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Thread: The future of titanium wheelchairs?

  1. #11
    Things are rather dismal with other dme. I just bought a low air loss mattress because the competitive bidding process implemented in some areas condemned me to receiving a low end used one. That is not good for people needing chronic wound care for long periods. Competitive bidding confines DMEs to supplying low cost, low end products. Then Medicare has a rent to cap policy. They must rent the mattresses on a monthly basis. If the user still needs the mattress after the cost cap is reached in 13 months it becomes hers or his and the DME bills no more. When it comes to repairs and replacement, Medicare assumes the user started with a new mattress. In most instances, however, the user will have started out with one that had been previously rented out to short term users. Coupled with the fact that it was low end and destined to have a limited life span long term users are really screwed. To the best of my knowledge Medicare has no user follow up to take stock of the competitive bidding program's impact on them.

    Of course, manufacturers of quality wound care mattresses are taking a hit and facing a dismal future at best. I have 6 Medicare competitive bid suppliers in my region and everyone offers the same low end Drive Medical mattresses, nothing else. I ended up buying my mattress online from a company in Florida to get the best price. Ironically, the mattress is made by SpannAmerica located right here in South Carolina.

    Incidentally, Medicare is happy because they are saving some $. They do not care that it is costing dme users more. Fortunately I can absorb the cost, but that is probably not the case for most people on Medicare ( and people with private insurances playing follow the leader.)
    You will find a guide to preserving shoulder function @
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  2. #12
    Senior Member elarson's Avatar
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    These changes took effect in the summer of 2013, after a few delays.

    Quote Originally Posted by NW-Will View Post
    Picked up my TR 1/1/2013, paid for by medicare / medicaid.
    Last edited by elarson; 08-12-2014 at 07:51 PM.
    Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

  3. #13
    Senior Member elarson's Avatar
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    I'm curious about the numbers too, and just took a stab at, because I worry if there are not enough to fund otherwise, these options may not be there in future.

    Yep, Lousy state of affairs and you are definitely preaching to the choir, but I still think it's good to talk about how these changes are affecting everyone. Especially those who do not have the option to purchase out-of-pocket.

    Quote Originally Posted by Andy View Post
    I'd be rather curious how many Ti chairs are actually funded private insuance vs. just purchased by the end user.
    ....
    I guess it is just a luxury to have a current technology assistive device in the view of insurers, heck we should be happy with a sheet of plywood and some casters, eh? Lousy state of affairs IMO, but I'm sure I'm preaching to the choir here.
    Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

  4. #14
    Senior Member elarson's Avatar
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    Wow, I did not know it was that bad. I would think that a mattress would be like a wheelchair cushion or back, that does not have to meet the rent-to-own model with competitive bidding.

    And your point about manufacturers of quality wound care mattresses is exactly what my concern is about. How can they stay in business with this mentality. My guess is that European companies will fill the void, but is that what they are really after at the CMS?

    What extremely stupid lack of insight to the needs of the average user who requires an LAL mattress. I have no words...

    Quote Originally Posted by SCIfor55yrs. View Post
    Things are rather dismal with other dme. I just bought a low air loss mattress because the competitive bidding process implemented in some areas condemned me to receiving a low end used one...

    Of course, manufacturers of quality wound care mattresses are taking a hit and facing a dismal future at best. I have 6 Medicare competitive bid suppliers in my region and everyone offers the same low end Drive Medical mattresses, nothing else...

    Incidentally, Medicare is happy because they are saving some $. They do not care that it is costing dme users more. Fortunately I can absorb the cost, but that is probably not the case for most people on Medicare ( and people with private insurances playing follow the leader.)
    Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

  5. #15
    My chair is going to be submitted to my insurance soon -- possibly even by the end of this week -- so I will definitely report back and let you know if it (and the other components) are approved. I was assured it wouldn't be a problem, so we shall see.
    Last edited by User Name; 08-12-2014 at 08:50 PM.

  6. #16
    We get very few private pay customers - the VAST majority of customers will refuse to contribute any amount of money towards their chair.

    I just did an eval with a customer who pulled into the parking lot in a brand new F350, had a nice watch on, trialed both the Icon and a TiLite, said he liked the A1 better (to the dealer, not in front of me), but decided to go with an AeroZ because he didn't have to make a $400-500 contribution.

    It's really hard to make nice things in the wheelchair market.

  7. #17
    It is crazy isn't it? My friends didn't bat an eye when I drop 20K on a Ducati but tell them the cost of a new wheelchair, or some nice wheels and people think I am nuts. Hell, I live in a damn wheelchair! There is a weird sense that all medical stuff should be paid by insurance.

    Quote Originally Posted by JeffAdams View Post
    We get very few private pay customers - the VAST majority of customers will refuse to contribute any amount of money towards their chair.

    I just did an eval with a customer who pulled into the parking lot in a brand new F350, had a nice watch on, trialed both the Icon and a TiLite, said he liked the A1 better (to the dealer, not in front of me), but decided to go with an AeroZ because he didn't have to make a $400-500 contribution.

    It's really hard to make nice things in the wheelchair market.

  8. #18
    Senior Member elarson's Avatar
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    I find that sad Jeff. So maybe the lack of insight is not just limited to governments, but also users. People should be looking at the total cost of ownership for a chair, and certainly there are compelling reasons to want an Icon that supercede needing to kick in a few extra bucks if one is able. Just out of curiosity, as both are K0005 chairs, why the extra contribution?

    What you mention about trying to make nice things in the wheelchair market is my exact concern. All of this nickel-and-diming by everybody has the potential to severely limit choice and innovation for all. If all of us are not careful, the industry is going to be left to companies where the lowest price is all that matters, which may have a place, but not in complex rehab.

    There needs to be solutions that allow manufacturers to sustain themselves, while still offering competitively priced quality products and spurring innovation. Not to mention dealers (can't believe I said that) who are not just lowered to selling the cheapest bid commodities like they are now. And there needs to be purchase options for users that don't just disqualify entire products, even if we need to pay a little extra for things that are not medically justifiable, but deemed needed, for whatever the reason.

    Okay, I'll get off my soapbox

    Quote Originally Posted by JeffAdams View Post
    We get very few private pay customers - the VAST majority of customers will refuse to contribute any amount of money towards their chair.

    I just did an eval with a customer who pulled into the parking lot in a brand new F350, had a nice watch on, trialed both the Icon and a TiLite, said he liked the A1 better (to the dealer, not in front of me), but decided to go with an AeroZ because he didn't have to make a $400-500 contribution.

    It's really hard to make nice things in the wheelchair market.
    Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

  9. #19
    Senior Member elarson's Avatar
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    For the core chair you have described, I don't think you will have much problem, unless you are going for the titanium upgrade. I've not heard of anyone who as done a titanium upgrade -- has anyone else?. It will be interesting to hear about any of the components that are not standard and not cosmetic. I'm assuming you are private insurance, and I also think it's good to name companies so everyone can get an idea of which are following CMS Medicare/Medicaid.

    Quote Originally Posted by User Name View Post
    My chair is going to be submitted to my insurance soon -- possibly even by the end of this week -- so I will definitely report back and let you know if it (and the other components) are approved. I was assured it wouldn't be a problem, so we shall see.
    Partner of an incredible stroke survivor. Limitations: hemiparesis and neglect (functional paralysis and complete lack of awareness on one side). Equipment: TiLite ZRA 2 and 2GX, Spinergy ZX-1, RioMobility Firefly. Knowledge: relative newbie for high-level equipment (2012), but willing to try to help others who are new with similar limitations (definitely not a guru, but inquisitive).

  10. #20
    Quote Originally Posted by elarson View Post
    I find that sad Jeff. So maybe the lack of insight is not just limited to governments, but also users. People should be looking at the total cost of ownership for a chair, and certainly there are compelling reasons to want an Icon that supercede needing to kick in a few extra bucks if one is able. Just out of curiosity, as both are K0005 chairs, why the extra contribution?

    What you mention about trying to make nice things in the wheelchair market is my exact concern. All of this nickel-and-diming by everybody has the potential to severely limit choice and innovation for all. If all of us are not careful, the industry is going to be left to companies where the lowest price is all that matters, which may have a place, but not in complex rehab.

    There needs to be solutions that allow manufacturers to sustain themselves, while still offering competitively priced quality products and spurring innovation. Not to mention dealers (can't believe I said that) who are not just lowered to selling the cheapest bid commodities like they are now. And there needs to be purchase options for users that don't just disqualify entire products, even if we need to pay a little extra for things that are not medically justifiable, but deemed needed, for whatever the reason.

    Okay, I'll get off my soapbox
    Both are K0005 chairs, so both are reimbursed at the same amount by the funding source, whether it's gov't or private insurance. The Icon is priced for now at $3,295, and the TiLite AeroZ is $2,195. The dealer was willing to give up some of his profit, but the customer wasn't willing to contribute any amount of money.

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