Power chair powerhouse: It’s time to diversify

Even though “95% of those who inquire don't qualify,” Mobility Products Unlimited has built an empire providing power chairs to Medicare beneficiaries across the country. Now CEO Brian Dylewski is looking to do the same in markets outside mobility, such as respiratory. Brian Dylewski In just seven years, the Hollywood, Fla., company has grown to become the second-largest provider of power chairs in the country. Driven mainly by a sophisticated direct-mail marketing campaign, the company has succeeded in a category receiving heightened scrutiny in the wake of the Wheeler Dealer scandal in Houston. Despite the negative publicity surrounding the power chair market, Dylewski maintains that “there is a legitimate need for our products and services” and that his firm has steadfastly adhered to medical necessity guidelines. “We believe in corporate compliance, which means learning the rules and regulations in all areas,” Dylewski said. “The processes we've developed for medical necessity have been established. It is very important to us that the right people are getting the product. We don't believe that people who just got done playing tennis or walking around the block should be getting power chairs.” Yet as Wheeler Dealer shows, the power chair market is controversial and in order for the company to remain vibrant, it has to diversify, Dylewski said. “The government could have a knee-jerk reaction that will affect all mobility providers, so to have all our eggs in one basket is risky,” he said. “We need to add depth to our organization.” As a result, Mobility Products Unlimited is in the beginning stages of adopting a catalog that incorporates other product lines into the business. Among them is Invacare's Venture Homefill 2 concentrator and a full complement of respiratory services. “What we've seen is that our customers have many needs - not only mobility needs, but bathroom safety equipment, aids to daily living and respiratory,” Dylewski said. “ We want to offer all of those things to them.” This expansion comes as no surprise to Lou Slangen, director of sales and marketing for Elyria, Ohio-based Invacare. HME providers are starting to follow the pharmaceutical industry's lead by taking their message to the public, he said. “We're seeing more providers adopt a model to reach the consumers who can benefit from multiple products,” he said. “The awareness level for products such as the Homefill 2 is still very low. At Invacare we have increased our advertising in order to gain more public exposure. Providers need to think in terms of retail. As the awareness of our products increases, we need providers who have the delivery capabilities in place.” While Dylewski prepares his company to enter a new realm of HME sales, he continues to fortify his bread-and-butter mobility business. His commitment to taking the high road with power chair sales has earned him a seat on a CMS anti-fraud task force assembled by former Administrator Tom Scully. Along with helping to police market integrity, Dylewski also sees his role as a chance to offer the industry perspective on policy issues. “We need to think of the government as a partner, not an enemy,” he said. “They want the same thing - Scully was clear about that. People are quick to say the government is making them victims, but my response is to get involved.” Dylewski has been actively involved over the past two years, seeking clarity from CMS on medical policy coverage criteria. Medical directors typically refer to physician progress notes in checking for medical necessity, but no specific documents are mandated, he said. “We're trying to get direction from CMS on what documentation providers need in the patient's file to establish medical necessity,” Dylewski said. “Is it a letter of necessity from a physician? An OT or PT assessment? Tell us what it is. As of today, we don't have clear direction.” Ideally, he said, industry leaders will coalesce on the issue, presenting quantifiable accounts of how power chairs give users independence and how that in turn boosts their physical, emotional and psychological health. “We have to build a case and present it,” he said. “If we were providing a product just sitting in homes not being used, we'd have no argument. But that's not the case.” Although Dylewski says breakthroughs with CMS have been made, scandals like Wheeler Dealer only figure to inhibit future progress. “We've gotten part of the agency on board with some of the recommendations we've made, but because of Wheeler Dealer, the agency is now on defense,” he said. “The reason why we never seem to get anywhere is because of the people who hurt us.” Even so, Dylewski remains optimistic about eventually reshaping Medicare policy in a way that satisfies both providers and the program administrator. “Will change happen overnight - no,” he said. “But I have hope. If I didn't, I'd throw in the towel right now.”