Access to complex rehab technology — medically necessary, individually configured wheelchairs, seating systems and components — continues to be threatened by Medicare reimbursement cutbacks. Because private insurance companies tend to use Medicare policies as guidelines, this affects all wheelchair users. Yet there is a widespread misconception that complex durable medical equipment is overpriced. People sometimes compare the price of high-end power and manual chairs and components to cars and bicycles. Quite simply, these are apples-to-oranges comparisons. To clarify the issue, we looked at some of the expenses involved in bringing complex rehab DME from original concept to the end user.

Research, development and design is the first step in creating equipment that addresses the orthotic support, proper fit, and skin protection that is so important to wheelchair users every day. “Complex rehab products are not commodity items that you pull off a shelf,” says C5-6 quad Josh Anderson, vice president of marketing for Permobil and former head of product management and marketing for TiLite. “Whether it’s a manual chair custom made for an individual or a custom-fit power chair where you can dial everything in to an exact fit — like a controller or a headrest that is specific to a person’s needs — the design of each part is about maximizing ability. It has to fit the person like an orthosis.”