New and updated research from RRC (Bryan, Texas), an economics consulting firm, boosts the argument that provision of power wheelchairs or scooters for the mobility-impaired saves money for Medicare – even more money than the consulting firm first reported in a study issued last year.

RRC's initial analysis of actual Medicare claims data indicated an average savings of $5,300 for Medicare, over a three-year period per recipient, as a result of power vehicle use, "equating," it said, "to a potential savings of several billion dollars."

It said that the "refinements" of this initial analysis now indicate that the savings, after accounting for the cost of the power vehicle, can run as high as $8,760 over a three-year period, amounting to a savings roughly 65% higher than the firm's previous calculations.

The new findings, RRC said, "highlight the fruits of assisting the truly mobility-impaired with power vehicles."

The conclusion, of course, is one that boosts the power mobility sector, as well as giving strong support to the proposed changes in reimbursement guidelines for the mobility systems under consideration by the Centers for Medicare & Medicaid Services (CMS; Baltimore).

Clifford Fry, PhD, executive vice president of RRC and an author of the study, told Medical Device Daily that the company's initial study data were gathered and reported as a contract effort with The Scooter Store (New Braunfels, Texas), one of the providers of power mobility vehicles.

The research work came in the wake of the crackdown by CMS on alleged fraudulent claims for the mobility devices – an effort dubbed by CMS "Operation Wheeler Dealer."

But Fry said that RRC's revision of the data, and the new savings data derived, was done independently as a way of following up on the "sensitivity" of the original study.

RRC put its initial study and data "on the back burner for awhile," he said, but "then decided we'd done a lot of work on this and wanted to make sure that the results weren't peculiar to one particular specification that doesn't hold up."

While he acknowledged that the revised effort was easier than "starting from scratch," he noted the difficulty of sorting through the vast amount of information in the CMS claims statistics database, primarily its Standard Analytical Files. "Its sheer size makes it difficult," he said.

Fry said he and the other study authors continued to test the accuracy of the earlier results by using alternative statistical approaches to identify the control group – those Medicare beneficiaries without power vehicles but physically comparable to those who received power vehicles.

The analysis determined who should be in the control group and when those in the control group become eligible for a power vehicle. Subsequent Medicare expenditures were then analyzed for those with power vehicles and for those "assigned" a power vehicle in the control group.

The refined requirements for entering the control group decreased the number of people identified for that group, RRC said. The more stringent requirements resulted in an increase in the relative savings for the "true recipients" of power vehicles – that is, the revised higher savings figure of $8,760.

By using the refined control group for comparing expenditures, the potential average savings are as high as $679.78 per quarter for each recipient of a power vehicle, RRC said. The initial report of savings per quarter for Medicare was $349.71 per recipient.

RRC's study showed that savings to Medicare begin in the year in which the power vehicle is acquired and continue to accumulate for at least a three-year period.

Fry said that the main purpose of the study was to look at costs and potential savings, and not specifically at the reason for those savings, but he offered for MDD, strictly "in the speculation area," some "anecdotal evidence" concerning the source of reduced costs.

Primarily, he said, disabled individuals who remain more mobile also are likely to remain healthier and thus require fewer hospitalizations.

"The findings are consistent with the idea that these people [using mobility vehicles] fall and break their hips a lot less," Fry said. And over the longer term, greater mobility "may keep them out of skilled nursing facilities longer."

The study notes other research indicating that greater self-sufficiency for the disabled is associated with lower Medicare expenditures, but it provides the caveat that the "exact causes of these savings await further research."

Fry said that the company is developing the new study as an article to be submitted to a peer-reviewed journal.

He noted that RRC does a good deal of research for the American Dental Association (Chicago), concerning policy issues and costs in that sector.

In business for 25 years, RRC's consulting efforts "are more research-oriented," he said, than providing an internal examination of an organization's activities.