by Aaron R. Smith
Functional Mobility’s rehabilitation business thrives because of highly trained staff.  In the world of mobility, Mark Tucker is a big-time investor. No, he doesn’t sit on the executive board of a national conglomerate or manage a huge Wall Street portfolio. Tucker is president of Functional Mobility Systems in Baton Rouge, La, and his big investment is in his skilled employees. It is, by extension, an investment in business success, too.
Founded in 1998, Functional Mobility now generates about $2 million in annual revenues, with two locations and plans to open a third in Texas this year. But success has not been driven by volume-based selling or knocking on physicians’ doors in search of referrals. Overhead is low, support staff is minimal, and marketing is nonexistent. Tucker maintains a disciplined approach to inventory, stocking very little equipment on the premises. Instead, Functional Mobility makes its mark through expert patient evaluation and customized equipment solutions. That kind of knowledge can separate a company from others that chase high-profit margins but fall short of delivering high-end rehabilitation in return. But how do you develop and grow that knowledge? It does not come easy or overnight. TALENT SEARCH
Tucker worked with mobility devices for 2 decades before stepping out on his own. Now he has taken steps to make sure his best people stay with him. He made partners of two “bread winners”: Richard Glynn and Sean Reed. “I could not afford to train them and then have someone hire them away,” he says matter of factly. “After I have invested a year and a half in training someone, my competitors are more than happy to pay them another $10,000 a year to join their companies.” Such is the reality of high-end rehabilitation competition. Tucker recently heard from a headhunter in Chicago, calling on behalf of a client desperate for someone with experience in the field. “I said, ‘No, I can’t help you, but if you find someone, let me know because I would like to talk to them, too.’ That is how scarce qualified people are.” Tucker has trained everyone who works at Functional Mobility. “Our job is very clinical,” he says. “My people are expected to determine how the patient is progressing, what is going to be needed in the future, and how to speak to the physicians and therapists at their level.” That level of training takes unusual commitment. An occupational therapist Tucker hired 3 years ago is only now getting to the point where she can work with children, he says. “The first year she was nothing but a cost—it was total training.” | On the Hunt Again |  Ray DesmaraisWhen Ray Desmarais was shot twice in a hunting accident, this avid outdoorsman’s days exploring the desert around his Poland Junction, Ariz, home could have ended. Desmarais has little use of his upper body and hands, and virtually no use of his legs. But thanks to an HME provider, he has a second chance at his favorite sport—hunting. Despite his limited mobility, Desmarais was committed to returning to hunting, so he commissioned the team at AccessAble (formerly Frazier Medical Supply) to transform his Polaris Ranger 4x4 into a vehicle he could maneuver on his own. For Eric Garner, president of AccessAble, it was a wonderful opportunity to really show what his company could do. He charged 20 hours of labor and $800 for parts, but the project was about more than money. “We absolutely love doing adaptive/modification projects that are different and that help people,” he says. In a sense, the project helped justify his decision to sell the majority of Frazier Medical Supply, a company that dealt primarily with DME/respiratory factors, in December 2001 in order to pursue work for people who request it. To get Desmarais back in the game, AccessAble installed controls so that he can drive and operate the accelerator and brake with his right hand. He can access the locking differential, transmission selector, and all-wheel-drive button with his right hand as well, and he can keep one hand on a steering knob at all times. AccessAble included a raised section near the edge of the floorboard to keep Desmarais’ feet from falling out. A cross chain over the seat section allows Ray to hold onto a trapeze triangle to help himself in and out of the vehicle. Finally, AccessAble added chest butterfly harnesses to the passenger and driver seats to keep Desmarais safely in place. It was a lot of work, but Desmarais’ reaction makes it worth the effort, Garner says. “He is so happy and proud. We have all been very excited. He grins ear to ear, has put some major hours on it, and loves taking others out riding with him.” | SUM OF THE PARTS
Because Functional Mobility’s equipment is high-end, the average customer financial transaction is larger than at most HME facilities. As a result, the company shies away from Medicare and focuses on private-insured cases. “You can’t do high-end rehabilitation under Medicare guidelines,” Tucker says. “A large part of Medicare mobility and positioning is rental. Typically, rental equipment is generic and you do not need experienced, trained personnel to supply the one wheelchair that you stock for everybody. You can pay a driver to do that.” Functional Mobility, in fact, stocks very little equipment. Instead, it works with a variety of manufacturers, ordering customized units—or customizing them itself—to meet each patient’s specific needs. “We sell whatever is appropriate for the client, not what we have in stock,” Tucker says. “We will order parts from eight manufacturers for one wheelchair. You may get a seatbelt from Seattle, a seat cushion from Maryland, and a headrest from Germany. That is why we call it a seating system: All the components have to work together. On a custom wheelchair, no component is an island.” Though the company can build an entire seating system from scratch, it does not have to do so as often. “Back in the ’80s, you couldn’t purchase customized units on the market,” Tucker says. “Now you can purchase fairly nice custom-built equipment that does the job most of the time.” That allows staff members to concentrate most of their time in the field—a minimum of 8 hours with each patient, not including follow-up visits, according to Tucker. “Our rehabilitation therapists go out in the field, evaluate, write the justification, design the equipment on paper and deliver it,” he says. “If the equipment breaks, we service it.” Follow-up visits are a fundamental part of the business. “We may sell an item only Functional Mobility Systems Fast Facts
Founded: 1998
Based: Baton Rouge, La
Employees: 11 (three certified respiratory therapists)
Locations: 2 (planning on opening a third in Texas)
Annual revenue: $2 million
Average sale: $4,000 | once, but we see many patients eight to 10 times with no additional charges,” Tucker says. It is one of the reasons, ironically, that Functional Mobility does not have delivery drivers or vans. “If the problem involves the seating or positioning, it is a very intricate process and the rehabilitation therapist has to make those adjustments. I can’t send a delivery driver to do that. If the problem was a flat tire or dead battery, they could, but they end up out in the field with a patient who says, ‘My back is hurting,’ and they have to call in the rehabilitation therapist anyway.” GREENER GRASS
Because Functional Mobility’s customizable product lines require a well-trained staff to service and demonstrate, margins are less attractive than some people perceive, according to Tucker. “People see a $25,000 wheelchair and think we are rolling in the money, but we are a small-margin business because we have to pay highly qualified employees. There are many times when my potential profit margin is less than sales tax.” While that leaves little margin for error, it also helps deter would-be competitors. “You do not see national companies doing high-end rehabilitation,” Tucker says. “You cannot just come in and open a high-end rehabilitation facility, because you cannot buy the experience. It is not as easy as lining up at the physician’s door and asking for customers.” On the other hand, Tucker admits he has more business than he can handle and a stack of charts on his desk to prove it. “You have to work real hard to prove yourself,” he says. “If you get an opportunity and mess it up, you will not get another one. You ... have got to know what you are doing.”
Aaron R. Smith is a contributing writer for Dealer/Provider. | Lobbying with Lightning Speed | | Medicaid is often construed as a rather foreboding, impenetrable force. But as Bruce D. Bayes, president of Custom Mobility of Largo, Fla, proved in May, if you have a good, organized case, effecting change may be easier than you think.  Bruce D. Bayes used photos of clients to illustrate the difference between what Florida Medicaid would have provided (top) and what trained clinicians would have provided (bottom).
Bayes became involved in lobbying Florida Medicaid when a January change in how the program applied Healthcare Common Procedure Coding System (HCPCS) codes began to negatively impact beneficiaries’ access to  wheelchair seating and positioning devices. Specifically, Florida was using codes such as the K0030, solid seat insert, planar seat, single density foam, to describe all seats regardless of the technology involved. Florida’s reimbursement system is based on a fee schedule, and in the case of a K0030, it is inadequate for the types of seating and positioning devices necessary for children with disabilities, Bayes says. Because Custom Mobility specializes in sales and service of adaptive wheelchairs—60% of its business is in pediatrics, 25% is in adult rehabilitation, and the remainder is in geriatrics—Bayes was concerned but not too worried. “Initially we were very sure Medicaid would realize they were misapplying the codes and would correct this problem,” he says. However, after a March 28 trip with his wife, Judi E. Bayes, to the local Medicaid district office in Tampa to discuss the problem he was less confident because no one in the Medicaid office would provide a definition of the standard. “It was this visit that convinced us we would have to take this project on with a major commitment,” he says. He and his wife concluded that justification letters would be necessary in order to eliminate the incorrect K codes. They got to work immediately, and eventually the cause received the intended attention. Through an extensive grass-roots campaign (which included correspondence from W.B. Mick, director of the National Rehab Network; Lucy Cohen, MD, medical director of the Children’s Rehabilitation Program; Rita Hostak, chair of the American Association for Homecare’s Re/hab and Assistive Technology Council; pediatricians; and affected families), Bob Sharpe, deputy secretary for Medicaid’s Agency for Health Care Administration, was inundated with requests to reverse the changes. Finally, on a May 6 conference call with Sharpe, Medicaid Florida providers, and Centers for Medicare & Medicaid Services (CMS) representatives, Sharpe agreed to suspend the current program and reinstate the prior approval process used before January 1. After just 26 business days, Custom Mobility had organized, fought, and won a campaign to change Medicaid policy. Bayes says their cause was helped by the issues being easy to explain visually. “The idea that Medicaid would change an Rx and expect providers to supply the outdated, adult-sized products to pediatric seating was so ridiculous that it was relatively easy to show and relate how wrong it was,” he says. For more information on how Bayes and Custom Mobility changed Medicaid’s mind, visit the company’s Web site at www.rehabinflorida.com. |
| Mobility Insider |  “I think those providers who survived the ’90s are professionals who are first and foremost in our industry to help people,” says Dan Meuser, president of Pride Mobility Products—USA, Exeter, Pa. Dealer/Provider spoke to Meuser about the relationship Pride has established with HME providers.Q How does Pride help HME providers achieve success?
A We want Pride providers to be excited about the successful results of our products. We ask a lot of questions and analyze closely what services providers need most from a manufacturing partner. We also are adamant about our provider services working effectively in the real world. “Substance over symbolism” sums up our goal in designing provider services. The services we extend that are used most often include literature customization, advertising development, merchandising, provider Web site development, consumer financing, and reimbursement services. And, of course, we offer hands-on training, via our specialized field sales representative teams and our nationwide seminar schools. Q What new developments can our readers expect from Pride?
A Look for continued emphasis on improving our products for providers and their clients, as well as focusing intensely on product services, including fulfillment, marketing support, provider training, and reimbursement consultation. Specifically, regarding products, we are focused on innovating our present product lines. Our focus includes advancing quality and maneuverability, and seeking technical simplicity. We will be showcasing new products in each of our product categories including scooter, light rehabilitation power chairs, and Quantum power chairs in the fall. This will include new seating innovations, known as Synergy Seating. Q What kind of marketing strategies have you employed or will you employ to get the word out about the new products?
A Providers know their communities and clientele best. We primarily work with our providers to customize marketing plans that are realistic and best suit the individual provider’s goals. Our 2002 marketing plan, “Jazzy Marketing Partner 2002,” includes a new commercial emphasizing the professionalism of Pride providers and featuring the song “Young at Heart.” Our provider marketing plans also include training on product use, technical service, customer service, and reimbursement consulting. We complement our provider marketing partnerships with some national print advertisements, where all leads/ referrals are received by our providers. Q What do you see as your role in the mobility industry?
A We at Pride have become leaders in power mobility, retail mobility, light rehabilitation mobility, and high-end rehabilitation, through our Quantum Rehab division. And with leadership comes responsibility. Such responsibility includes setting plans and ideologies that are professional and in our providers’ and the industry’s best interests. It means maintaining a discipline to deliver on our promises and do what is right, not what is easy. We also hope to make Pride Mobility Products’ corporate location the relied-upon headquarters for providers’ power mobility product and service needs. Q What do you think we can expect from the mobility market in the near future?
A I think that industry long-term providers care about their reputation with their clients, manufacturers, and funding sources. I hope such professionalism means a more symbiotic business understanding between government legislators, sources, manufacturers, providers, and users, including groups like the AARP (American Association of Retired Persons). I know the industry will see continued innovations in power mobility products and provider services, which will allow providers to improve their business health and be able to take care of their clients better than ever before. |
Related Articles - Mobility Today
|
|
|
 |
|
Resources
