As important as serving these patients is, an even greater consideration is the impact on the nurses and staff. Fortunately, several new design approaches are entering the market to address the problem.

"Patients are getting larger and caregivers, principally the nurses are getting older. We are trying to address their needs as well by bringing products to market that make it easier for the caregivers to push the wheelchairs," said Rich Derks, Vice President of Marketing for the Durable Medical Equipment division at Medline. The company produces and distributes several hundred thousand standard wheelchairs (non-powered) each year worldwide.


The new design approaches involve lightening up the chair by using different alloys. Reducing friction for easier rolling is also a priority. Medline is exploring new frame and wheel designs using computer-aided engineering and materials used in high-tech bicycle manufacturing. The company's Freedom chair is one of the lightest on the market at 14 pounds.

Wheelchair attachments such as a push bar can give staff more leverage and improve ergonomics. (A related retrofit is to add an anti-theft bar that prevents chairs from folding so they're hard to steal, since theft is a big problem in hospitals.) Medline has also added hand brakes to some models. All of this innovation does add cost to the equipment, but typically hospitals, imaging centers and nursing homes buy based on quality as well as price.

"Hospitals look at wheelchairs as something important to take care of, but they don't want to revisit it every year. They want chairs that are going to last," Derks said.

Servicing wheelchairs is not easy and parts from overseas are difficult to get, so it's understandable that providers are willing to invest in quality equipment as long as the value is good. As providers and purchasing organizations try to cut costs, the smaller medical equipment distributors feel the squeeze.

"There's a move by the hospitals to deal directly with the manufacturer to reduce their costs. They are starting to compete with mom and pop durable medical equipment companies," said Steven Tabor, Vice President of Sales at 1st Senior Care, a web wholesaler in Tigard, Oregon. The company offers a truly unique product, made in Israel-a portable scooter that folds for easy storage in a car trunk. They also have a folding rollator, which folds side to side instead of front to back to go through narrow doorways.

Regulatory Matters

Regulatory issues are important influencers of sales in mobility equipment. Medicare reimburses for this equipment but the manufacturers must receive pre-certification for eligibility. And things are tightening. For instance, on the home healthcare side, a prescription for a power wheel chair now requires detailed face-to-face physician evaluation and documentation.

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