What can you do to help fix Funding for DME.

The item coalition, as well as NRRTS, RESNA, NCART, and countless other groups and manufacturers have been fighting a battle for the mobility challenged community. For years, it has been up to our industry to police itself, and there have always been a few bad apples that have ruined our system, reducing our credibility and have forced CMS to take action. As a long time supplier, I remember the signs “FREE LIFT CHAIR”, which providers abused until Medicare blocked the code, and made it difficult for consumers to get these items.

Over the past few years, since powered wheelchairs have become fashionable and attractive; suppliers had found a loop hole which could be very lucrative. We have all seen the people who receive powered wheelchairs, but can still walk. We have also recently witnessed many providers becoming indicted for billing for this equipment and never providing it to their patients.

I have repeated over the years, to my congressman, to organizations, consumers, and professionals; that the only solution is to rid the industry of its bad apples. The problem stems from the manufacturers, who see increased demand of their equipment through outlets who do not offer service, customization, or any choice to the consumer. If manufacturers demanded their suppliers were credentialed, and provided adequate service with the capacity to follow up the product; our industry would be very professional and respectable. Instead today, suppliers are looked at as people you cannot trust; and only in it for the money.

There is a genuine concern about the competitive bidding program that Medicare is initiating. As a supplier my concern is that to put something out for bid in an industry which is already providing (in many cases) substandard equipment; the allowable for equipment will plummet. Competitive bidding means that in a community all providers bid their lowest price they can provide a service for. Since many suppliers are providing non-US equipment, the price ceiling would most likely be set for these lower imported products.

The obvious concern here is that when reducing costs so much, what happens to the service. What many individuals do not understand is that most equipment that is provided (by responsible providers) requires an assessment from the provider, with a team consisting of a physician, therapist, and family to provide the best solution for the patient. When you set a capped amount on equipment, both the choice of equipment and the specialty of customizing, and fitting a mobility product will disappear.

What most people don’t know, is that most physicians and therapists are not familiar with equipment and depend on the supplier they are working with to recommend the most appropriate equipment. In reality the equipment that is being prescribed, is left up to the supplier to choose. When you reduce the funding, and reduce the choices, you will lose the specialty providers; and have only a delivery system. Would you rather a delivery person drop off your equipment, or a specialist who can instruct, train, adjust, modify and make suggestions to you?

The competitive bidding issue still has a long battle ahead, as there are too many uncertainties; like if you award a company a particular demographic; and they turn out to be a bad provider; what is the recourse. When you award one provider the work for an entire area, you will certainly force many of the other providers out of business. So how do you replace a provider that fails to perform?

The larger picture may be that by providing cheaper products that will be outsourced to non US countries, our Gross National Product declines. To spend billions of US dollars on healthcare for most of that revenue to be sent outside the US , is not good for our country. Even worse, is the amount of unemployed, skilled workers from local equipment suppliers, and from national manufacturers.

Now is the time to get involved, voice your concerns to legislators; tell them of the importance of local providers who can supply, fit, repair and customize products. Nothing in this world is free, when you see these ads for free power wheelchairs, no cost to you, qualifying people who can still walk- turn them in to Medicare. We cannot be blind and turn away as this problem is not going away; and when you need Medicare benefits they are not going to be there.

This article was provided by Carey Britton, seating and mobility specialist for Active Mobility Center. He can be reached at 954-946-5793 or at cbritton@wheelchairguys.com

Thinking Out Side the Box.

It amazes me how many times I hear clients tell me that their old equipment suppliers/providers told them NO it couldn’t be done. For many industries this may be the case, but for our industry, the custom seating and positioning industry; telling people NO, can mean the difference of independence, or the equipment not being used.

Of course our company says NO, when it liability or safety is a concern; but we offer our client’s the option to customize their equipment to the extent is makes their lives easier or more independent.

Our company advertises its ability to provide custom mobility and seating equipment. If we advertise this we must be able to deliver. Our company continues to offer off the shelf products when needed, offering molded seating systems, customized seating frames, tilt in space, recline, elevating seat, and standing options.

To further our out side of the box thinking, we have the ability to add, specialty lighting to equipment. Many of our clients are children and young adults who were robbed of the ability to own, customize and drive a car. We have been offering neon and other lighting packages to accessorize their rides. Kicking it up a notch, or octave is mounting stereo systems, amplifiers, and speaker systems to the chairs for the entertainment of themselves and their peers.

A new addition, has been adding rear view camera and display systems for clients who have difficulty seeing behind the chair. For may wheelchair users, there is a big blind spot behind their chairs. We have been offering a camera that mounts to the rear of the chair which is attached to a LCD screen on the front of the chair to enable clients to see what is behind them.

Our company still strives at providing systems that fit, and interact with it’s users. We challenge ourselves everyday in enabling our clients; maximizing their abilities!!!!

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

What Can You Do to Help Make a Positive Change

If you know me, you know that I attempt to do the very best at whatever I choose to do in life.  In regards to my work, I am passionate about helping others through Seating and Mobility.  Over the past few years, there has been an attack by CMS/Medicare on this small industry that positively affects so many people; allowing them to live a more productive and independent life.  With the help of Active Mobility, I have been able to spend time advocating and lobbying for access to these services.

The number one (1) complaint that we here at Active Mobility Center, is that it takes too long to receive new equipment, and that the hoops needed jump through are unbearable.  As an industry we have done a poor job educating the public on how to advocate for themselves. We, as a collective group, always want to satisfy our customers, avoiding all the negativity of the increasing pressures.  When there was more of a margin/profit on medical equipment, we could hire more staff and facilitate equipment faster; however now with these changes- we have to do more with less.

These increased funding pressures, combined with the amount of requirements now to qualify and prior authorize equipment is making this process much more lengthy. CMS/Medicare had created new watch dogs who are bounty hunters only profiting by finding errors in paperwork, so suppliers have to spend much more time on the details; than the actual equipment provision.

Over the past few years, you may have heard of a program called competitive bidding. This program, no longer only a Medicare problem; has been finding it's way into the private sector; and if Obama's plans go into affect in 2015, will affect state medicaid programs. 

As of April 1st 2014, Manual Tilt in Space wheelchairs as well as some other DME products will become capped rentals. Many providers have already voiced their concerns that they will no longer be able to accept this and will no longer provide these services.

Equipment providers can no longer afford to be the sole Advocate for the users of medical equipment. The pressures exerted have taken the profit out of the system and where equipment users will need to get involved to avoid access to these services.  There are many ways that you can get involved, from contacting CMS/Medicare, your state and local representatives, or attend lobby groups to show how important this is to you and others.

Staying in touch through NRRTS.org, NCART.us or other similar organizations can help guide you and help your voice be heard.

This article was written by Carey Britton, ATP/SMS, CRTS for Active Mobility Center. He can be reached for comment at cbritton@wheelchairguys.com or at 954-946-5793.

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

Active Mobility Center says to Emb(race) Everyone

Emb(race) is an event put on by Stand Among Friends at FAU to support diversity.  Active Mobility Center was pleased to support the 4th annual race on February 23rd of 2014. Hundreds of people came out to support this all-inclusive family fun event that features a 5k & 10k walk/run and one mile family walk; all to enhance the lives of people with disabilities.

Their programs help them transition to greater independence; learn work, technology and social skills while emphasizing their talents, interests and education. We help them realize and achieve their career aspirations and widen their social opportunities--so they can experience a meaningful life, both personally and professionally.

Through a comprehensive employment program, state-of-the-art assistive technology program and lab, vocational evaluations and community outreach efforts, Stand Among Friends helps people regain their independence and dignity. Over 1,200 individuals have participated in our programs and we have placed over 500 individuals in active employment.

The Disabilities Center is located on the campus of the Florida Atlantic University in the Christine E. Lynn College of Nursing in Boca Raton, Florida. The Center, which is designated as a Center of Excellence in the State of Florida University system, coordinates research efforts to develop new approaches, products and services for people with all disabilities.

Thanks to all that came out ad supported this event. Carey Britton, seating and mobility specialist, can be reached at cbritton@wheelchairguys.com or 954-946-5793.

Active Mobility Supports PBC Schools at the S.T.A.R.S. Conference

 

Active Mobility Center was honored to support the Palm Beach County Schools 9th Annual S.T.A.R.S. (Start Transition And Realize Success) conference at John I Leonard High School in Lake Worth, Florida.  This year was amazing, with a student panel who discussed their struggles, successes and made suggestion on how to make it better for the next generation. 

 

The group was very wise at 20-23 years old; Burn Your Path, Follow your Dreams, and Have Fun. 

 

One of the speakers said it is important to have Patience, Advocate for yourself, Belief that anything is possible, Setting Goals, Building a network of support.

 

We were priveleged to meet some very inspiring young people, and were able to network with many professionals to increase the value we can offer to our customers.

 

Carey Britton, Seating and Mobility Specialist can be reached at 954-946-5793 or at cbritton@wheelchairguys.com .