As with many sectors in HME, manufacturers say the market for
manual wheelchairs continues to grow right along with the aging
population that needs them.
“Even in an environment of reimbursement challenges, unit
volume is going up,” points out Steve Cole, president of
Dedicated Distribution. “More folks are entering the part of
life in which chairs are more commonly required. The baby boomers
just began turning 60 [this] year; we're only at the front of the
usage curve.”
“The need for independent mobility has and will continue
to grow,” states Invacare's John Vadeboncoeur, group product
manager of IVC products. “While Medicare utilization appears
to be slowing on certain HCPCS codes, additional volume is now
being driven by other market channels, such as retail and Internet
providers.”
Indeed, a recent report from Research and Markets lists among
market drivers increased demand from consumers who may see mobility
products in retail settings such as Wal-Mart. As the baby boomers
age and need wheelchairs, “they will be willing to pay
directly for mobility and comfort as they do for homes and cars
now. This trend will assure market growth worldwide,”
according to the report, which adds that, as a result, there is
also strong potential in the companion vehicle lifts market.
“Because of the nature of the population, I think there
will be a better opportunity for retail,” says Dave Jacobs,
president of Medline's DME division. “Baby boomers are
affluent and used to a certain lifestyle, and they will do as much
to maintain that as they can.
“People will be very interested in those [items that make
their lives easier], and they will be willing to pay for them. I
think there will continue to be more of a growing market on the
cash side [for mobility products] that give people more flexibility
and independence.”
Along with the strong demographics for manual chairs, the
Research and Markets report points to concerted initiatives by
major manufacturers that have resulted in help for providers who
are dealing with cost-control struggles and increasing demands from
customers. Drop-ship programs that offer delivery to end-users'
homes are evolving, giving providers no products to stock, no
minimum order requirements and delivery within one or two days. The
supply chain also is focused on maintaining low-cost and
high-quality products to meet market needs, the report says.
So What's the Catch?
As always — and again as in other product sectors —
even in a market with strong potential there are funding jitters.
The Deficit Reduction Act's 13-month DME rental cap was unexpected,
the particulars of competitive bidding are still unknown, and
drastic cuts in power mobility reimbursement (set to take effect
Nov. 15) have left the market unsettled.
“The reimbursement uncertainty in the market, especially
now with power wheelchairs, has affected most of the market as
providers become wary of both short- and long-term
viability,” according to Vadeboncoeur.
“Providers are looking for products that address patient
needs while still allowing them to be profitable. The recent
changes in capped rental policy will definitely have an impact on
what equipment they can afford to offer and how they will support
that product once the title transfers to the patient,” he
says.
“Due to this,” adds Invacare Group Product Manager
John Lescher, “now more than ever providers will be looking
for other avenues to increase revenue which will trickle down to
manual wheelchairs. The need to offer low-cost manual wheelchairs
will continue in the K1 through K4 reimbursement segment and will
become more prevalent in the K5 market in the upcoming
years.”
“We still feel pressure even in our niche market,”
notes John Box, president of Colors In Motion, whose customers for
sport and lightweight chairs are mostly in the preteen to mid-40s
age range, outside of the Medicare market. However, Box points out,
“Medicare sets the pace. As they lower the bar, everyone else
lowers the bar as well.”
He says providers now place price above all else when looking at
product. “The main concern is price, not performance,”
says Box, who adds that as a wheelchair-user himself, that's
frustrating because a user spends an average of 14 hours a day in a
chair and needs both comfort and performance.
“Today, consumers are more active, knowledgeable and
independent. They expect the same things from their technology as
everyone else,” agrees Brent Hatch, product manager for
Quickie adult manual and sport products for Sunrise Medical.
The good news, he says, is that the technology is available to
offer benefits that are not simply about improving lifestyle but
also health. Unfortunately, he continues, “due to various
funding modalities, not all people have an equal access to products
that maximize their need from a clinical and lifestyle perspective.
Limitations are growing in both the ultralight and geriatric market
as funding becomes more constrained.”
And, says Medline's Jacobs, “We're going to continue to
see pressure to reduce prices, especially with competitive bidding
coming up. It is a challenge from a manufacturer's standpoint. The
demand is strong, but pricing has gone down dramatically. We've
seen items where the selling price is down 10 percent.”
With the DME rental cap, Jacobs sees growth in the economy chair
market as providers search for products for Medicare patients who
will cap out after 13 months. At the same time, he explains,
acquisition costs for materials such as aluminum and steel are up.
“If we have to reduce costs any more, we'll have to reduce
quality, and that's something that we're not willing to do,”
he states.
“It's hard to bring new technology into a market that
doesn't want to pay,” Box sums up. If the situation
continues, he says, “we're going to have serious problems.
There are consequences of putting people in an inferior
product.”
A Couple of Hot Tickets
Nevertheless, there are some bright spots in specialty
segments.
“Bariatric choices for mobility continue to be a need in
the market, especially as our society becomes more educated on the
bariatric epidemic and treatment options. Transport options, either
through vehicle restraint systems or through lighter-weight chairs
that are easier to lift, also are driving growth as those with
mobility needs become more active day-to-day,” says
Invacare's Vadeboncoeur.
“As the bariatric patient becomes more ambulatory as a
result of new treatments, our business will grow,” agrees
Roberta Jacobs, national sales manager for Gendron, which
specializes in bariatric products.
“Consumers … expect a manual wheelchair that fits
them,” she continues. But because the needs for bariatric
patients can vary so much, she points out — “You may
have a 4'11", 60-pound patient, or a 6'1", 720-pound patient”
— the company has added adjustable seat-to-floor height and
back height adjustments to accommodate the range of sizes for these
users.
The transport chair segment also is “growing
significantly,” says Medline's Jacobs. He notes a super-light
transport chair weighing less than 15 pounds that has a carrybag
and a cupholder is selling well, and says such lighter-weight
chairs are particularly popular among elderly caregivers because
they are easier to lift in and out of a car.
There is adjunct growth in accessories, Jacobs says, because
people are looking for products that allow them to carry cell
phones and keys. And continuing a trend of the past several years,
he says, in addition to lighter chairs, consumers also want less
institutional-style products and more variety in terms of colors
and other aesthetics.
According to Dedicated Distribution's Cole, in general consumers
are looking for “improved functionality, lighter weight,
ease-of-use, smaller size for portability and value.” And he
believes consumers “will place more emphasis on value when
more of the payment burden shifts to them.” In response, the
company has recently introduced a combination rollator and
transport chair.
But these manufacturers say that while the demand is there
— and the products available to meet it — the future
for the manual wheelchair market will be shaped by its
reimbursement.
“Providers are looking for the best clinical solution at
aggressive prices that make sense in a business environment where
health care costs are constantly being evaluated,” concludes
Sunrise's Hatch. “The reality is that manufacturing costs
associated with producing better product (lighter, faster,
stronger) are higher, which presents a challenge.
“Providers are faced with the difficult task of matching
the appropriate technology to the appropriate user while managing
the funding.”
Experts Interviewed:
John Box, president, Colors In Motion, Corona, Calif.; Steve
Cole, president and CEO, Dedicated Distribution, Kansas City, Kan.;
Brent Hatch, product manager, Quickie adult manual and sport
products, Sunrise Medical, Longmont, Colo.; Dave Jacobs, president,
DME division, Medline Industries, Mundelein, Ill.; Roberta Jacobs,
national sales manager, Gendron, Archbold, Ohio; John Lescher,
group product manager, and John Vadeboncoeur, group product
manager, IVC products, Invacare Corp., Elyria, Ohio
