CHICAGO — The current and future political climate for health care may pose both threats and opportunities for the O&P profession, according to speakers at the American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium.
Jared Howell, MS, CPO, FAAOP, of the Baylor College of Medicine, and Bruce McClellan, CPO, LPO, FISPO, FAAOP, of Prosthetic-Orthotic Associates, addressed the trends and developments in health care that have emerged in recent years and months, spanning the approval of the Affordable Care Act (ACA) in 2010 to the executive orders of President Donald J. Trump. One such order signed by Trump instructs agencies to abolish two regulations for every one introduced, which speakers said could have wide-ranging effects on the O&P profession.
“Now, if you do not know this, O&P is in the process of trying to get a regulation passed, so that regulatory environment flipped a complete switch,” Howell said. “In fact, we have multiple regulations that we would like to pass this year within the O&P climate. Most of them are bipartisan and have significant support across the board, but at the end of the day, we do not know how this will affect us. This is something you need to be aware of.”
Howell outlined five health care trends that have emerged in the political climate since the passage of the ACA and will impact how the O&P profession moves forward. He said these include the following: the expansion of value-based payment systems; improved data and research in O&P; health care providers United and Aetna dropping out of the ACA insurance exchanges due to high costs; the growth of Accountable Care Organization models; and an improvement in the visibility of O&P as a “unique, viable member of the health care team.”
According to Howell, threats to O&P in the current political climate include a lack of evidence-based practice in O&P compared to other medical specialties; fear and uncertainty, which has caused some O&P providers to change the way clinicians practice; increased scrutiny from outside regulatory groups; and the possible return of RAC audits, prepayment audits and prior authorization.
“We have a lack of clinical evidence, and that is a problem,” McClellan said. “[CMS] wants to see medical necessity, which means they want literature and there is not much of that. However, we are working on increasing that.”
However, there are many opportunities present in the O&P field, Howell and McClellan said. These include the high quality of students entering the O&P profession; increased access to new technologies; the increased influence of information technology and “big data,” which has paved the way for the emergence of wearable technology; and increased outreach and feedback with HHS, CMS and the NIH.
“We have the ear of HHS, CMS and NIH for maybe the first time in history,” Howell said. “We will have to see what happens now.” – by Jason Laday
Reference:
Howell J and McClellan B. Future Political Climate for Health care. Presented at: American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium; March 1-4, 2017; Chicago.
Disclosures: Howell and McClellan report no relevant financial disclosures.
