex rehab providers.

First-month purchase option elimination: While consumer power only represents less than 5 percent of our revenue, this new Medicare process does have an impact. We have negotiated better pricing with manufacturers and developed creative financial solutions to lessen the severity of this challenge.

PECOS requirements: PECOS represents a unique challenge for our business, as it requires more resources be dedicated to educating physicians on the PECOS system.

Competitive bidding: While we all hope for a repeal of competitive bidding, our company is moving forward with preparations to bid in MSAs in round 2.

Payor mix: Currently, our payor mix is almost 40-percent Medicare. Our goal is to be below 20-percent Medicare by the end of 2011.

This article originally appeared in the January 2011 issue of Mobility Management.

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