If changes in healthcare policy continue then OT's will have to adapt to maintain their standard ...

1. Changes in healthcare since the 80's

1.1. shift towards privatization and corporatization of health care, capitation payments become the norm

1.1.1. managed care was designed to control, quality of health care and amount of reimbursement to providers

1.1.1.1. focus on cost control

1.2. Consolidated Omnibus Budge Reconciliation Act 1986, allowed former employees to stay in their previous employer's group health care plan, if they could afford it

1.3. rising costs associated with healthcare

1.3.1. expansion of managed health care helps to moderate increase in health care costs

1.4. Health Security Act 1993, mix of universal coverage

1.5. Health Insurance Portability and Accountability Act 1996 (HIPAA), provided privacy standards and restrictions on pre-exisiting conditions

1.6. Balanced Budget Act 1997, expanded medicaid assistance to uninsured children with incomes to high to qualify for medicaid

1.7. Medicare Part D 2003, update medicare to include prescription drug care

1.8. Affordable care act & pre-existing conditions 2008-2016, establish open market place, where insurance companies cannot deny coverage based on pre-existing conditions

1.8.1. transition to value-based reimbursement, ACA initiative

1.8.1.1. why we need to prove the value or our services, focus on using evidence based practices

2. Ways to maintain this standard of care

2.1. making sure to complete all documentation and take detailed therapy notes

2.2. stay educated and find the best evidence based practices to implement into intervention plans

2.3. consider changes in therapy (ie: virtual therapy) and stay consistent and document and highlight patients challenges and outcomes

2.4. define and practice high quality care, to demonstrate our unique value to the healthcare system

2.4.1. focus on patient centered care

2.4.2. be able to demonstrate our efficacy across settings

2.5. collaboration between clinicians, researches, and educators to define quality care measures

3. Health insurance changes are one of the most influencing factors that impact OT services

3.1. AOTA advocacy made significant changes to the health reform legislation involved in the ACA

3.1.1. achieved inclusion of rehabilitation and habilitations in the essential health benefits package