Let’s get educational

Thursday, July 31, 2008

WATERLOO, Iowa--The VGM Group already has a reputation for solid educational programming, but if Elizabeth Cole has anything to do with, it’s only going to get better. U.S. Rehab, a division of VGM, brought Cole on board in May as director of clinical rehab services. In her new role, Cole, a physical therapist, will add a clinical bent to VGM’s existing educational programming and help develop new programming, especially for rehab providers. Cole, who worked most recently for the consulting firm The Orion Group and wheelchair manufacturer Sunrise Medical, spoke with HME News in June about the rehab landscape, including national competitive bidding.

HME News: What’s the biggest educational need out there?

Elizabeth Cole: There are a lot of new providers coming into the market, like technicians looking to become RTSs, who need basic info. There used to be a lot of that around, but manufacturers have kind of whittled down their programs. Then there’s always a need for more advanced courses. Even seasoned professionals have to maintain CEUs. Developing those courses is always a challenge, because they’re the experts. There’s even a need for education for case managers. If they don’t understand the types of products and why they’re needed, that can be a problem. I want to get out there and talk to these different groups of people to find out what they need to become more knowledgeable-and profitable.

HME: With shrinking reimbursement, are providers spending money on education?

Cole: We’re trying to get education to them in a way that’s affordable and convenient. We’re looking to put more courses online because we know providers don’t have the time or money to travel. It’s a matter of figuring out where it’s important to do things in person and where we can do things online.

HME: You started off in this industry in 1985. How have you seen things change?

Cole: One of the biggest changes has been technology. When I first started, it was easy. There were only a couple of different wheelchairs and basic electronics to choose from. There have been huge leaps in sophistication. The seating used to be plywood foam naugahyde; now it has shape and contours and it’s made of high-tech materials. There’s a huge difference in the level of assistance we can give people with disabilities. Unfortunately, there have also been big changes in reimbursement that, often, are at odds with technology.

HME: Is that providers’ biggest obstacle: reimbursement?

Cole: Again, when I first started, we were in the age of the golden commode and it was easier to get what people needed. Now Medicare coverage criteria has gotten tighter and documentation requirements have gotten stricter. Also, in the past few years, a lot of the Medicaid programs and private insurances started following Medicare, instead of doing their own thing. It used to be, if someone had Medicaid or private insurance, there were more possibilities, but not anymore.

HME: Is there anything providers can do about reimbursement?

Cole: One of the successes of the past few years has been the industry really coming together and saying, “We’re not going to take this anymore.” Every provider and clinician has a responsibility to be involved in industry lobbying efforts.

HME: What does the future hold for rehab?

Cole: It really depends on whether competitive bidding continues to include complex rehab. If it does, unfortunately, in many cases, it will mean patients getting equipment that’s not appropriate and providers, even contract providers, going out of business. You can have a contract provider and he can be a good provider, but if the bid’s so low that he can’t afford to provide quality equipment, it doesn’t matter. It will change the face of things.