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.
