Pediatric HME outgrows product-driven systems

The pediatric HME market faces a fundamental mismatch: Children’s needs are developmental, relational and long term, while the systems serving them still operate around products, codes and short-term approvals.

“It’s still one of the toughest parts of this space,” said Catharina Tunberg, executive vice president of product innovation at Permobil. “There’s general agreement that early and appropriate intervention matters, but the funding system does not always keep up with how fast kids grow and change.”

That disconnect creates a constant tension for manufacturers and providers—designing products flexible enough to adapt as children develop, yet practical enough to be funded, delivered and used consistently.

Reimbursement limits and regulatory barriers inevitably shape what’s possible, Tunberg added.

“It’s a balance,” she said. “The goal is to move things forward while still making sure products are accessible in the real world.”

Broader thinking influences design

That same tension is pushing the market to think beyond mobility alone. Tunberg points to opportunities to integrate supportive technologies into a single device, reducing the need for families to manage multiple pieces of equipment or constant transfers.

At the same time, the relatively small size of the pediatric CRT market means many advances still build on developments from the adult rehab space, said Ian Hendry, ATP, Leckey sales director for Sunrise Medical, North America.

Even so, manufacturers are targeting pediatric-specific innovation, particularly in outcome tracking and monitoring. Sunrise Medical, for example, has introduced tools like the MyWay+ Pedal app, which connects via Bluetooth, along with wearable technologies designed to monitor pressure, posture and other metrics.

“The aim isn’t just physical growth, but creating an environment where the child is supported to function at their best,” said Hendry. “As they develop, the equipment should continue to enable learning, play, communication, feeding and rest.”

Funding realities shape what reaches patients

For all the innovation, reimbursement remains one of the clearest pressure points.

Dustin Moss, clinical vice president of rehab for Inspired by Drive, says providers are navigating paperwork, shifting payer rules and reimbursement rates that do not always cover the cost of specialized equipment.

“For families, the biggest challenges are delays and denials, especially when children need equipment quickly or may outgrow it in a short time,” he said.

In pediatrics, those delays carry added consequences. While a child is waiting, their positioning, tolerance and participation may already be changing.

That reality shapes not only access, but the types of products that succeed in the market, said PJ Ruflin, senior vice president of revenue for Sunset Healthcare Solutions.

“That tends to push the market toward products that can demonstrate practical value, ease of use, and operational fit,” he said. “Innovation still matters, but the products that gain traction are often the ones that balance clinical benefit with real-world adoption.”

Specialization becomes a differentiator

For providers, success in pediatrics is less about expanding product lines and more about building depth.

“There is a lot of value in specialization if it comes with real clinical knowledge, strong service, and operational consistency,” Ruflin said. “At the same time, there is also value in offering enough breadth to support continuity of care. The best model is usually a focused core offering with the right adjacent products around it, not breadth for breadth’s sake.”

That balance reflects how families experience care, where coordination matters as much as coverage, Tunberg said.

“In my view, it’s less about how many categories you cover and more about how strong your clinical approach is,” she said. “The best providers either build that depth internally or partner really well to fill the gaps.”

That depth extends beyond equipment to include clinical expertise, education, follow-up and caregiver support.

“Pediatric mobility is not a one-and-done situation,” said Tunberg.

As care moves home, expectations rise

As more care shifts into the home, expectations around usability are rising.

“In pediatrics, a product can be clinically sound, but if it is uncomfortable, difficult to fit, or hard for a caregiver to use consistently, it will fall short in the real world,” Ruflin said.

That reality is pushing manufacturers to design products that are lighter, softer, more adjustable and easier to use, without sacrificing performance.

At the same time, families are playing a growing role in shaping expectations, with a stronger focus on participation and quality of life, Tunberg said.

“What feels significant right now is a broader shift toward inclusion and accessibility becoming the default, not an afterthought,” she said. “There’s growing recognition that schools, playgrounds, public buildings, and cultural spaces need to be designed from the start so children with disabilities can participate on equal terms.”