Power wheelchair vendors: Declines in rural market activity.

BACKGROUND

Power wheelchair access and maintenance are important for older adults with mobility limitations. Traditional Medicare regulates wheelchair vendors through a competitive bidding program and prior authorization requirements potentially affecting market activity.

OBJECTIVES

This observational study assesses changes in power wheelchair sales, rentals, and repairs by rurality over time.

METHODS

We used aggregated traditional Medicare power wheelchair claims from 2015 through 2022 to calculate annual vendor counts and per-vendor rates of sales, rentals, repairs, and accessory sales, comparing trends between rural and urban vendors.

RESULTS

The number of traditional Medicare wheelchair vendors shrank from over 1292 (918 urban; 374 rural) to 986 (804 urban; 182 rural) between 2015 and 2022. The number of rentals per vendor decreased among urban vendors (322 in 2015 to 178 in 2022) but stayed more consistent among rural vendors (69 in 2015 to 66 in 2022). In contrast, sales per vendor increased among urban vendors (8.7 in 2015 to 16.7 in 2022) and remained low among rural vendors (0.6 in 2015 to 1.4 in 2022). The disparity in repairs performed per wheelchair sale or rental among urban and rural wheelchair vendors grew between 2015 (0.32 for urban; 0.31 for rural) and 2022 (0.44 for urban; 0.18 for rural).

CONCLUSIONS

Between 2015 and 2022, traditional Medicare experienced changes in power wheelchair vendor participation and patterns of sales, rentals, and repairs, with more pronounced declines in repair activity among rural vendors. Policies regulating the power wheelchair market should consider wheelchair access and maintenance in rural areas.