CRT Technology Showcase

U.S. Rehab White Paper Shows Need for Intervention

Getting an appointment to meet with a member of Congress or a Congressional staffer is the easy part; knowing what to say once you get to the meeting is more challenging. You have a very short time to get your message across: that losing access to complex rehab technology (CRT) is hurting the clients and families you serve every day.

What should your talking points be? What reading materials should you leave behind?

The VGM Group and its CRT division, U.S. Rehab, have the answer: an easy-to-digest, yet comprehensive white paper on CRT access, funding and the future.

The Cost of Lower-Quality CRT

The white paper, titled “The Delivery of DMEPOS Is in Jeopardy,” was written by U.S. Rehab President Greg Packer.

Packer systematically describes the impact of reimbursement rates, including reductions via Medicare’s competitive bidding program, on both seniors and people with severe and permanent disabilities. “DME and CRT are cost-saving programs when administered correctly,” Packer says in the paper. “With a reduction in selection along with quality of products and services due to price pressure, there will be an increase of the ancillary cost to other areas of the system over time, mainly in hospital readmissions and premature diseasestate deterioration.”

Packer argues that CRT clients are at greater risk of adverse effects due to their complex clinical issues.

“This patient population has much higher risk of destabilization with improper treatment or equipment,” he explains. “It is this improper treatment of equipment that increases lifetime healthcare cost and shifts expenses from the DME sector to another silo, sometimes leading to hospitalization and/or other medical complications.”

A Comprehensive Overview

The white paper reviews what has happened to both durable medical equipment (DME) and CRT providers — and their consumers — as Medicare has continued to cut funding. Packer described the impact on Medicare beneficiaries when DME suppliers go out of business, and what happens to CRT clients when only lower-quality, less functional products are covered by Medicare.

Packer told Mobility Management why U.S. Rehab and VGM chose a white paper as their vehicle.

“It is an unusual way, but we felt it was pretty important to inform people about the topics, as there are a lot of different topics and they’re very complex,” Packer said. “CRT spells it out in its name. It is not simple. It’s not just delivering something to a home, like Amazon does. It’s much more intricate and highly susceptible to issues if not done correctly.”

While VGM is a member service organization, Packer pointed out that VGM has close relationships with industry manufacturers, as well as DME consumers and CRT clients. For Capitol Hill visits, “when a manufacturer walks in, [legislators] say, ‘Well, they’ve got a stake in this.’ When a provider walks in, ‘They’ve got a different stake in this.’ When a patient walks in, ‘They’ve got a different stake in this.’

“We work to make sure that the effort is a team effort, that everybody is taken care of and that the delivery system works and can manage itself. With the funding cuts, it’s been more difficult to manage, so we feel this is very holistic, a 30,000-foot view that spells out why we’re where we are, how we got here and here’s some proof. That’s what I keep hearing when I go to D.C.: There needs to be proof.”

Packer knows that perspective first hand, having served three terms in the Kansas House of Representatives.

“When I was sitting in the legislative seat, I was trying to make decisions on things I understood very little about,” Packer said. “I’d have a lobbyist come in on the pro side, and I’d have a [lobbyist] on the con side come in. I would never hear the full story, and I would’ve loved to have had something that would have taken me 30 minutes or less to read, that could encompass the whole aspect of what was happening so I could make a very informed decision for my constituency, to make sure the people that it was serving were being served appropriately.”

Packer worked with VGM’s John Gallagher, Mark Higley and Tom Powers on the white paper, which VGM is making available for anyone in the industry to use (download it for free at “Our hope,” Packer said, “was to get the information at your fingertips so you didn’t have to go out and do a lot of research.”

The white paper is very readable, and at seven pages in length, is a valuable and viable “leave-behind” for policy-makers to study again later.

“This paper will be something that they can use in any instance,” Packer said. “There’s a lot of issues out there, and it brings them all to culmination so you can actually talk about them quickly and concisely.”

Even better, Packer said he’s working on additional white papers on such topics as K0009 manual chairs and ultralight titanium funding.

“We’re going to do some specific papers,” Packer confirmed. “I’m going to drill down into several areas before the end of the year.”

This article originally appeared in the October 2017 issue of Mobility Management.

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