Editor's Note

Not an Option

Why won't Medicare fund power elevation? It should be a basic power chair capability by now.

• By David Kopf
• Apr 01, 2018

Let’s do an experiment: If you have the full use of your legs, the next time you go to a wedding, or an industry conference, or any other social gathering, try sitting in a chair — for the entire event.

Watch how the people around you behave when they interact with you. Will they sit down and talk with you, eye-to-eye, or will they stand there while they carry on a conversation and look down at you?

Chances are you will discover that the majority of your interactions will involve the other person standing, while you crane your neck to look up at them. By the end of the night, you’ll feel like you’ve spent the entire duration of “Dr. Zhivago” seated in the front row at your local movie theater. That kind of constant neck-twisting should be considered an “enhanced interrogation” technique.

Mind you, it’s not your friends’ fault. They probably aren’t connecting the dots that an “inclined conversation” is painful and off-putting for you. (Like most common sense, that awareness isn’t all that common.) Heck, I freely admit someone had to tell me when I entered the industry that I should make sure I talked eye-to-eye with mobility users.

But that’s daily life for your typical mobility user. In fact, as my friend and colleague, Laurie Watanabe, the editor of Mobility Management magazine, points out, the constant neck craning forced upon mobility users can result in stress injuries and ailments to the neck and shoulders. They’re almost commonplace.

That’s not right. In fact, I find it literally cruel — and not just in terms of physical pain an inconvenience. Human beings are social animals. Our wellbeing depends on carrying on interactions with our fellow humans on familiar and equal terms, and being relegated to a diminutive position makes it almost impossible to fully establish those human connections.

That’s why industry vendors have been doggedly developing and perfecting elevation systems for standard power mobility devices and complex rehab chairs for years. A good example is Pride Mobility Products and Quantum Rehab. We first started seeing Quantum’s Q6 CRT chair get the i-Level elevation upgrade in 2015. It’s power elevation on steroids, with the ability to negotiate angled surfaces at speed while still elevated. Less than two years later, Pride was offering the Jazzy Air with an elevation option. Pretty much the full spectrum of mobility needs had a power elevation option.

And yet Medicare will not fund this technology. There are some private payer, state Medicaid programs, the VA and other non-Medicare funding sources for power elevation, but not when it comes to the biggest public payer. That continued reticence on Medicare’s part to fund power elevation leaves me puzzled and perturbed.

Innovation is not a static thing. When we as a society develop technologies, there is an early adopter phase, and over time — sometimes quickly, sometimes slowly — that innovation’s use becomes more common. Then its use becomes ubiquitous, and it very quickly becomes a necessity, rather than an option.

Let me use a non-HME example. Some of you might now that I used to edit magazines for the telecommunications industry. Well, the telephone is a perfect case example. In the 1830s, the telegraph was high tech; the domain of the wealthy, big business, and governments. Within three decades, sending telegraphs was commonplace. At the same time, the telephone entered a phase of rapid technological development and by the turn of the century, hand crank phones were commonplace. By the 1930s, standard rotary phones had passed the point of ubiquity to that of necessity.

And now? Now you have the ability to produce a television network news segment from your pocket.

Again, innovation is not static. The discussion and debate over power elevation has gone on for more than a decade, and every expert in the field recognizes that the technology aids in transfers, increases safety, reduces stress injuries, helps with daily activities, and improves social interaction.

It’s time for Medicare to rise to the occasion (I apologize; there was no way I could avoid using that terrible pun), and start funding power elevation for its beneficiaries. Forcing Medicare to adopt and support this innovation should be a top priority for the industry.

This article originally appeared in the April 2018 issue of HME Business.