10 Years: Perspectives from the Industry

Julie Piriano: From Re/hab to Complex Rehab, Decades of Advancement

Julie PirianoEarly in my career, I evaluated thousands of individuals with disabilities and mobility challenges as a clinician working in a seating clinic. There were not very many products to choose from and little research to back up what we knew to be the correct way to meet an individual’s needs. However, there was sufficient funding for clinicians and providers to take the time we needed to get it right and to fix our mistakes when we didn’t.

Every year was a whirlwind of change with new and improved products, technology advances and innovative developments occurring throughout the emerging rehab industry. Having spent many hours making one-off solutions for my patients, I left the clinical setting to design and develop numerous product solutions. Thankfully, there were others who also had their sights set on establishing the research and education to continue moving this industry forward.

As the rehab industry moved into the new millennium, I was fortunate to be given the opportunity to manage others who were performing the skilled professional services rendered by a complex rehab provider. There were a multitude of products to choose from, a growing body of knowledge to draw from, and reimbursement was stable.

Then came 2003 and Operation Wheeler-Dealer. The growing controversy surrounding the small group of unethical “providers” soon grew to epic proportions and cast its shadow across the whole industry. Despite the challenges created by the negative perception of the industry and the knee-jerk reactions that still impact us today, I think it made the complex rehab industry stronger. It ignited a fire in the people who were in the business for the right reasons and provided fuel for further advancement. During this time, I became responsible for the assessment and compliance of payor documentation requirements for reimbursement of complex rehab equipment. While this presented some inherent challenges due to reduced reimbursement rates, it was clear early on that complex rehab had many of the processes and procedures in place to succeed.

The challenges the industry has faced proved to be the driving force in a call for change and fair treatment of all complex rehab stakeholders. Patients, clinicians, providers and manufacturers who have engaged in a team approach to complex seating and wheeled mobility intervention have known for years they were utilizing a “best practices” model. The complex rehab industry had the pieces in place to achieve the principal goal of meeting the patient’s needs with quality product solutions. Success became a matter of educating policy makers about the important work we do.

It is exciting that we are now embarking on a separate benefit for complex rehab that will better define the policies that govern coding, coverage and payment for these products and associated services. I have been fortunate to advocate for access to appropriate seating and wheeled mobility products for more than 27 years, and I have never been more excited about the direction of the complex rehab industry, or the possibilities that lie ahead, than I am today.

About the Author

Julie Piriano, PT, ATP/SMS, is the director of rehab industry aff airs for Pride Mobility Products Corp. and sits on MM’s editorial advisory board.


This article originally appeared in the October 2011 issue of Mobility Management.

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