Dear Margaret,
Hi!! I am an OTR, have done sub-acute programs with
some elderly also a part of the population. These programs
focus upon Community Reentry skills when there is some
residual deficits in functional skills. The treatment team is
multidisciplinary & the rehab goals focus upon maximizing
functional gains, and careprovider/family member training in
any assistance levels required in ADL's (Activities Of
Daily Living ).
Currently , in the US, the Medicare A (State and Federal Funded)
have been remodeled into the PPS format for health care delivery
business. This is the Prospective Payment System. This health
care delivery model focuses upon Profit for insurance companies.
They are now only allowing Therapist to do evals. only , and the
PT and OT assistants do all the treatments.
One Rehab Center that I am signing on with is allowing
rehab program development with the emphasis upon 'Community
Reentry Skills', and even adapted computer communication skills
and some avocational experiences. But the Salary for the involved
therapists is reduced because such services to the patients
are no longer 'reimbursable' from government, and the treatment center
must deduct these special program costs from a cost-per-day allowance
that Medicare grants for each admitted patient.
Outpatient setting would have different reimbursement parameters.
Is your British health care system more generous in what they
allow for therapy treatment frequencies?
Sincerely, Edinah Lincoln Jewett, OTR/L
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