Technology advances fast in complex rehab

Friday, January 22, 2016

Complex rehab is a market where rapidly advancing medical technology is intersecting with drastically improving manufacturing techniques. The level of sophistication of various mobility and therapeutic equipment offers new and better options for patients, which should be good news for providers, manufacturers say.

“The advances we are seeing are numerous,” said Doug Francis, principal and co-founder of Drive|DeVilbiss Healthcare in Port Washington, N.Y. “We’re seeing products that are designed to accommodate the needs of today and tomorrow with out-of-the-box adjustability. Products are being designed to be lighter weight and more durable using new materials. In the pediatric space we’re seeing products that are designed to bring special needs children closer to their families by making the products softer, more ‘touchable’ and more attractive.”

Cody Verrett, president of Los Angeles-based ROVI Mobility Products, agrees technology is “constantly evolving and improving for consumers,” but that the innovations must be kept in line with the funding streams available.

The HME industry is also responsible for ensuring that assistive technology professionals are fully trained and up to date on all features, he said.

“It starts with the ATPs and how they carry themselves and communicate with the client and caregivers,” Verrett said.

At Sewell, N.J.-based Active Controls, the focus is on fulfilling “the glaring need for stable, substantial midline mounting systems for power chair drive controls,” said Jordan Flowers, general manager. “A recent study conducted at Moss Rehab in Philadelphia substantiates this and we feel that the next industry trend will be to utilize the drive control as a positioning device in conjunction with seating products and supports.”

Funding conundrum

Although complex rehab has been mostly immune to Medicare competitive bidding, the impact of CMS’s move to apply bid rates to accessories could be “devastating” to the market, Verett said.

“With S.2425, complex power wheelchairs received a delay, but complex manual wheelchairs did not, so the impact is real and it is happening right now,” he said.

Verett contends that CMS is “inappropriately” applying competitive bid rates to the accessories of products that were previously excluded from competitive bidding.

“In many instances these reimbursement rates fall below manufacturing costs, which means the consumers will lose access to them,” he said. “Plain and simply, folks just won’t get the equipment they need. This is a classic case of CMS being penny-wise and pound-foolish.”

Depriving patients of the right equipment will have an unintended consequence—higher healthcare costs, says Verett. In the short term, providers may shift their focus from Medicare to private pay and Medicaid, but Verett says those programs base their rates on Medicare fee schedules and will likely make the same changes.

“That’s why the negative consequences of CMS’s actions go beyond Medicare,” he said. “I don’t know if it will cause further consolidation in the marketplace, but I’m certain it will cause significant hardships for people with disabilities who rely on complex manual wheelchairs.”

Ultimately, “any moves that are made to reduce reimbursement for medical products will create a market reaction,” Francis added. “Something has to give when these cuts happen and it’s usually a drop in services or a scramble to find products that meet the code without exceeding the need.”

Future direction

Clinically, complex rehab will continue to evolve in a direction toward correction and not just accommodation, observed Greg Sims, CEO of Irvine, Calif.-based Matrix Seating USA.

“Many European countries have been using adjustable micro-modular seating as a corrective measure for decades and significant declines in spinal rod implant surgeries and reactive surgeries have been noted as a result,” he said. “Non-profit children’s hospitals in the USA are recognizing the clinical benefits and cost savings of using corrective seating over invasive surgeries. Manufacturers are working toward further developing AMMS components so that complex rehab wheelchair seating can be individualized for each client to maximize contact and be gradually adjusted over time to create corrective forces.”