Dr. Kevin Wong's Research Leads to Major Medicare Policy Change
In 2018, while attending the American Physical Therapy Association (APTA) national conference, Dr. Wong held the elevator door open for an individual using a cane. Striking up a conversation, they discussed his research and opinions on prosthetic technology and their benefits. Remarkably, that individual was at the conference to engage in timely discussions about Medicare policy. This year, Medicare is poised to adopt new guidelines to approve microprocessor knees for K2-level users.
Previously, the prosthetics individuals received were largely determined by Medicare rules, which assigned more advanced technology to those with the highest functional levels, known as K-levels. Although not bound to adhere to Medicare rules, coverage policies for private insurance and even countries with universal healthcare closely follow Medicare's K-level criteria. As a result, older individuals with lower functional levels (K2) and a higher likelihood of falling were unable to receive microprocessor knees. With the new Medicare guidelines, this is set to change, largely due to Dr. Wong's influential studies. Below, he discusses some of the research that contributed to this significant policy shift.
"My research established the Berg Balance Scale (BBS) as a reliable and valid balance assessment for people with lower limb loss across functional K-levels—since adopted worldwide as the standard—and as a determinant of falls in community dwelling lower limp prosthetic users. Subsequent research demonstrated that performance measures associated with falls could be positively modified through exercise and training with microprocessor knees. Additional work funded by the National Center for Advancing Translational Sciences via the Columbia University Irving institute Precision Medicine Award using remote step count monitoring led to a novel method of quantifying person-step fall and injury risk that incorporated risk exposure. Ultimately, my research was cited in the new 2024 LCD (local coverage determination), poised to be adopted, which approves microprocessor knee prostheses for people at the K2 functional level because of their fall prevention and stumble recovery features."