The effect of third-party payers on the clinical decision making of physical therapists

Occupational Therapist Home Evaluations: Inequalities, But Doing the Best We Can?

“…The results of this study highlight the very real constraints occupational therapists operate under in daily practice and support the findings of similar research reported in the physical therapy literature (Uili & Wood, 1995). Factors such as third-party payer exert a daily influence on a therapist's ability to provide optimal rehabilitation for his or her patients, because "optimal" is defined within the constraints of "the patient's ability to pay."…”

“…Many occupational therapists who work in inner-city environments already pursue alternative modes of funding to implement home safety recommendations (Pynoos, Tabbarah, Angelelli, & Demiere, 1998). Another strategy is to learn and employ the specific rules and documentation language of insurance companies so that occupational therapy interventions have the best chance of being accepted by payers (Uili & Wood, 1995). These strategies may be useful to address some of the inequalities highlighted in this study, but they can only be effective at the level of the individual.…”

Occupational Therapist Home Evaluations: Inequalities, But Doing the Best We Can?

“…The results of this study highlight the very real constraints occupational therapists operate under in daily practice and support the findings of similar research reported in the physical therapy literature (Uili & Wood, 1995). Factors such as third-party payer exert a daily influence on a therapist's ability to provide optimal rehabilitation for his or her patients, because "optimal" is defined within the constraints of "the patient's ability to pay."…”

“…Many occupational therapists who work in inner-city environments already pursue alternative modes of funding to implement home safety recommendations (Pynoos, Tabbarah, Angelelli, & Demiere, 1998). Another strategy is to learn and employ the specific rules and documentation language of insurance companies so that occupational therapy interventions have the best chance of being accepted by payers (Uili & Wood, 1995). These strategies may be useful to address some of the inequalities highlighted in this study, but they can only be effective at the level of the individual.…”

Factors Predicting Discharge Disposition Following Head and Neck Free Flap Reconstruction

“…Our results support this finding, as patients who lacked family support were significantly more likely to be discharged to IPR, insinuating not only lack of aid at home but also lack of a support system for decision‐making. Another study by Uili and Wood showed that the patient's potential for meaningful, rapid, and measurable improvement; prior level of function; and the acuity of the condition were all determinants of the level of care recommended by physical and occupational therapists 12 . Although all patients in our study were undergoing a similar procedure type that involved comparable postoperative status, we did find that the existing need for assistance for activities of daily living and presence of baseline cognitive problems were significantly associated with discharge to IPR.…”

Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care? Results of a qualitative study

“…For example, an American study showed that policies set by Medicare aiming to rationalize and downsize rehabilitation costs influenced physiotherapists’ clinical decisions [34]. In the same vein, the establishment of a therapy threshold for PT care within the US Medicare prospective payment system (i.e., imposition of a maximum reimbursement cap of 10 sessions) led to ethical struggles and affected therapy practice patterns [35].…”

Occupational Therapist Home Evaluations: Inequalities, But Doing the Best We Can?

“…The results of this study highlight the very real constraints occupational therapists operate under in daily practice and support the findings of similar research reported in the physical therapy literature (Uili & Wood, 1995). Factors such as third-party payer exert a daily influence on a therapist's ability to provide optimal rehabilitation for his or her patients, because "optimal" is defined within the constraints of "the patient's ability to pay."…”

“…Many occupational therapists who work in inner-city environments already pursue alternative modes of funding to implement home safety recommendations (Pynoos, Tabbarah, Angelelli, & Demiere, 1998). Another strategy is to learn and employ the specific rules and documentation language of insurance companies so that occupational therapy interventions have the best chance of being accepted by payers (Uili & Wood, 1995). These strategies may be useful to address some of the inequalities highlighted in this study, but they can only be effective at the level of the individual.…”

Factors Predicting Discharge Disposition Following Head and Neck Free Flap Reconstruction

“…Our results support this finding, as patients who lacked family support were significantly more likely to be discharged to IPR, insinuating not only lack of aid at home but also lack of a support system for decision‐making. Another study by Uili and Wood showed that the patient's potential for meaningful, rapid, and measurable improvement; prior level of function; and the acuity of the condition were all determinants of the level of care recommended by physical and occupational therapists 12 . Although all patients in our study were undergoing a similar procedure type that involved comparable postoperative status, we did find that the existing need for assistance for activities of daily living and presence of baseline cognitive problems were significantly associated with discharge to IPR.…”

Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care? Results of a qualitative study

“…For example, an American study showed that policies set by Medicare aiming to rationalize and downsize rehabilitation costs influenced physiotherapists’ clinical decisions [34]. In the same vein, the establishment of a therapy threshold for PT care within the US Medicare prospective payment system (i.e., imposition of a maximum reimbursement cap of 10 sessions) led to ethical struggles and affected therapy practice patterns [35].…”

Occupational Therapist Home Evaluations: Inequalities, But Doing the Best We Can?

“…The results of this study highlight the very real constraints occupational therapists operate under in daily practice and support the findings of similar research reported in the physical therapy literature (Uili & Wood, 1995). Factors such as third-party payer exert a daily influence on a therapist's ability to provide optimal rehabilitation for his or her patients, because "optimal" is defined within the constraints of "the patient's ability to pay."…”

“…Many occupational therapists who work in inner-city environments already pursue alternative modes of funding to implement home safety recommendations (Pynoos, Tabbarah, Angelelli, & Demiere, 1998). Another strategy is to learn and employ the specific rules and documentation language of insurance companies so that occupational therapy interventions have the best chance of being accepted by payers (Uili & Wood, 1995). These strategies may be useful to address some of the inequalities highlighted in this study, but they can only be effective at the level of the individual.…”

Factors Predicting Discharge Disposition Following Head and Neck Free Flap Reconstruction

“…Our results support this finding, as patients who lacked family support were significantly more likely to be discharged to IPR, insinuating not only lack of aid at home but also lack of a support system for decision‐making. Another study by Uili and Wood showed that the patient's potential for meaningful, rapid, and measurable improvement; prior level of function; and the acuity of the condition were all determinants of the level of care recommended by physical and occupational therapists 12 . Although all patients in our study were undergoing a similar procedure type that involved comparable postoperative status, we did find that the existing need for assistance for activities of daily living and presence of baseline cognitive problems were significantly associated with discharge to IPR.…”

Physiotherapy for injured workers in Canada: are insurers’ and clinics’ policies threatening good quality and equity of care? Results of a qualitative study

“…For example, an American study showed that policies set by Medicare aiming to rationalize and downsize rehabilitation costs influenced physiotherapists’ clinical decisions [34]. In the same vein, the establishment of a therapy threshold for PT care within the US Medicare prospective payment system (i.e., imposition of a maximum reimbursement cap of 10 sessions) led to ethical struggles and affected therapy practice patterns [35].…”