Is Medical Equipment too Expensive?

I have seen many posts lately on Face Book and in Blogs about the high prices for DME and Medical Equipment. I have seen comparisons to Sport Aid and other online pricing compared to the brick and mortar companies. 

As a tax payer, and after taking an Ethic course and discussing the outside perception of the costs of Medical Equipment; I understand the concerns.  It is hard to fathom that a powered wheelchair may cost as much as a car, that an ultra light weight wheelchair may cost $3000. 

That being said, have you seen how much a refrigerator, furniture or a racing bicycle may cost?  I have a friend that has a bicycle that costs $5K.  I understand that the racing bicycle may be considered a luxury and where a wheelchair is not; but there are a lot more bicycles sold yearly than the same custom wheelchairs. Bicycles do not have the same requirements and liabilities as do wheelchairs.

As a Complex Rehab,  DME supplier and Board Member of NRRTS, I see the other side of the equation.  Generally Medical Equipment is funded through Insurance and all insurance companies follow Medicare guidelines. Unlike the Sport Aid type companies, we are forced to comply with all Federal, State, Local, Accreditation, and Insurance guidelines.  Unlike Sport Aid, we have to follow the clinical model and have to provide a report that builds a case for medical necessity, we have to chase all the paperwork, submit the request to funding, help with any appeals, order, assemble, deliver, fit and then submit the claim for billing; which can take up to one year to be reimbursed. 

Retail companies, advertise their products, take a deposit or the entire amount up front, and ship the equipment to the customer.  There is little cost and risk in this process. Catalog and On-line companies can be anywhere, allowing them to reduce costs, they do not have to have the insurance coverage, they do not need to be accredited, inspected, or follow the same standards as Insurance providers.

There are costs associated with playing the game. In retail, it is all about price and value. When providing equipment through insurance, you have to have a location that is certified, inspected, accredited, bonded and insured. The costs above the rent, staff, trucks, equipment, parts; etc. is the Professional and Liability Insurance ($10-$20K / year), Accreditation ($3-$5,000/year), Medicare and Medicaid Licensing ($1K/year), Bonding ($1K/year). There are regular audits by the insurance carriers, which cost much time, and expense in fulfilling the requirements and ensuring payment for services.

DME companies offer and provide knowledge, education, and their experience to improve the quality and successful outcomes. I am the first to agree that there are not enough safe guards in the DME world, which is why NRRTS is aggressively promoting trying to carve out Complex Rehab Equipment from DME.

There are studies that have been conducted, showing that in Complex Rehab that the net profit for most DME's are under 7% which is very low in comparing to other industries. This offers very little room for growth, pay increases to staff, or any additional benefits to workers. 

Competitive Bidding was introduced, reducing payments for many DME products. After the first year 33% of the winning providers went out of business as they could not afford to stay in business.
It is important to remember, that DME companies purchase the equipment they are providing, and help with all the insurance paperwork and do not receive any compensation until the equipment is delivered.  All of the labor costs from the intake, evaluation, quoting, requesting medical documentation, submission for approval, ordering, assembly, and ensuring there is a service staff to help with concerns is all funded through the sale of the product.  It is a semi-flawed system, however if insurance companies paid a lower rates, and considered labor hours for the entire process; the price of the equipment would be higher than it is now.

This article was written by Carey Britton, Seating Specialist for Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com.

Active Mobility Center Knows the Power of Networking

People buy from people they trust, and they need to get to know you before they trust you.  This process makes it difficult for companies who depend on traditional advertising. 

If you have tried print, video, social marketing, networking, and exhibits, I am sure you will have found that networking and exhibits where you are face to face with people increase your odds in building a relationship of trust which will likely recruit more customers.

Many people do not know they are networking every day of their life.  They tell people what they like and what they don't like.  In business, advertising is expensive, and networking can dramatically help increase the number of people that you can explain why you are valuable.

If you have a clear message, and can back up what your promise you will create an amazing word of mouth business. 

This article was written by Carey Britton with Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com

Wheelchair Clinic at Broward Center for Independent Living

This past Friday, November 1st, we held our 2nd Wheelchair and Seating Clinic hosted by Broward Center for Independent Living, Nova University and Active Mobility Center.  The clinic is held the first Friday of each Month; offering education, adjustments and recommendations on adatpive and rehab equipment used by people with Mobility Impairments within our community.

This clinic was started with the concern that many people do not know much about their equipment or the importance of seating and positioning. Through the development of a progam with Adrienne Lauer, OT and professor at Nova University and Carey Britton, Seating/Mobility Specialist at Active Mobility Center, we have started something special.

This month, we met with 11 individuals to help maintain and improve their seating and mobility.  We expect to expand these services and are constantly listening to attendee's on how we can improve our program.

For more information or to schedule an appointment, please contact Brian at BCIL  954-722-6400.

This article was provided by Active Mobility Center which is located in Pompano Beach Florida, and questions or comments can be directed to (954) 946-5793 or cbritton@wheelchairguys.com .

Danny Murphy and CinemAbility 2013

Danny Murphy in Permobil C500 

The last Screening of CinemAbility in South Florida came to a close on Saturday November 2nd in Ft. Lauderdale at the Cinema Paradiso.   Thanks to all that came out to support the Film and the community. The event was a fund raiser for the Broward Center of Independent Living.  CinemAbility is a documentary of Disabilities in Silent films to modern day Silver Screen and TV. 

Danny Murphy, an Associate Producer with the project was on site to introduce the film and answer questions the audience had.  The Project was Directed by Jenni Gold, and was well attended in Ft. Lauderdale during the Ft. Lauderdale Film Festival. 



Auto Mobility and Active Mobility

Active Mobility Center along with Permobil and Auto Mobility were the Sponsors for this event.  An after party was held outside the Cinema to further discuss the film, to network and bring the community together.

This is a good piece of film that should eventually be televised, and can be really good for School education.

This Article was written by Carey J. Britton, Seating and Mobility Specialist at Active Mobility Center, he can be reached at (954) 946-5793 or at cbritton@wheelchairguys.com.

Nova South Eastern University OTs come to Active Mobility Center

On Monday, we welcomed nearly 40 second year Occupational Therapy Students for a morning Seating and Mobility training.  Each year, we host this training to provide a glimpse into the world of complex rehab and assistive technology equipment.  We divided the group in to four groups and created stations including; Insurance Coverage and the process of getting equipment, manual wheelchairs and scooters, seating and positioning, and powered wheelchairs.

With smaller groups, the OTs were able to ask questions and interact with each presentation. At the Insurance coverage session, the groups heard how complicated the process is. There are many changes in health care that make the intake, insurance verification and needed documentation a specialized process. The groups were disappointed in learning that the complex rehab process can take 2-4 months for patients to receive their permanent equipment.

At the manual wheelchair and scooter group, they learned about standard through ultra light wheelchairs, about tilt in space and recliners, and the differences in scooters. The groups were fascinated on how the process to determine the equipment was more involved that thought. They had not learned about competitive bidding and how it is negatively affecting individuals needing this type of equipment.

The groups learned about how many different types of foam cushions, contoured cushions, and molded seating types there were. Some were overwhelmed not sure how they could ever grasp how much information, and options were available.

In the powered wheelchair group, the students were shown the different types of powered wheelchairs, different ways to control them, powered seating systems and were able to trial driving these chairs; including a stand and drive permobil. 

Concluding the program we discussed how important the team (physician, therapy staff, equipment provider, individual and caregivers) is in equipment provision.  We discussed how the physician initiates and drives the process; however the PT and OT are just as important, and in some cases more important.  We discussed the importance of a good dialogue on the history of the patient, their past equipment experience, patient environment, patient dimensions, patient goals, and caregiver needs.  It is critically important to gather this information, and openly discuss the options to ensure that the patient is satisfied and that their life is improved. What is selected and provided affects that patient for a minimum of five years. 

It was impressed on these students, that if they find themselves helping someone with complex rehab, that they seek assistance if they are unsure of what best resolves the needs.  We explained that ego's should be checked at the door as the process is not for us, but the individual needing this equipment.  We suggested that once they find a position that they find a peer mentor to help them. Additionally they should find a RESNA and/or NRRTS registered provider to be part of their seating and mobility team/program.

Although many of these OTs may never be involved with Complex Rehab Equipment, they now have some basic knowledge, were give some valuable tools and have  a better respect for Complex Rehab Equipment.

This article was provided by Carey Britton, Seating and Mobility Specialist for Active Mobility Center located in Pompano Beach, Florida. Carey can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .