Effects of Billing Medicaid for Occupational Therapy Services in the Schools: A Pilot Study

402

342

Since silence implies compliance with the status quo, the authors encourage occupational therapists to develop their own dialogue about occupational injustices in order to address them openly with others. Dialogue about occupational justice is timely as occupational therapists around the world articulate what distinguishes this numerically small, rather invisible profession and its contributions to individuals, populations, and societies.

Section: Literature Reviewmentioning

confidence: 99%

Occupationaljustice and Client-Centred Practice: A Dialogue in Progress

Townsend¹,

Wilcock²

2004

402

342

“…However, Medicaid was intended for medically-related, not educationally-related occupational therapy services. This forces service providers to use a medical model and potentially limits the therapist's ability to provide services to children who are not eligible for Medicaid and yet require occupational therapy (Royeen, Duncan, Crabtree, Richards & Clark, 2000).…”

Section: Use Of Theory and Determination Of Treatment Prioritiesmentioning

confidence: 99%

The Impact of Reimbursement Systems on Occupational Therapy Practice in Canada and the United States of America

Jongbloed¹,

Wendland²

2002

Different funding and cost-control mechanisms in Canada and the United States of America (USA) have a powerful influence on occupational therapy practice in each country. Canada's public health insurance system emphasizes access to health care services based on medical need. Costs are controlled at the provincial government level by limiting the capacity of facilities and personnel. Occupational therapists in publicly-funded settings have considerable professional autonomy to use occupational therapy theoretical models and to be client-centred. The measurement of outcomes is not always required and the interventions of individual occupational therapists are infrequently scrutinized. The USA has no universal, publicly-funded, comprehensive health insurance. Health care policies are driven by financial priorities and cost control occurs at the service delivery level. Insurance companies define the scope of occupational therapy practice by identifying what services they will pay for and they scrutinize occupational therapy interventions. The emphasis on effectiveness and efficiency leads to critical examination of interventions by therapists. Canadian occupational therapists can learn much from their colleagues in the USA in this area.

“…This is one example of a perceived misalignment between policy directives and occupational therapy values. A number of studies from the United States examined the implementation of new payment schemes and the implications for occupational therapy practice and pointed to the same direction of misalignment between client-centredness and fee for service policies, for instance (Fisher & Friesema, 2013; Royeen, Duncan, Crabtree, Richards, & Clark, 2000). In these cases, the call for action is for occupational therapists to become involved in the policy process to influence the way policies are shaped to prevent this type of misalignment between actual policies and occupational therapy practice values.…”

Section: Resultsmentioning

confidence: 99%

Examining the intersection of policy and occupational therapy: A scoping review

Lencucha¹,

Shikako‐Thomas²

2019

Background. Policy has direct bearing on occupational therapy practice and is a key dimension of the environment. To date, there has not been a synthesis of how policy is addressed in the occupational therapy literature. Purpose. The purpose of this review is to identify and analyze the ways that policy is addressed in the occupational therapy literature. Method. We conducted a scoping review of literature on policy and occupational therapy. Articles were analyzed deductively using a policy framework and inductively to identify overarching themes. Findings. Sixty-four papers were included for analysis. We present the descriptive information of the included articles according to policy type, sphere of action, stage of policy development, level, and actors. The qualitative analysis uncovered two broad concepts: “awareness” about the relationship between policy and practice and messages pertaining to “action.” Implications. There are numerous areas for further research into the policy–occupational therapy nexus, as policy has numerous pathways to shape practice. Practitioners will benefit from better understanding these pathways and actively engaging to align policy with the values of the profession.