The Past, Present and Unclear Future of Assistive Technology
Education & Research Understanding where assistive technology is headed requires an understanding of what it took to get here, as well as what’s standing in the way of progress.
Mediaplanet: What industry do you see the fastest development in assistive technology?
Tom Borcherding: The integration of technology within assistive technology device platforms. When you look at all the incredible technology that we all use in daily life, enabling assistive technology device platforms to integrate such technology and seamlessly interface from one device platform to another is under rapid development. This will allow the person reliant upon the technology to streamline his or her needs and devices, ultimately delivering better health and functional outcomes.
MP: What is the biggest innovation in the industry in the past ten years?
TB: The answer to this depends upon your perspective, since all areas of assistive technology have seen significant innovation over the past decade. If we narrow this question to the mobility device itself, the increase in the functionality of powered mobility bases has been dramatic.
Ten years ago, most power wheelchairs were rear wheel drive systems designed with the primary capability to move an individual driving the chair from point A to point B. Today’s power wheelchairs are designed with capabilities extending far beyond just mobility itself. They incorporate capabilities for improving functional posture and positioning. They incorporate integrated communication devices to allow a person to interact efficiently with their environment. They incorporate standing platforms that allow the individual using the chair to engage in face-to-face communications with their friends and family, and improve health outcomes in the process. Today’s power wheelchairs can be more accurately described as technology platforms rather than mobility devices.
MP: What will the big innovation be over the next ten years?
TB: I expect you will see a continuation of this convergence of technology, merging currently independent platforms of technology into a single common platform that encompasses mobility, seating, communication, safety and health outcomes.
"Unless something is done to stop the continued attacks and address the very near term funding cuts, end users will be faced with having to pay for much more of their complex rehabilitation and durable medical equipment needs out of pocket, or choose to go without."
A clear indication of this is the recently enacted Steve Gleason legislation, which makes speech generation devices more readily accessible to individuals with neurological disorders, supported by reimbursement eligibility through Medicare and Medicaid.
MP: What the most important thing our readers need to know about assistive technology?
TB: Access and reimbursement for such items is under growing, and continual attack in the United States. The promise of the Americans with Disabilities Act is threatened by a health insurance system that continually sees assistive technology as a place to cut funding in order to pay for other, much more expensive areas of health care. Even with all the recent advancements, we as an industry can do so much more with proper reimbursement and coverage. We’re barely scratching the surface. For example, currently all of the following exist or are in the midst of being considered or implemented:
Private insurance companies’ benefits for durable medical equipment, prosthetics and orthotics are normally very small or non-existent and often include a small, lifetime cap on payments. Some simply get around covering AT items by implementing non-covered benefit policy language.
Medicare has recently published a new policy for coverage and payment of orthotics and prosthetics, which, if implemented, would dramatically reduce access to a variety of items, including artificial limbs.
Medicare is in the midst of implementing a new payment rule (CMS 1614-F), which will significantly cut the rate it is willing to pay for complex rehabilitation wheelchair accessories and seating systems. This rule will go into effect on January 1, 2016 and will cut payment rates for these critically needed items by 10 to 25 percent.
Virtually all other payers follow Medicare’s lead. If Medicare implements the funding cuts discussed above it is very likely that all other payers will follow suit, and may actually cut funding for such items even further.
Ultimately, unless something is done to stop the continued attacks and address the very near term funding cuts, end users will be faced with having to pay for much more of their complex rehabilitation and durable medical equipment needs out of pocket, or choose to go without. We all have a high likelihood of needing or relying on these products at some point in our lives. We should be adding to—not subtracting from—this field in terms of coverage and investment. These technologies save countless health care dollars spent treating secondary complications if individuals are limited or denied the products and technology they need and deserve.