HME Experts: Industry Must Shape the Future of Equipment Reuse
ATLANTA–It’s an issue that can be sharply divisive in the HME
industry: equipment reuse.
On the one hand, reuse can be viewed as a way to get much-needed
equipment to people who would otherwise go without. On the other
are warnings about the dangers of faulty equipment and undermining
innovation from manufacturers who could be pushed out of the
marketplace from payers who are not buying new.
Jeremy Buzzell, a program specialist for the Washington-based
Rehabilitation Services Administration, works with grants and
programs designed to help more people with disabilities get
assistive technology through statewide programs. The RSA is a
division of the Office of Special Education and Rehabilitative
Services under the U.S. Department of Education.
Buzzell notes equipment reuse has been going on for a long time
in many parts of the country, in some cases for up to 25 years.
“It’s something that vendors and manufacturers of durable medical
equipment should be aware of,” he said.
According to a study by the Rehabilitation Engineering and
Assistive Technology Society of North America, there are 154
assistive technology reuse programs across the country this year.
Of those, 60 refurbish assistive technology, 45 reassign it and 26
run an exchange program. Of the remaining programs, 11 refurbish,
reassign and exchange devices; for the other 12, information is
incomplete.
From October 2005 through September 2006, according to the RSA,
24 states reported the reuse of 5,602 devices. Of those, 678 were
exchanged, 4,482 were reassigned and 442 were on long-term
loan.
Buzzell said while reuse has been around for decades, what’s new
is RSA’s focus on it, beginning in 2004 with the reauthorization of
the Assistive Technology Act. The department also works in
conjunction with President Bush’s 2001 New Freedom Initiative,
which, among other things, is intended to help people with
disabilities get access to assistive technologies and promote
increased access to community life.
Buzzell, who participated as a panelist in a Medtrade 2007
seminar on equipment reuse, said one of the concerns he hears from
DME suppliers and manufacturers is that reuse will hurt their
bottom line, not only by impacting new sales but from the fear of
liability issues.
As far as DME reuse hurting provider sales, Buzzell said, “A
majority of folks who go to a reuse program are uninsured, aren’t
qualified for Medicare or Medicaid or have no other option for DME,
so [they] wouldn’t be able to purchase DME anyway.”
Regarding liability, Buzzell said his department shares that
concern, which is why it has focused on ways to facilitate reuse
correctly and build partnerships with DMEs.
According to Buzzell, there are many advantages to DMEs getting
involved in equipment reuse. One is that they can collaborate with
reuse programs to ensure outgoing equipment is in good condition.
Another is that the programs offer a way for providers to get rid
of excess stock.
They’re also a donation venue: Providers can refer people who
need equipment but can’t pay for it to the programs, or donate
equipment that was given to the provider because someone no longer
needed it.
“Some of these programs benefit from vendors and manufacturers
who just volunteer their time and their expertise,” Buzzell says.
“The most successful ones that we have seen are ones where there is
some collaboration with the vendor community.”
A national collaborative for reuse is the Pass It On Center,
based in Atlanta. The center is also home to a national task force
on the matter that includes members from universities and industry
associations with a goal of “finding solutions to issues in AT
reuse.”
Rita Hostak, vice president of government relations, Sunrise
Medical, Longmont, Colo., and president of the National Coalition
for Assistive and Rehab Technology, was also a panelist at the
Medtrade session. She said initiatives like the Pass It On Center
will ensure that “issues are thoroughly investigated, data is
gathered to support informed decisions and guidance is published
that will go a long way in ensuring that reuse of DME is performed
in a responsible way, a way that is sustainable, and that strives
for a positive clinical outcome of each individual.”
In addition, Hostak said, “The Department of Education, Office
of Special Education and Rehabilitative Services is dedicated to
making sure steps are taken to identify good service/delivery
models.”
It’s not that simple, however. While noting the positive aspects
of reuse–that, for example, valuable and useful equipment that
might otherwise be abandoned somewhere can be given to people who
are uninsured or under-insured–Hostak also identified “a number of
logistical and financial issues” with the concept.
“If medical devices are not reassigned through a model that
ensures positive clinical outcomes for the individuals it serves,
then the good intentions are completely lost,” she said. “In
addition, there are FDA regulations that apply to medical devices
which cannot be overlooked. Moreover, if re-issuing is used as a
way to reduce health care budgets related to the provision of DME,
then there is a whole new set of negative consequences for
consumers, suppliers and manufacturers.”
According to Hostak, the HME industry must be proactively
involved in shaping the future of reuse.
“Reuse has the potential for doing harm to consumers as well as
suppliers and manufacturers,” Hostak says. “While there are
dedicated and thoughtful people like those involved in the Pass It
On Center and the national task force who are dedicated to
investigating all of the important issues and gathering the type of
data that will be necessary in controlling how reuse is applied,
the industry must be engaged and equally as dedicated to ensuring
the right outcome.”
Hostak said “now is the time” to work to ensure that, if
equipment is reused, it is “done appropriately and only in the
right circumstances.”
“We cannot just say no to reuse,” she said. “It is already
happening today to a much greater extent than most people are
aware.”
To visit the Pass It On Center Web site, go to
www.passitoncenter.org”.
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