The current model of Complex Rehabilitation Technology (CRT) procurement depends heavily upon insurance coverage and authorization of the prescribed equipment. Due to increasingly restrictive insurance coverage guidelines focusing on funding devices with the lowest up-front cost, many wheelchair users are being issued CRT that does not adequately meet their needs. This population includes people with spinal cord injury, multiple sclerosis, cerebral palsy, and ALS who risk developing serious medical complications from using ineffective CRT such as pressure injuries, urinary tract infections, rotator cuff injuries, and carpal tunnel syndrome. When their full-time mobility devices do not adequately compensate for their medical and functional deficits it is a significant detriment to the client and creates a significant economic impact to our healthcare system. Equipment provision guidelines emphasizing issuance of devices with the lowest up-front cost need to be re-evaluated to ensure wheelchair riders receive CRT that fully meets their medical and functional needs.
This 1-hour course will discuss and challenge the current model of reactive equipment prescription and explore the true health economic costs using this model. Clinical studies and case presentations will demonstrate the economic and medical/functional benefits which occur when a proactive prescription model is used. A compare/contrast discussion will highlight usage of basic versus complex manual and power wheelchair configurations and the medical implications of issuing lower quality or cost devices that do not meet clients’ needs. This course will include an exploration into the healthcare economic impact when inappropriate wheelchair configurations are prescribed, as compared to potential cost-savings via decreased healthcare utilization when appropriately prescribed equipment is provided. Attendees will be able to directly apply the course concepts when selecting wheelchair and seating products and will be empowered to advocate for insurance authorization to provide the most medically and functionally appropriate equipment for meeting their clients’ needs.