AAH council spells it out

New white paper highlights importance of both complex rehab, standard mobility
Friday, November 17, 2017

WASHINGTON – AAHomecare’s Complex Rehab and Mobility Council this month published a short white paper that outlines the differences between complex rehab and standard mobility products in grids and photos.

While industry stakeholders have published other materials highlighting the specialized nature of complex rehab, this three-page paper also highlights the benefits of standard mobility, says Chairwoman Nancy Froslie.

“We wanted to show the importance of both,” said Froslie, an ATP and the rehab manager at Sanford HealthCare Accessories in Jamestown, N.D. “We didn’t want it to come off that one was more important than the other. Different patients have different needs.”

The main element of the paper is a grid that outlines the patient population, length of need, configuration, positioning capacity and pressure management, and prescribing and fitting process for four categories of products: standard manual wheelchairs, CRT manual wheelchairs, standard power wheelchairs and CRT power wheelchairs.

The council envisions providers using the paper to, among other things, explain why accessories for complex rehab manual wheelchairs should be exempt from competitive bidding. The paper includes a grid with photos of both basic and complex accessories.

“Being able to see the differences between the two in a picture—to me, that’s really important,” Froslie said. “It’s representative of how the products are used.”

The council also envisions providers using the paper to advocate for a separate benefit for complex rehab, and for fair coverage and reimbursement with non-Medicare payers.

“We wanted something that, even though we’re targeting Medicare, was broad enough to be a tool for other payers,” said Ashley Plauche, manager of government affairs for AAHomecare. “It could even be used in a clinical setting or with patients to help them better understand what their options are.”


Hoping you will consider another version of this important paper.  Using the degree of customization required to mitigate functional limitation IS an effective way to differentiate Complex Rehab equipment. 

But use of the word "standard" underappreciates the need to also customize NON-complex rehab equipment. 

The attitude reflected in this term is how patients and family caregivers end up with the ubiquitous manual wheelchair with its heavy frame and uncomfortable seating, even though such construction makes the chairs hard to self-propel.  There is growing research that the "standard" chair is in fact, good for no individual, just adequate for most.  Improvements beyond that have been considered "convenience" for the patient and the caregiver, effectively making the experience of care harder than it has to be.

Perhaps the next version of this whitepaper could take the position that both require a degree of customization, differentiated by the severity of the physical disability. 

I suggest either "adaptable" or "mitigating" equipment rather than "standard."  Complex requires a great degree of customization  whereas "adaptable/mitigating" still requires customization but to a lesser degree.  I suspect that there is an even better term, so encourage others to weigh in.

Patients and Families deserve more attention to the functional independence needs of the non-complex patients.  Would be great if AAHomecare could help to lead that charge too.