What does the affordable care act mean for Therapy Professionals?

Since Obama won the 2012 election, speculation about whether or not the Affordable Care Act (ACA) would be repealed has ceased. Instead, healthcare providers are continuing to figure out how to adjust to the new regulations as implementation deadlines are looming ever closer.

PT Solutions works with a cross section of rehabilitation providers; from independent out patient clinics to large regional healthcare systems. We’d love to hear from you about the changes that your organization is making to adjust to the new regulations.

For an in-depth explanation and analysis of this issue, we recommend taking 49 minutes to watch the following webinar, which is posted by Advance Magazine: Physical Therapy and Health Care Reform: A Check-up One Year after Passage , presented by Justin Moore, PT, DPT, vice president, government affairs and payment policy, American Physical Therapy Association, Alexandria, VA.

For a less time consuming option, we’d like to share some observations, based on our experiences, that might help you prepare for what’s to come. We’ve noticed four main ways that the ACA is effecting therapy professionals.

INCREASED DEMAND FOR THERAPY SERVICES.
Thanks to the hard work of our APTA lobbyists, we should soon be seeing more insured patients coming thru our doors.

One of the 10 essential benefits included in the new health care exchanges are “rehabilitation” and “habilitation” services. These services will have to be offered by every new health care exchange. Although legislators are still definining what exactly “rehabilitation” and “habilitation” services include, and co pays and reimbursements for these services will continue to vary, the fact that physical rehabilitation is included as an essential benefit is a huge victory for therapy providers.

In spite all of the uncertainty surrounding reimbursement, the demand for rehabilitation services will continue to grow. According to the United States Bureau of Labor Statistics, from 2010-2020, the following therapy professions are expected to grow at the following rates:

• Physical Therapist jobs (39%)
• Physical Therapist Assistant jobs,(46%)
• Occupational Therapy jobs (33%)
• Certified Occupational Therapy Jobs (41%)
• Speech Language Pathologist Jobs (23%)

INCREASED EFFICIENCY AND PRODUCTIVITY EXPECTATIONS.
There’s no way around it. What used to be only an issue for large organizations with lots of overhead to cover, is now becoming a concern for every rehabilitation provider. In the face of looming cuts in reimbursement, health care providers are asking their clinicians to see more patients each day. According to the APTA’s 2009 PT Productivity Summary Report, therapists in an acute care setting, who spent over 76% of their time in direct patient care, saw a median caseload of 30 patients a week ( 6 patients a day). We recently watched a large hospital system increase their minimum daily patient case load expectation to 9 patients a day. Staff had to adapt to the increased expectations or choose to find different employment. Therapist’s jobs are increasingly stressful as they juggle patient care, documentation, and interruptions; such as patient cancellations and in service meetings. Therapists are adapting and finding new ways to be even more efficient in their patient care.

HIGHER COMPUTER REPORTING AND DOCUMENTATION EXPECTATIONS
The Affordable Care Act’s increased emphasis on reporting outcomes ensures that computer documentation is here to stay. As computer documentation plays a larger and larger role in the therapist’s job description, employers have begun to measure a therapist’s success based on how quickly they adapt to new technologies. One of our home health agencies recently decided to dismiss a therapist, not because of her patient management skills, but because she was too slow with her computer documentation.

LARGER EMPLOYERS.
ACA’s “bundling” requires health care providers to offer a “continuum of care,” in order to receive reimbursement for patient services. Mergers and acquisitions will continue as health care providers figure out how to make ends meet with this new system. According to the APTA’s 2010 Physical Therapist Member Demographic Profile, 14.4% of all therapists work in a inpatient hospital setting. Of the therapists who work in out patient settings, 38% work in hospital owned clinics and 62% work in privately owned clinics. For those who are currently working for a hospital based system, those systems continue to become larger and larger and function more like corporations than like non profit organizations. Privately owned therapy practices have to compete with health care systems that seem to have a monopoly in a surrounding region.

Currently it seems as though there is enough demand for services to keep both the privately owned and the corporately owned clinics in business, inspite of ACA changes. Therapy providers are expanding locations and positioning themselves to capture the newly insured patients entering the market.

If these trends match your experience, or if you have other insights that might help our readers understand what changes to expect, please comment below. We’d love to hear from you.