Showing posts from February, 2018

Analysis of occupational therapy leadership statements on student debt and the doctoral mandate

The occupational therapy profession is joining the credential inflation bandwagon through the mandate of its membership organization AOTA and its educational accrediting subgroup ACOTE.  Proposals are in place to advance the entry level for occupational therapists to the doctoral level .  A companion proposal to advance the entry level for occupational therapy assistants to the baccalaureate level has been made but is in temporary abeyance . It is important to analyze the statements of the leaders and future leaders of these groups in order to understand their positions on these topics.  Additionally, it is important to hold leaders accountable for their statements. 1. When queried about the impact of credential inflation in the occupational therapy profession to the doctoral entry level, AOTA President Elect Wendy Hildenbrand made several statements related to costs that require analysis.  She stated  I’m not a fan of the escalating cost of higher education generally,

Selective use of statistics to support a flawed advocacy position on Medicare therapy cap repeal

This is a recurring theme - what should occupational therapists focus on when they are making decisions about services?  Should they focus on the people that need services, or should they focus on the amount of money being spent? These ethical choices have been discussed in this blog before. This question also applies to the latest situation with the repeal of the Medicare therapy cap and the resultant payment differential that has been applied to OTAs. When attempting to develop an advocacy position - should the occupational therapy profession measure impact in terms of lives affected or in dollars spent?  Here is an analysis of how the professional association is cherry-picking statistics in order to suit their chosen advocacy position. Perhaps we can call this analysis "A Tale of Two Table Fours" Here is Table 4 from the Moran Company Report, commissioned by AOTA to look at the Medicare cap issue. The RED information indicates the numbers of people (benef

When your honey-do list involves analysis of Medicare expenditures

The title explains my role in all this fully. A rather complex report was commissioned by AOTA that involved data related to the distribution of fee for service therapy spending in the Medicare program, as well as how different cap thresholds would impact the system.  The report also breaks out information about where spending is happening based on place of service. Now the reason why I was given this task is because if you read the report, and my first paragraph, your eyes might already be glazed over.  My purpose will be to put all of this in very plain language. Here are the three primary takeaways from this report, and I will provide the detail below each statement: 1. The 'cap problem' impacted PT significantly more than it impacted OT. The reason why the 'cap problem' impacts PT significantly more than it impacts OT is based on volume.  Of all the Medicare patients out there who use Part B services, 90% of them get PT.  By contrast, of all the Medica

The curious incident of the changing dates and content of web pages.

I was a little surprised to see a message from AOTA today that states After the late-night release of the bill, the following day, Tuesday February 6, while the Senate was still creating its version of the budget package, AOTA reached out to our Congressional champions to oppose these provisions, and, alongside the American Physical Therapy Association, proposed alternatives to the OTA provision—alternatives that would have stopped its adoption or minimized its impact. Additionally, on Tuesday AOTA changed all grassroots advocacy messages related to the repeal of the therapy cap, to include details of the OTA payment changes.  This was surprising to me because I read every available piece of documentation on this as it was unfolding and I did not recall seeing any such messaging.  In fact, I was so distressed that AOTA did not inform anyone that I wrote a blog post about it . I was surprised to go back today and re-read the AOTA 'messages' and I was surprised to find