Not-so-cheap sleeps: expensive beds drive a wedge in workers' comp programs: when beds were made of slats and springs and cost a few hundred dollars, tacking the cost of a bed onto an insurance bill was a no-brainer. But with some beds costing as much as $30,000, it pays to think twice before signing on the dotted line

Risk & Insurance, Sept 1, 2004 by Thomas G. Dolan

Mankind's most popular healing tool, a good bed, isn't always covered by workers' compensation insurance. That's not necessarily because compensation bean counters are obsessed with pinching pennies. It's because some beds--costing as much as $30,000--don't come cheap.

"We definitely provide coverage for workers' compensation and sometimes also for our insurance program," says Susan Lake, a workers' compensation coordinator for the County of Missoula in Montana.

But for Jason Smitherman, a risk manager for Oklahoma City, asking insurance companies to cover high-tech beds is not an open-and-shut case.

"Like any medical equipment, motor scooters, wheelchairs, equipping vehicles, we depend upon doctors and ease managers to advise us," he says. "We look at the therapeutic outcomes, and whether it's cost justified."

Forget the standard hospital beds that, at the push of a button, raise the patient from a prone to a sitting position, or elevate the head or legs. The past decade has seen important developments in bedding technologies, according to vendors. Newer beds turn patients from side to side, says Anthony DaCosta, a representative for Pro Bed Medical Technology, a Canada-based vendor.

Then there are the specialty beds. One such bed--42 to 60 inches wide and 84 inches long--is designed for obese patients. It supports people who weigh as much as 1,000 pounds.

"Sometimes a patient will see a product on TV and want it, but it might not be that important for the clinical outcome," said Sally Byrnes, a nurse with PharmaComplete Special Sales, PMSI, in Tampa. "I have to look at the diagnoses and the clinical goals and outcomes intended for each particular ease. Sometimes I'll approve a bed, and sometimes not."

Another specialty bed is the percussion bed for respiratory conditions. The upper body lays on an air system that vibrates, dislodging matter in the lungs. Then there are the mattresses, which themselves offer a host of technological improvements designed to speed recovery and return-to-work.

"There is no single standard," says Rick Fontaine, director of regulatory affairs for the medical division of Temper-Pedic, a Kentucky-based maker of mattresses. "Some workers' comp programs cover the bedding absolutely, and regard it as a part of a rehabilitation program. Some do not. Regions of the country differ from one another in this regard. Sometimes within the same company, one branch in one part of the country will cover it, and in another branch in another part of the country it will not be covered."