Complex rehab market is not increasing
I read with great interest the “growth market” article in your Vendors section in last month’s issue (“Rehab attracts new players,” February 2016).
While there are certainly changes with regard to the providers and manufacturers in this particular segment, it is simply not accurate to refer to the complex rehab industry as a “growth market.”
Let’s look at the most recently available Medicare data for complex rehab. In 2014, it shows that Medicare paid for 14,100 complex rehab base power wheelchairs (K0848-K0864). In 2012, Medicare paid for 16,732 complex rehab base power wheelchairs. That is a decline of more than 2,600 units during that two-year period.
Certainly there are other factors that businesses take into account when evaluating whether to enter or exit a market, but it seems clear that complex rehab is not a growth market like other healthcare sectors.
While the baby boom population has provided for an increased market for many health care products and services as more people age into the Medicare program, complex rehab has not experienced that growth.The complex rehab market serves a rather small population of people with severe disabilities such as ALS, cerebral palsy, multiple sclerosis, muscular dystrophy, spinal cord injury and traumatic brain injury, who qualify based on their disability.
It is accurate that the DME competitive bidding program and other regulatory changes have resulted in a significant decline in the standard mobility market. Those figures are quite alarming and will hopefully normalize as prior authorization, the audit backlog and overall audit reforms are put in place.
It is not accurate to indicate that consumers who may have previously received a standard power wheelchair are now being put in complex rehab wheelchairs. If there are isolated incidents where that has occurred, and it was not due to a change in health condition, then those limited cases should be addressed.
However, there is a significant difference in the people, products, and processes that are required to be followed when providing complex rehab wheelchairs as compared to standard wheelchairs. There are different quality standards and an assistive technology professional (ATP) is required to be directly involved in the evaluation and recommendation for complex rehab. It is a gross exaggeration to try and paint the picture that the products or patients may be exchangeable.
—Seth Johnson, Pride Mobility /