Q&A: Tara Kersten: Show, don't tell, payers

BRENTWOOD, Tenn. – Tara Kersten, M.D., has seen firsthand the medical complications that can result from patients being denied or delayed access to complex rehab technology. Here’s what Kersten, Numotion’s new chief medical officer, had to say about how that motivates her to disrupt the current system. 

HME News: How did you become a specialist in seating and mobility? 

Tara Kersten: I was drawn to the specialty because of the focus on improving function and quality of life, rather than just treating a symptom or disease. My first physician role was in rural, central Iowa. While I was recruited to that position to perform electrodiagnostic testing and to serve as the medical director of their inpatient neurorehabilitation unit, I quickly identified the need for a wheelchair seating clinic there. Patients living in rural Iowa were traveling hours for multiple evaluations with different providers. I saw a need to have a clinic where the patient could be evaluated by a therapist, physician and ATP all in one visit. When I was recruited back to practice in Milwaukee, I got a team together to build another interdisciplinary wheelchair seating clinic, which has now expanded to four hospital locations within the health care system.  

HME: What can happen when patients don’t have access to complex rehab technology? 

Kersten: There are so many success stories that I’ve seen in my clinic and so many sad cases where medical complications could have been prevented with a proper wheelchair seating system. My motivation to build a clinic came from a patient who was placed in a Group 2 power wheelchair with a standard backrest and captain seat. He really needed a custom molded seating system to accommodate for his severe scoliosis and joint contractures to prevent him from developing pressure ulcers. Unfortunately, he developed a severe pressure ulcer that ultimately required an above elbow amputation. This could have been prevented if the proper Group 3 power wheelchair had been ordered for him, approved by the payer and delivered to the patient in a timely manner. These types of preventable complications, ultimately, result in a much greater financial cost to our health care system than the cost of complex rehab technology itself, and most importantly, these complications lead to unnecessary patient suffering.  

HME: One of your responsibilities as chief medical officer is to provide Numotion with strategic clinical advice. What is the latest in clinical research? 

Kersten: A main focus right now in our field is expanding access to power seat elevation and power standing systems for Group 3 power wheelchair users. There is extensive evidence in the literature to support the medical necessity and medical benefits of power standing systems. I would like to see this technology more widely available.  

HME: How can the industry increase access to these technologies?  

Kersten: I think it is important to focus on outcome studies. For this technology and other new technologies to become widely available and accessible, they need to be funded by payers. That is only possible through outcome studies that highlight the increased functional independence and/or the reduced morbidity associated with these new technologies.   

HME: One of the ways your path crossed with Numotion’s path is through advocacy. Why have you made that a priority? 

Kersten: I believe access to complex rehab technology is a right, not a privilege, for patients who have the proper medical necessity. And, after conducting a thorough history and physical exam, I believe the physician and the therapist are in the best position to determine whether a patient has the proper medical necessity for a mobility device. This is what needs to drive policy change and Medicare and Medicaid benefits. With my education, training, and clinical background, I believe I’m well positioned to make this argument.