In a time of change……………maintaining our ability as therapy providers to ensure adequate patient care can be a challenge. As Physical, Occupational and Speech Language Pathologists our focus is on restoring function and improving quality of life. As reimbursement requirements continue to change in the current political environment it is increasingly apparent that as therapy providers we will need to come up with creative ways to provide needed services and advocate for therapy more vigorously than ever!
Skilled therapy has a vital role to play in quality of care in the long term care environment. It is often the advocacy of the therapist that promotes services conducive to returning a resident to prior level of function (PLOF) and ensuring a safe return home. This advocacy has many levels — political advocacy is crucial in repairing deficits in insurance coverage that negatively impact a residents quality of life in, including the continuation of the Manual Medical Review for those Medicare patients that reach the $3700 part B threshold. Many of these cases are being denied continued coverage. It is imperative that we write letters, send emails, make phone calls and generate discussions with our state and national policy makers! Do not think that one person will not make a difference. If all the individual care givers in our long term care industry make contact the impact would be great! In addition, advocacy directed at other members of the health care c community can have positive results — make an effort to frequently educate physicians,intermediaries and billing personnel, etc. The more we educate others in the value of providing therapy services to the elderly, the increased support we will have with referrals and supporting documentation. Provide outcomes, generate good, provide ongoing communication and be specific as to how therapy services impacted the resident.
Clinically, what can we do to ensure we are providing appropriate services given current reimbursement challenges…………..think outside the box and clearly define our service delivery in the changing health care environment. Adding clinical programs for Occupational, Physical and Speech Therapy that have positive impact on our client population and reach a greater number of residents with therapy needs is the Clinical initiative for Functional Pathways for 2013. If you would like further information on these initiatives, please contact Cherie Rowell, Director of Clinical Services, Functional Pathways at firstname.lastname@example.org.