Gail Fisher, Jennifer Friesema; Implications of the Affordable Care Act for Occupational Therapy Practitioners Providing Services to Medicare Recipients. Am J Occup Ther 2013;67(5):502-506. doi: 10.5014/ajot.2013.675002.
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The passage of the Patient Protection and Affordable Care Act of 2010 (ACA; Pub. L. 111–148) represents the largest expansion in government funding of health care since Medicare and Medicaid were established in 1965 (Curfman, Abel, & Landers, 2012). Although the health insurance mandate and Medicaid expansion have received the most attention as a result of legal challenges and the July 2012 Supreme Court ruling on the legality of the ACA (Henry J. Kaiser Family Foundation, 2012), other ACA initiatives may have even greater implications for occupational therapy. The ACA includes sections on improving quality and health systems performance for Medicare recipients, with some sections also applying to Medicaid recipients. Insurance companies commonly follow Medicare rules; therefore, the Medicare reforms are likely to spread across all payers, health care settings, and care recipients.
Education of clients and family members regarding warning signs that warrant a hospital visit, and those that do not, in the context of performing occupations
Reviewing which level of care is recommended on the basis of symptoms and making sure the patient and family have a realistic plan for determining what type of consultation is needed before going to the hospital
Self-management of symptoms, including medication management with accommodations for cognitive, sensory, and physical limitations
Use of evidence-based assessments and interventions to address fall risk in the home or residential facility, a frequent trigger for a readmission
Engaging the client in carefully selected physical and cognitive therapeutic activities that will build functional capacity as well as strength and endurance.
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