Health care may be perceived as on a negative trajectory these days, what with so much discussion of Medicare changes, threats and cuts to state Medicaid benefits, and the Supreme Court arguments over the Accountable Care Act mandate and other issues two weeks ago. (See AOTA's article http://www.aota.org/News/AdvocacyNews/Supreme-Court-ACA.aspx)   Is health care changing? Where is it going? Is the state of flux really presenting problems? Is it threatening OT or are there opportunities for promoting and growing the profession?

I contend there are opportunities irrespective of the ACA, the Supreme Court and political fighting about funding. I believe this because there are forces working to change the system because the system needs to be changed.  There is talk about the “Triple Aim” of health care reform:

Improving the U.S. health care system requires simultaneous pursuit of three aims: improving the experience of care, improving the health of populations, and reducing per capita costs of health care. Preconditions for this include the enrollment of an identified population, a commitment to universality for its members, and the existence of an organization (an “integrator”) that accepts responsibility for all three aims for that population. The integrator’s role includes at least five components: partnership with individuals and families, redesign of primary care, population health management, financial management, and macro system integration.  Donald Berwick, M.D., Health Affairs, doi: 10.1377/hlthaff.27.3.759 Health Aff May 2008 vol. 27 no. 3 759-769; http://content.healthaffairs.org/content/27/3/759.abstract

Furthermore a recent article in the Washington Post supports the notion that health care is a growth industry:

(T)he political (and now, legal) version of the health-care debate is in many ways a distraction from what matters most, which is how care is actually delivered to patients. And that’s changing, inexorably, because of underlying cost pressures.  David Ignatius, Washington Post, March 31, 2012; http://www.washingtonpost.com/opinions/the-health-care-revolution-marches-on/2012/03/30/gIQAvAQ6lS_story.html?wpisrc=emailtoafriend

And all these factors—especially cost saving—are planting seeds for OT growth.  But we must tend those seeds of opportunity.

Though Medicare may be under siege, whatever happens to the program the services OT provides and the outcomes OT achieves are what the system needs.  The “Triple Aim” requires that services meet patient needs for quality, good experience, and reducing short and long term costs.  Prevention will be the watchword and OT can be there to contribute.

If you are attending conference, there will be a health care town hall where participants can listen to members of AOTA’s Ad Hoc Committee on health care reform discuss their work in accountable care organizations, prevention, telehealth, and care coordination.  (Short Course 139, Thursday April 26, 2-3:30). 

If you think falls prevention is a great way for OT to contribute to cost savings, learn about the “Stepping On” programs and efforts by the Center for Disease Control to promote OT in this area. (Short Course 132, Thursday April 26, 12:30-2)

 

For a view of one primary care program and its possible implications for occupational therapy, attend the workshop “Occupational Therapy in Primary Care - An Emerging Practice Area,” which will discuss how the Affordable Care Act initiated aggressive efforts to improve access to primary care through Patient Centered Medical Homes and Accountable Care Organizations.  The session will provide views on how new healthcare models create opportunities for OT practitioners to discover, innovate, and generate evidence to lead the way in prevention and chronic disease management in primary care. (Workshop 406, Sunday April 29, 8-11:00 am)

What do you see that you can do to promote OT in a new role?