Opportunity through optimal mobility comes at a cost
To live life to its fullest, you have to show up. Whether it’s school, work, or get-togethers with friends and family, wherever you go to give your life meaning, you first have to get there.
For many individuals, wheelchairs are critical to full participation in life, to getting where one wants or needs to be. As our population ages, there will be increased demand for durable medical equipment (DME) and assistive technology (AT)—and increased costs to meet those needs. National healthcare expenditures are projected to top 20% of the gross domestic product, eclipsing manufacturing and defense sectors and generating vigorous debate. How can healthcare systems contain costs through greater efficiencies while at the same time improving the level of service?
The question is nowhere more pertinent than when it comes to wheelchair repair. When wheelchairs or other DME malfunction, users are currently at the mercy of repair service providers and medical care professionals to remedy the situation. A flat tire can keep a person with quadriplegia in his or her bed for a week or more and result in skin breakdown and increased personal-care costs. A problem with a computer integral to a modern power wheelchair can take significantly longer to resolve—resulting in even higher costs.
Slow responses often also prevent individuals with disabilities from maintaining employment and contributing as independent members of society. Absence from work, especially when it is lengthy, highly variable and unpredictable, impacts people who rely on DME for their independence through lost wages and impacts their employers through lost production and higher turnover costs.
Assistive Technology Across the Lifespan for Managed Care Organizations
There are two areas where we can assist MCOs with issues related to purchase, maintenance, repair, and retirement of AT:
- Training on Maintenance and Repair of Wheeled Mobility Devices
Our courses on maintenance and repair of both manual and powered wheelchairs are designed to improve the experience for the user and others associated with AT. The programs are customized for three target audiences:
Members/end users: Our experience providing training for users of wheelchairs indicates they are very interested in learning about their chairs and what needs to be done to keep them in good repair. In addition, they are interested in learning about when to contact a repairperson or organization, particularly if the problem is not yet diagnosed. They would like the opportunity to see what routine maintenance should be performed on their chair. And finally, they want their chairs inspected by experienced technicians. All of this is included in the course for users.
Caregiver teams: This course gives caregivers the tools to assist users with both maintenance and repair of their wheelchairs. The training focuses on inspection methods, including wheelchair logbooks. There is also discussion on when to seek technical assistance for potential wheelchair repair.
DME/AT experts within MCOs: This training provides a broader study of wheelchairs, including manual and powered wheelchairs. Inspection methods and routine maintenance items are also covered.
We are prepared to present any of these courses at your convenience. Please contact us using the information below to arrange the training.
- Broader system issues that are a challenge for organizations providing AT
We believe that there are a number of ways to reduce DME/AT costs and improve the experience for the end user. For example, current practice in procurement may result in higher costs for the MCO than is necessary. Potential solutions include bid-based acquisition procedures for procurement of DME/AT and reuse/recycling of DME/AT. In addition, we are reviewing and compiling information from other HMO/MCOs because there may be model systems already in place that can benefit Wisconsin MCOs.
For this to have any chance of success, however, it is necessary that we work directly with the MCOs to determine current practices for procurement, maintenance, repair and retirement of DME/AT. Then together we can determine which of the possible means of improvement is applicable and most appropriate. Again, we are available to discuss how we might work together at your convenience.
