Rehab Equipment Tricks

Business Lessons from Piracy

noreply@blogger.com (Paul Jensen) — Sat, 25 Apr 2009 22:40:00 +0000

The world has demonized the image of the pirate but maybe we should learn a couple of lessons from those 'scurvy dogs.'

Pirates held the utmost contempt for anything that diluted the focus of the mission at hand. Pirates were focused on one thing and one thing only; bringing home treasure. Everything they did revolved around that one goal.

The pirate ship was run as a democracy with each member of the crew given a vote. The leader or captain was elected at the beginning of the voyage but didn't always come home commanding that same authority. If the crew was not satisfied with the results produced by the elected leader or had lost trust and confidence in the methods employed, a new leader could be elected. The deposed leader had the choice to walk away gracefully or fight the entire crew. Clearly, maintaining a good relationship with the crew and supporting them attaining their goals was not only a priority but also a survival technique.

Since booty was the goal, everything was built or designed to gather in that booty. Ships of that time were built to contain ballast in the hull that changed the characteristics of how the ship sailed. The ballast was usually composed of rocks or some other dead weight. While the ballast was important to sailing, it was less important than the booty. If the haul exceeded the weight capacity of the ship, the ballast was quickly traded to increase carrying capacity. In some extreme cases, a strategic decision was made to pitch cannons overboard to allow for more treasure. There were no sacred cows or cries of "but we always sail with dead weight in the hull." There was only focus on gathering treasure and getting it home no matter how creative the solution had to be.

Once the treasure was gathered in, the celebrations began. Guns were fired, mead was drunk, backs were slapped and cries of "Huzzah!" filled the air immediately after the work was done. In addition to their share of the treasure, pirates receive instant gratification and reward that binds the team together and creates legends that can be referred to as motivational stories for years to come.

You don't have to rape and pillage villages to be a corporate or an entrepreneurial pirate. You have to be focused, take care of your team, and celebrate every accomplishment.

Are you ready to wear an eye patch to your next business meeting?

Stable, Not Static [CELA]

noreply@blogger.com (Paul Jensen) — Thu, 23 Apr 2009 15:05:00 +0000

Dynamic Seating to Improve Movement and Function Presenter:
Allen Siekman, Siekman Consulting

The pelvis was designed for standing and movement, it was not designed for sitting.

Dynamic Seating allows or enhances controlled natural movement patterns while providing stability.

Natural reaching patterns include pelvis and upper trunk movement. Restricting pelvic and trunk movement restricts functionality.

Standard shoulder harness usually does not allow torso movement, limits push range, strength, and reach for daily activities.

45 degree belts limit anterior tilt and limit range of motion. 60 to 70 degree belts allow for greater pelvis range of motion. 90 degree belts use the legs to hold the pelvis and allows increased pelvis range of motion. It is also possible to lean forward and do a pressure relief while using a 90 degree pelvic belt.

A leg harness (like the one from BodyPoint) allows pelvis and torso movement while holding the legs down and back.

A product like the HipGrip from BodyPoint is built to be a dynamic device that supports dynamic movement.

Although there are specialized options available, there is a lot of dynamic seating that can be done using traditional belts set up at the correct angles.

Image from: http://www.urz2.com/avivaw/images/drawing/pelvis_lateral.jpg

Powered Mobility Training for Children with Comples Needs [CELA]

noreply@blogger.com (Paul Jensen) — Thu, 23 Apr 2009 13:04:00 +0000

Presenter:
Karen Kangas, OTR/L, Seating and Positioning Specialist in private practice, Shamokin, PA

Children are not small adults!
One of the reasons that children are not usually considered for powered mobility is because we view them within the paradigm of adults. Adults all ready know how to be mobile and move within space. Children may not have learned what it feels like to move in space they are still experiencing mobility.

For successful use of a powered mobility system, these three issues must be resolved:

Seating for task performance
Powerchair is programmed adequately
head first, hands free operation

Training should take place within the child's home or pre-school in an environment that is familiar.

We can not place adult standards of practice on children. Children will not demonstrate judgement or safety as these come with maturity and experience. The adults are responsible for these.

There is no doubt that independent mobility is critical for development, and that without it, delays in cognitive, emotional, social, and motor development are evident.

Image from: http://www.dragonmobility.com/as.php

Looking Back [CELA]

noreply@blogger.com (Paul Jensen) — Thu, 23 Apr 2009 11:54:00 +0000

Lessons for the Future

Presenter:
Hymie Pogir, Vice President of Product Planning, National Seating and Mobility

This morning's session is a look back at the history of the rehab industry hoping to identify exactly where things went wrong and how to fix our future.

A call for educating people on exactly what we do. We shouldn't be the "wheelchair providers." We should be viewed as the people that are product experts, help people get jobs, provide functionality, help sick children.

Is the NRRTS Code of Ethics inconvenient or is it only being used when it is convenient? If adherence is inconvenient, we should change the code. If the changes are inappropriate, insist on adherence to the Code AS IS.

Mass marketing has made a positive impact on the industry. There is very little if any stigma to the usage of a powerchair. Mass marketing has expanded the market and increased the knowledge of the consumers. What should set rehab dealers apart from mass marketers is the process that the company uses.

As an industry, we do not unite together to fight the problems that come from payors and legislation. There is no unified organization, there is only a series of small and larger businesses that have to aggresively take a stand to save the industry.

All politics is local. We can not rely on someone else to do the work. We need to do the work and we need to involve the consumers. Consumer's stories are worth much more than the impact we can make on lawmakers.

Doing More With Less Part 2 [CELA]

noreply@blogger.com (Paul Jensen) — Wed, 22 Apr 2009 14:59:00 +0000

Doing more with less - Making appropriate seating and wheeled mobility clinical decisions in the face of funding cuts - part 2 - Power Wheelchairs and Seating

Panelists:
Mike Babinec, OTR/L, ABDA, Product Manger: Power Wheelchair Electronics, Invacare Corporation
Julie Piriano, PT, ATP, Director, Rehab Industry Affairs, Quantum Rehab
Ann Eubank, OTR/L, Director of Education, Permobil
Moderated by:
Joni McGhee, OTR, Clinical Coordinator, TIRR/Memorial Hermann

Julie Piriano started off by explaining the role of the "SPARC" principle at Quantum. Singularity of Parts and "first time quality" in supply chain and manufacturing practices have provided cost savings that have been passed on to the dealers. Quantum understands that the more successful a company becomes the more risk they take on with repairs. By providing equipment that is tested and has a high quality, there will be fewer failures and less money lost on repairs.

Mike Babinec opened up stating that the manufacturers need to get the education out into the field about the coding process and why equipment has certain codes. We need to educate consumers because they are the people that have the most potential to make changes on Capitol hill. We need to educate our therapists more so that they understand better how to justify power equipment as well as so they understand the pressures that the dealers are working under.

Ann Eubank talked about limiting choice. Is there an ethical dilemma when we limit choice based on reimbursement. We should offer all alternatives to customers regardless of their insurance reimbursement possibilities. Offering the best alternative, even if it is not financially provided by their payor, is empowering. Only offering alternatives available based on funding is oppressive. We should be advocates for each customer based on their actual needs.

Develop and forge a relationship with local and statewide disability groups. Explaining why changes happen, what the issues are the industry faces, and what the issues are that the consumers will face will help build that relationship while educating them at the same time.

Teach consumers how to find their congressman and advocate for themselves.

The question then becomes how to help consumers overcome their fears and be able to advocate for themselves.

Ann Eubank made us aware of a new advocacy group called Users First Alliance. The alliance is focused on helping people with disabilities gain access to the seating and mobility equipment that they need and deserve. They also give a unified voice to the fragmented demographics of the disability community.

Educate the customer on all of their options and provide the optimal solution for them. Discuss funding last after they are sold on the solutions and on the benefits that the solutions will provide their daily lives. When the discussion turns to money, they are more likely to write a check for upgrades or non-reimbursable items if they see them as a whole package of care.

OR. . .

Discuss funding up front. By knowing the insurance company information, you can have the discussion with the client about what the needs are, what the solution HAS to be as well as what the solution CAN be. Once the options are available the consumer, provider, and therapist can make more informed decisions.

Doing More With Less [CELA]

noreply@blogger.com (Paul Jensen) — Wed, 22 Apr 2009 13:47:00 +0000

Doing more with less - Making appropriate seating and wheeled mobility clinical decisions in the face of funding cuts - part 1 - Manual Wheelchairs and seating

Panelists:
Foster Davis, Freedom Designs
Tom Whelan, Global Vice-President, Seating, Sunrise Medical
Tina Roesler, MSPT, ABDA, Director of Sales & Education, TiLite

Moderated by:
Joni McGhee, OTR, Clinical Coordinator, TIRR/Memorial Hermann

A discussion panel focused on how to provide the right equipment with fewer dollars and shrinking funding sources.

Tom Whelan started off explaining the need for education of our referral sources, payors, and our customers. We need to educate all parties on the need for the right equipment

Tina Roesler opened her remarks with a call for better collaboration. She noted that we need to go back to the model of the RTS/ATP working in collaboration with a therapist to come to a decision on the best outcomes for the customer. She stated that many RTS's are providing services to consumers for free that a therapist can bill for and may be more appropriate for a therapist to provide.

Foster Davis begins with advocating the development of a state organization of suppliers that can band together to work with each state legislature to develop the Medicaid program. The association in Texas has been able to work with the state in development of new programs to strengthen the Medicaid standards of care for the customers. This also allows the industry to impact the development of the laws rather than react to the laws.

The first question from the audience is in regards to the new Medicaid program cuts proposed in Georgia and how to build a relationship similar to Texas.
Time and relationship building are very important in building that relationship. It was also suggested from the audience that we should share our equipment costs as well as time and labor involved in providing the equipment for a consumer. Texas legislators have begun to understand the costs of doing business and are more sympathetic to the dealers now that they have a working relationship with the dealers in the state.

One of the keys to building that relationship is to show how you can save the state money. You may have to reduce spending or utilization on items like diapers (as was done in Texas) to a reasonable level in order to build trust and confidence when other items need to have the allowable raised.

NCART is building a repository for Medicaid information for all states across the country. There is a News, Toolbox, and Medicaid by State section of the website.

A call for uniformity in discount pricing. Since some payor contracts are based on discounts received by manufacturers, some providers have asked their manufacturers to reduce their primary discount and increase their secondary discount so that they can receive a higher reimbursement from the payor. If there is a standard discount for all rehab products (suggested 40%) and then negotiate secondard discounts based on purchase volume, credit terms, etc.

Doing more with less can not always mean going back to the manufacturers for discounts to get more money. We need to educate our therapists and payors on what our actual costs are to make the business argument to maintain or increase reimbursement. We need to show that rehab does not have the same cost structure as DME but is closer to the overhead cost structure of O&P.

Does providing products based on reimbursement, keeping the suppliers and manufacturers in business, and taking a stand on maintaining profit negatively impact the end user? At what point do we stop providing "appropriate" equipment and start providing "OK" equipment?

Image provided from: http://api.ning.com/files/8DI5WcJFfBFz9bITKl7sxWmPAxsZreeBOyf7qJtJijiy7CbIMk6m4Xf3dKnAfsLftCgnduYND9G-8PeZACABCUhciY5p-g4H/consensus.jpg

Saying No [CELA]

noreply@blogger.com (Paul Jensen) — Wed, 22 Apr 2009 13:02:00 +0000

A survival skill for complex rehab providers and therapists

Presenter: Gerry Dickerson, CRTS, Director of Rehab Technology, Medstar, Inc.

Different Types of No in the Rehab industry:

Corporate No (or not saying no). This is when saying no is out of your hands based on business decisions, practices, or insurance contracts.

Managed Care contracts
Making it up in volume
Leveraging Complex Rehab (Loss leader to get a contract for different business)

Saying No in this instance may be out of your hands based on existing practices but it is also important to have the ability to say no in the future based on opportunities that arise. The caution here is to not use rehab business as a loss leader for gaining other business. This hurts the industry as a whole as well as hurting the consumer by reducing access to needed equipment as reimbursements are continually lowered.

Point of Service No (including items that aren't fundable)

"Can you just grow my chair. . . "
"It's just a simple repair. . . "
Giving a product or service away for free
Formularies

Our job is ". . .Providing the best available product match based on clinical indicators allowed under the payer source." Our job is not to give stuff away for free. Free service, upgrades, and products set unrealistic expectations with the therapists and the consumers.

New York state Medicaid Myth:
Gerry shared his experience with providing a TiLite K0009 Wheelchair in New York City to a customer with Medicaid. In New York, a provider can set up a private pay agreement with a consumer IF:

both parties have agreed PRIOR to the rendering of the service that the enrolee is being seen as a private-pay patient
signed consent
NEVER bill Medicaid for that particular piece of equipment

The message is that we need to stop assuming that we can't bill a Medicaid beneficiary cash for items. We need to investigate the rules and laws that govern the benefit and take full advantage of all options available state to state.

Pushing Back
Just because you hear no from a payor source does not mean that the equipment can not be provided. Push back to the funding source and exhaust all avenues. Investigate alternate options. Don't forget cash. Use video to prove the medical necessity of the equipment needed by your clinic.

Image provided by: http://happybrainstorm.com/wp-includes/images/just_say_no.gif

CELA Blog

noreply@blogger.com (Paul Jensen) — Wed, 22 Apr 2009 12:55:00 +0000

I had the opportunity to attend the CELA conference in Baltimore this year. CELA stands for the Continuing Education and Legislative Advocacy conference. NRRTS put the conference on as a piggyback to the HME News Exposition & Conference.

I'll be typing up my notes from the presentations and interactions during the show and posting throughout the rest of the week.

The conference started off with a trip to Capitol Hill to visit with Senators and Representatives to lobby for a reversal of the recent 9.5% Medicare cut as well as to create a new industry standing for Rehab technology.

The trip to the hill was fun for me as it was the first time I've been to the Capitol. I got to meet with Legislative Aides and discuss the state of the industry with my local representatives. It was my first time participating in the democratic process more than voting in general elections.

At the de-brief the following morning, those who attended the days activities and spoke with their congressional office representatives were able to share their stories from the previous day. There was a wide range of reactions from the congressional reps. Some were very knowledgeable and willing to support both the reversal of the 9.5% cut and creating an independent status for Rehab. Some were very uninformed and needed an education on what the definition of DME is.

The majority of responses seemed to be that the 9.5% cut will not be coming back. There seems to be a positive reaction to creating an independent status for Rehab simlar to O&P. The suggestions from almost every office was that we needed to get a bill put together so that it could be reviewed and supported. Every office seemed to think of suggestions of another office to sponsor the bill but none of the offices volunteered to sponsor it themselves.

Overall I would rate the first day of the conference as a minor success. We were able to share the rehab story on the hill but we didn't receive an overwhelmingly warm reception or volunteers to champion the cause. Suggestions from the group are to have a bill next year and to bring consumers to the hill in wheelchairs to illustrate the importance of rehab better.

Image provided by: http://www.marines.mil/units/hqmc/cmclegalasst/PublishingImages/Stock%20Images/capitol-building-picture.jpg

No, Really. It's True

noreply@blogger.com (Paul Jensen) — Thu, 03 Jul 2008 20:49:00 +0000

I saw this article in HMENews today. Granted, now that competitive bidding is a real life monster in many people's lives, it is also a fact of doing business. But the results of the bid and who wins the contracts affects more than the businesses competing for the bid and the customers competing for quality care. Referral sources are a bit taken aback by the process as well. We all know that referral sources have their preferences on whom they will work with to supply their patients with equipment. This is a vaunted trusting relationship. We as suppliers promise to do our best to work with the therapists as an extension of their plan of care. Therapists may have long term relationships that are comfortable but may not be available to them now that competitive bidding is in the works. I can understand the idea behind being connected to a supplier since I have spent many years cultivating those same relationships.

But this quote just blew me away:

A big concern among callers during the Q&A session was whether complex rehab contracts were awarded to enough clinically-qualified providers. One occupational therapist from the Dallas-Fort Worth area, said she was calling on behalf of all beneficiaries.

"Of 10 complex contracts (awarded), three winners were pharmacies, two of the winners do not do Medicare, one was up for sale, because he knows that having the bid increases his selling price, one was The Scooter Store, and one hadn't done rehab in over a year," the caller said.

Wow. I can understand having concerns about working with pharmacies if they do not provide rehab equipment on a regular basis. I can understand having concerns about working with a company that is propping itself up for a sale. I can understand having concerns about working with a company that has not done rehab in over a year. But throwing The Scooter Store under the bus with absolutely no qualification whatsoever? Just because of perception and a brand name?

Full disclosure. I have recently been employed by Alliance Seating and Mobility a division of The Scooter Store.

The Scooter Store did win bids for complex rehab. They have started a new division to handle the rehab market. There should be no fear that rehab customers will be forced into a consumer power chairs. ATS's employed by Alliance do not sell consumer power, focusing on rehab customers only. In fact, with a name like The Scooter Store attached to everything we do, there is a higher level of scrutiny expected around everything that we do.

Medicare may have made some blunders and some contracts may have been awarded to companies that should not be doing the business. Hopefully lessons will be learned by all parties involved and applied to the next bid cycle.

My message to referral sources:
Rest easy. Find suppliers that they feel comfortable working with based on skill and results, not necessarily brand name. And remember that the ultimate power is still in the hands of the consumers. If your customer goes to ABC Pharmacy for a Sip-N-Puff chair and doesn't feel well treated, that consumer has every right to stop doing business and go to the next provider. Keep watch over your patients and how they progress working with a new supplier and you may be pleasantly surprised.

In other words, let us suppliers throw themselves under the bus. Don't do it for us.

Besides, this competitive bid thing may not last the month.

Fix-A-Flat

noreply@blogger.com (Paul Jensen) — Mon, 30 Jun 2008 00:22:00 +0000

How many of your customers get a high performance, ultra-lightweight, titanium chair so they can have the lightest, baddest, chair on the block and then put heavy solid inserts in their tires to prevent flats? Wheelchair flats can be a major inconvenience and some users may not be able to reliably or safely maintain their own tires. But for many users, the advantages of a pneumatic tire far outweigh the potential for downtime caused by a slow leak.

I've learned by working with a group of Boy Scouts that there are large numbers of kids who know how to ride bikes but do not know how to fix their own flats. Since I grew up changing tires and fixing flats, I just assumed that all kids learned that skill as a right of passage. So maybe there is a large number of wheelchair users that could benefit from air tires that just don't know how to maintain them and are scared of getting a flat and being stranded by a flat.

Make an addition to your online help guide (you do have one, right?) for the products you sell and support with this helpful how-to video tutorial from BicycleTutor.com.

Many of the high end chairs use high pressure clincher style tires. High pressure tubes usually have a "Presta" valve rather than the "Schrader" valve that we are used to seeing on our mini-van tires. This next tutorial explains the difference and shows how to use an adapter to add air to tires.

Maybe a small, inexpensive tire repair kit could find its way into the complimentary backpack on the backside of new wheelchairs that are delivered?

Spare Tube (Pre-Slimed tubes will help prevent slow leaks)
Tire levers (Many brands are made from recycled materials)
Patch Kit
Presta/Schrader adapter

Or you can point them to an inexpensive kit like the one sold at Amazon.com with either a mini-pump or a CO2 cartridge.

Empathy For The Mobility Impaired

noreply@blogger.com (Paul Jensen) — Sun, 01 Jun 2008 22:05:00 +0000

Similar to the fat suit or the pregnant suit that seems to show up on daytime talk shows every now and again to make us feel bad about how we treat people that are different from us, Nissan is using an "old" suit to help young designers empathize with the mobility impaired. The suit adds 15 pounds of weight, decreases vision, limits joint mobility, and causes the wearer to stoop and slouch. The young engineers are able to test their idealistic blueprint designs against the real world capabilities of many of their potential customers. 40% of Japan's population will be retirement age in the very near future. The suit has also been used to test bathroom accessibility.

The DME and Rehab industries tend to be better than many when it comes to empathizing with those of our customers with mobility impairments. But I have worked at one company that did not have accessible bathrooms. Another location had bathrooms that were accessible, but violated HIPPA regulations if a customer used them. Another location had plenty of handicapped parking in the parking lot at the front of the building. The handicapped doorway was located in the rear of the building. I have seen customer service desks that are so tall, wheelchair users can not interact with the employee on the other side.

It seems like a no-brainer, but I am surprised by the number of times I see members of our industry making it hard on themselves to do business with the very demographic they are targeting.

Look at your location and how you do business from the perspective of your customers. If you have to build your own "old" suit or sit in a wheelchair, than do that as well. Speak with your customers and ask them their opinion of your store layout from the parking lot to the bathroom and the space between shelf fixtures. You may be surprised by the suggestions.

Too Cool For Crutches

noreply@blogger.com (Paul Jensen) — Tue, 08 Apr 2008 02:44:00 +0000

We have become very well acquainted with the four wheeled walker with seat and brakes. The walker combines the safety of the wheel locks with the convenience of a place to rest.

This new concept crutch combines the convenience of a place to rest with . . . well, a little bit of style I guess.

The design doesn't show much of a nod to ergonomics in the handle design or placement of the forearm pads, but the two crutches do stick together and lean against things.

I don't see this design gaining status as medically necessary or having a HCPC code assigned, but it is nice to see some innovation and style in the development of DME.

HME News Poll - Has Medicare been over-paying for HME?

noreply@blogger.com (Paul Jensen) — Tue, 25 Mar 2008 18:35:00 +0000

HME News is running a poll to gauge the industry reaction to the 26% cut in Medicare reimbursement to HME.

If the winning bidders think they can survive with a 26% cut, does that mean that Medicare has been overpaying or does that mean that vendors are undervaluing their products and services thinking that the only way to increase demand is to lower prices?

If you decide to play within the Medicare box, it looks like you might just get trapped. Medicare has limited businesses to the point that they are only allowed to compete on price. If you want to compete on a different level, fire Medicare and choose the customers you want to work with.

Vote early and vote often.

Pack Up, We're Out of A Job.

noreply@blogger.com (Paul Jensen) — Fri, 21 Mar 2008 02:30:00 +0000

Even Competitive Bidding announcements couldn't have killed off the rehab industry as entirely as this recent press release. Israeli industrial design and engineering firm Argo Medical Technologies, has announced the development of the ReWalk Exo-Skeleton.

The exo-skeleton concept is not new, UC Berkeley and Sarcos have prototypes focused on military applications. While impressive, they are bulky and not suitable for everyday living conditions.

The Argo Medical exo-skeleton brace type device is designed to attach to the body of a person with a spinal cord injury and allow that person to stand and walk. Using motors, sensors, and rechargeable batteries, attached to the brace frames and a backpack, the ReWalk is designed to allow users to walk safely with the aid of crutches. A video demo can be seen on Argo's web page.

Besides showing off the new product, Argo also dedicates some room on the website to justifying the financial impact this type of product will have. With the first two years of paraplegia estimated to cost insurance companies 285,941 dollars, the possibility to offset costs promised by the ReWalk at 120,000 dollars per year makes the device rather attractive.

This device would not only make wheelchairs obsolete, it would also kill off the standing frame industry. Argo is hoping to have this device on the market by 2009, do you see a HCPC code assigned to this product in the future? But the real question is: Will this device be included in a competitive bidding carve-out?

CMS unveils competitive bidding fee schedule for DMEPOS

noreply@blogger.com (Paul Jensen) — Fri, 21 Mar 2008 00:53:00 +0000

CMS press release as seen on HMENews:

WASHINGTON - Providers in the first 10 competitive bidding areas submitted bids that on average will lower the fee schedule rates on many DME items by 26%, CMS officials stated during a late afternoon press conference.

"This new program means that Medicare beneficiaries will have access to some medical equipment and supplies at substantially lower prices than they are paying now," said CMS Acting Administrator Kerry Weems. "The Medicare program and taxpayers will share in these savings. This program represents yet another way to use the competitive marketplace to bring the best possible and most efficient care and services to people with Medicare. Because new accreditation and quality standard initiatives are being implemented in conjunction with the phase in of competitive bidding, this program will provide assurance to beneficiaries that they are receiving high quality medical equipment for home use."

Here's my first reactions:

26% reduction in reimbursement? DMEPOS has fought every reduction in reimbursement tooth and nail, usually unsuccessfully. Given the chance to rally together and set the rates that everybody can live with has resulted in a self-imposed reduction of 26%. Not to mention the 100% reduction in reimbursement for those who did not win the bid because they wanted to keep their reimbursement higher. Ouch.
"The Medicare program and taxpayers will share in these savings." Sounds all warm and fuzzy to the average American who doesn't need any DMEPOS and doesn't realize how little of the total Medicare budget is actually spent on DMEPOS (1.7%).
Does anybody else cringe when you read 'use the competitive marketplace' in reference to a program that actually reduces/eliminates competition? He who controls the language, controls the debate.
When was the last time any government program was able to deliver on a promise of 'best possible and most efficient' especially when it comes to care or service?
Of course with the 'new accreditation and quality standard initiatives' that are being implemented, service providers have no choice but to provide the best possible equipment and service to beneficiaries.

Round 1 bid awards are expected to be announced any day now. I'm sure this announcement was a precursor to set the tone of the upcoming announcements and quell as much public debate as possible. Are you (your company) ready for this?

Round 1 Announcement Imminent

noreply@blogger.com (Paul Jensen) — Tue, 18 Mar 2008 01:51:00 +0000

Seen on Notes from The Golden Commode:

Here’s the lastest news on round one of competitive bidding, courtesy of Don Clayback, The MED Group’s vice president of government relations. Clayback had a call with the Competitive Bidding Implementation Contractor (CBIC) earlier today. Here’s what he found out:

1.) The CBIC will send out notices to all Round 1 bidders within the next two weeks. That could mean this week or next; they would not be more specific.
2.) All letters (winners and losers) will be sent out the same day via Certified Mail. That means everyone should get their letter within a day or two of each other.
3.) Winners will receive a contract to be signed along with the new fee schedule. They will have 10 days from the mailing date to respond.
4.) The contract will be for a three year period commencing July 1, 2008.
5.) Unsuccessful bidders will also receive a letter stating they were not selected.
6.) Despite Clayback's additional inquiries, the CBIC would not share more specific information at this time.

Can Your Wheelchair Read Your Mind?

noreply@blogger.com (Paul Jensen) — Mon, 17 Mar 2008 04:59:00 +0000

Ambient made waves a little while ago when they announced the ability to control a wheelchair by thought. They have recently expanded the application to the technology to include communication devices, access to the internet, or darn near anything else that can controlled via voice.

Controlling a wheelchair or creating an augmentative communications device may be the ultimate purpose of the technology, but these lofty ideas will not likely pay the bills. Hopefully the technology can be made available to applications with wider appeal and fund the development of the intended goal.

Competitive Bidding vs. Congressional Signatures

noreply@blogger.com (Paul Jensen) — Mon, 17 Mar 2008 03:34:00 +0000

HME News reports that there are two letters being circulated around congress right now with the intent to put pressure on CMS about competitive biding. The letters have been signed by 100 congressmen so far. The letters don't call for an end to competitive bidding but they do ask for CMS to reexamine the impact on the small DME companies and might give enough time for congress to investigate the process as well.

The letters may just be a shot over the bow of CMS. It seems to me that if congress really wanted to stop competitive bidding there would be more aggressive moves made. However, a step is a step. Call your congressman and make sure his/her signature is on the letters.

Is this a sign that congress has decided that their local business community might be affected? Is this a sign that congress has decided that their constituency might be affected? Is the signature of 100 or more congressmen strong enough to make an impact on CMS?

Wheelchair Dude

noreply@blogger.com (Paul Jensen) — Wed, 12 Mar 2008 03:45:00 +0000

Gizmodo Blog points out that the Apple Thesaurus has a strange suggestion for how to use the word observe in a sentence.

So. . . who is this wheelchair dude? Apple is usually pretty conscientious about what they do. This one must have slipped through the cracks.

What would you do?

noreply@blogger.com (Paul Jensen) — Tue, 11 Mar 2008 16:44:00 +0000

Here's a tale that seems to be all to familiar to those of us in the rehab industry. It is told by a cab driver who is sent to pick up a 'Lil' Ol' Lady' from the hospital. The poor woman is non-ambulatory and should be sent home in van transportation, but the cab ride was cheaper. This puts the cabbie in an awkward situation:

"Look, lil' ol' lady," I told the Lil' Ol' Lady, "the only way I can get you into this car is to pick you up and put you in it." We were not supposed to do this, because of our insurance. Imagine if I had dropped her and she had ended up not with a bruised hip but a broken one. Worse, imagine if she had croaked.

Have you ever been in a similar situation? When you get to an appointment and realize there is nobody there to help make transfers in and out of a chair or bed, what do you do?

EyePod

noreply@blogger.com (Paul Jensen) — Tue, 04 Mar 2008 21:23:00 +0000

Reuters is running a story on a Japanese University that has created a switch to control an iPod via a series of blinks. The movement of the skin around the eyes is read by a series of sensors attached to eyeglasses or headphones.

"Wink strongly for one second with one eye to rewind, use the other to skip to the next song, or close both eyes to pause and play, Taniguchi told Reuters in an e-mail interview.

But what if users accidentally blink only to find themselves in a completely different soundtrack?

"It doesn't happen at all. This system doesn't malfunction even if the user eats, talks, walks and runs," Taniguchi wrote, saying there were differences in movement between an accidental and an intentional blink or wink."

This type of switch means:

You can independently rock your playlist even if you can't use that cool 'click wheel'.
Ipod accessories and options will start showing up on Invacare and Sunrise Medical invoices.
The switch may be adaptable as another drive option for power chairs. Lots of possibilities with that!

How To Read An Income Statement

noreply@blogger.com (Paul Jensen) — Thu, 14 Feb 2008 21:16:00 +0000

This is an important skill for all business owners, entrepreneurs, or anybody interested in making a business work. There are a myriad of financial forms, graphs, and other documents that are available to help you look at your business, but the income statement can give you some of the best data available. And it's really not as hard as it sounds.

Jeff Cornwall, director of the Belmont University Center for Entrepreneurship, gives the secret:

"It is important to look beyond the numbers presented in the income statement and examine the percentages that each of those numbers represents. Look at major expenses every month to see what percentage of sales is being used to pay for each expense."

The rest of the simple article gives some good examples on how to use that little nugget of information, but the key is to 'look beyond the numbers' and look at trends over time. Did you really make any money when you got that new account after all of the time spent courting them? Was the hassle of getting that custom product rushed in from a new vendor worth it financially? Will I be able to continue doing business with Medicare and the new competitive bidding reimbursements?

It's important to balance what is seen on the paper with what is going to work for your business. You may show that your initial investment in that new account is sucking you dry on paper, but it may be worth it for the future revenues. Just make sure you have a way to re-examine your loss leaders before your whole business is a loss.

One of my favorite managers to work under shared the monthly income statement with her staff during the first team meeting of each month. She stepped everybody through how to analyze the data on the sheet as well as what that data meant in relation to each person's contribution to the branch. It didn't take long before everybody felt ownership and a sense of pride when numbers were up and also felt a sense of urgency when numbers were down.

Not everybody shares financial numbers with their staff. If you don't, why not? If you do, what changes have you seen in staff productivity and ownership?

Know When To Fold 'Em

noreply@blogger.com (Paul Jensen) — Wed, 13 Feb 2008 02:06:00 +0000

I recently received an email from Invacare announcing their new folding 3-in-1 commode. Drive Medical has had their version available for quite a while now. We have use the Drive product ever since our rep told us about it. From the pictures, it looks like the Invacare product is similar to the Drive product.

Why is a folding commode important?

Keep all the parts to the commode in one place. Never get to a house or hospital again only to find that the splash guard is missing.
Portability for the customer. The product folds easy enough that the users can take it with them when they travel. Makes any hotel room or family member's house that much more accessible.
Easy to store in the warehouse and on the retail floor.
Can be shipped via UPS/FedEx.

The folding commode only handles 250lbs where the non-folding version will usually handle 300lbs, so be careful who this product is recommended for. The folding commode does cost a couple bucks more than a regular commode, but we have decided that the benefits outweigh the price difference and have converted most of our commode stock to the Drive folding product.

Wheelchair Skills 101

noreply@blogger.com (Paul Jensen) — Tue, 12 Feb 2008 21:24:00 +0000

OK, you just sold your favorite customer your favorite chair. It is the coolest thing on wheels. It is lightweight, narrow enough to get through doors, the seating and positioning are perfect, you even got the insurance company to fund it, and they have already paid. Your customer is happy. You are happy. Everything is perfect, right?

What if your customer doesn't know how to use the chair?

New wheelchair users face a large number of barriers with their new lifestyle. Your job is to help eliminate as many of those as possible. The first step is to provide the most appropriate mobility equipment. The second step is to educate them on how to use that equipment safely. Our industry does a good job at pointing out features and reminding people to use their safety (positioning) belt and anti-tippers. But who is in charge of teaching people how to pop a

wheelie?

A charity in the UK recently sponsored a wheelchair users course to educate young wheelchair users on how to use their chairs. The course covered everything from balancing on the rear wheels, climbing

and descending curbs

, and even demonstrated going down

and up stairs

for the very brave.

Why should you hold your own wheelchair users course?

This is information and skills that every new wheelchair user needs
You want to be the company that everybody thinks of when they need wheelchair information
Get more wheelchairs and wheelchair users in and around your store on a Saturday than you ever thought possible.

What do you need to get your event started?

Find your experts.

Invite PT's, OT's and others who work with out-patient wheelchair therapy
Invite your local wheelchair sports team (basketball, rugby, curling, etc)

Pick your date, about 3 months in advance (make sure you will have a reasonable chance at good weather, spring/summer)
Invite your customers, and your competitors customers, and their friends and families

Fliers in the store, website, newsletter, statement mailing
Contact your local newspapers and TV stations

Invite the reporters to attend and cover the event

Make sure your course is laid out in stations so people can find the skills that are most interesting to them.
Have lots of loaners and sample chairs on hand for people to borrow, check out, and buy.
Be prepared to do it again!

Let us know if you have done something similar. If you decide to plan a course, let us know so we can promote your event on RehabHacker.com!

A Case for Logic [Accessories]

noreply@blogger.com (Paul Jensen) — Mon, 04 Feb 2008 01:57:00 +0000

I've never seen a mobility accessory that I've really liked. The backpacks that come from the manufacturers are either cheap and flimsy or built so tough they add more weight than the flat free inserts in the wheels. I've seen cane holders that let the canes bounce out, baskets that can't be reached by the chair user, and cup holders that break when you look at them funny.

Case Logic, makers of some very high quality bags and electronic accessories, have come out with a line of 13 nylon mobility accessories. I first saw the line at a local Walgreen's store. They are also available for sale on the web site. I don't do retail and don't keep a stock of these types of items, so I didn't look into vendor pricing, but even the retail pricing on the web site is very reasonable.

Case Logic has created some well thought out products for manual and power chair as well as walker users. My favorite feature is the zipper pulls. Ever watch an incomplete quad try and use a zipper? The zipper pulls are part of each item sold with a zipper as well as available as a separate item that can be used to retrofit a favorite bag or parka. At 4.99 for a 3 pack, the price is almost too reasonable. I'm sure if Medicare had a HCPC code for it they would be much more expensive.

I also like the catchall that is built to hang on the side of a manual chair leg rest. It's just big enough to keep a couple of small items in an easy to get to place.

Case Logic has thought out some good products that make use of space that is not traditionally used for storage. Now if we could just find a basket for a power chair that the user can actually access while sitting in the chair.