Pondering the future of complex rehab

Between a proposed Medicare expansion of power seat elevation, potential advancements in technology and impending financial challenges, the complex rehab category has cast a sharp eye on the future. 

To be sure, questions abound on how these upcoming developments will impact the industry, though expectations at this point are generally optimistic. 

Seth Johnson, senior vice president of government affairs for Duryea, Pa.-based Pride Mobility Products, is encouraged that expanded coverage for power seat elevation on certain power equipment will offer enhanced benefits for Medicare beneficiaries. 

“This is a great next step in the Medicare coverage process and one that is long overdue,” Johnson said. “Medicare beneficiaries should soon have access to this life-changing technology that enables more independence and safety as they participate in their activities of daily living.” 

The technology nearly doubles the functionality of the power wheelchair and enables consumers to access the vertical environment both at home and throughout their daily lives, Johnson said.  

“Providers will now be able to offer this technology to all their patients who could medically benefit from it and no longer be in a position where only their non-Medicare patients have access.” 

Audra Watt, vice president of marketing for Lebanon, Tenn,-based Permobil, asserts that helping more people benefit from seat elevation “has long been a goal of ours. Getting to this point in the process has required consistent and collaborative efforts – not only from the CRT community, but also from our bi-partisan congressional champions.” 

Yet John Wright, senior vice president of sales and marketing for Torrance, Calif.-based Shoprider Mobility, is more pensive: “We have yet to see what the fee schedule will be for the seat elevate option as well as the medical justification required for PAR approval. These currently would be restricted for Group 3 eligible users, which is progress but also a disservice to Group 2 patients that could also benefit greatly by a seat elevate system.”  

Technology outlook 

Medicare coverage, coding and payment policies over time absolutely have an impact on technological advances and innovation, Johnson said.  

“This will likely be no different, and while it is hard to know to what extent currently, we should know more specifics later this year,” he said. “Most complex rehab power wheelchair manufacturers offer a power seat elevation option today and while those products will likely evolve, this is a small but important change that may not be enough to generate new interest from those outside the market.” 

In contemplating the impact of seat elevation, Watt says “we certainly hope to see more manufacturers offer seat elevation.  We’ve seen firsthand how life-changing it is to have your world within reach. The wheelchair community is asking for it, and clinical research shows how valuable it is for health and functional benefits.” 

Wright sounds more confident that policy will influence technology development. 

“There will certainly be advances in the seat elevate mechanisms as well as the electronic controls to operate them,” he said. “The seat elevation business will attract new entrants to the market and innovation as well.” 

 Evolution & challenges 

The “real challenges” that exist in the post-pandemic marketplace, Johnson said, include “labor, due in large part to the reimbursement policies that do not reflect the post-pandemic cost structure of today.” 

He also listed higher costs of doing business, fixed reimbursement rates that have not accounted for the true cost of doing business, hiring skilled rehab repair technicians for competitive wages, getting out from under the backlog of repairs brought about by supply chain shortages, and third-party payer challenges. 

Watt points out that CTS's face challenges ahead because “it is a relatively small niche and so it struggles to achieve the attention, funding, and overall legislative priority it deserves.  

“Now, even more than ever, we need to put our differences aside and band together as an industry to move the needle when it comes to policy and systemic changes.”