The Orthotic and Prosthetic Alliance: The Sum of its Parts

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The Orthotic and Prosthetic Alliance (the Alliance) is a unifying force established to elicit the cooperation and coordination of like-minded organizations in the O&P profession and among consumer groups. Its efforts are spent raising awareness of public policies that benefit O&P patients and the providers who serve them, as well as advancing consensus legislation and regulation that achieves the O&P community's goals and objectives.

Established in 2007, the Alliance began with four organizations and now comprises five national O&P groups: the American Academy of Orthotists and Prosthetists (the Academy); the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC); the American Orthotic & Prosthetic Association (AOPA); the Board for Certification/Accreditation (BOC); and the National Association for the Advancement of Orthotics and Prosthetics (NAAOP). As emphasized by Peter W. Thomas, JD, counsel to the Alliance, in a 2008 article, the Alliance does not represent the entire field or every aspect of O&P. Rather, communications on policy issues and related matters are functions of the individual member organizations. As such, the Alliance functions under a rule of unanimity. If any one member does not believe a particular issue should be subject to Alliance involvement, then that issue is not dealt with as an Alliance priority. The O&P Alliance has been successful in projecting a unified voice of the O&P profession since its inception.

Summary of the Parts

The O&P Alliance derives its strength from being the sum of its parts. Each member brings a unique perspective to the table.

The Academy, as a professional membership organization, advocates to help the O&P professional provide the best patient care possible. These tools include access to the best research, continuing education opportunities, and an awareness of legislation and regulatory issues that might impact O&P professionals. The Academy's partnership with the Alliance provides an enhanced service to its members and makes their views more clearly known to Congress and federal agencies like the Centers for Medicare & Medicaid Services (CMS).

ABC advocates for high standards in the provision of safe and effective orthotic, prosthetic, and pedorthic care. Being a member of the Alliance provides ABC a means to support its mission by interacting with policymakers about professional standards, working with leading researchers in the profession to support their efforts and make them aware of funding opportunities, and fighting for fair reimbursement policies.

AOPA "ultimately must look at all issues from the perspective of what is best for patients. As to the Alliance, while O&P is a small aspect of healthcare- less than 1 percent of Medicare [spending]-there are many different organizations. The Alliance provides an opportunity for these diverse organizations to speak to each other, work cooperatively on topics of common interest, and as often as possible to speak with one voice on key legislative, policy, and regulatory efforts, like the 2015 proposed local coverage determination changes for lower-limb prosthetics," says Tom Fise, JD, AOPA executive director.

BOC has been an Alliance member since 2012 and offers a thoughtful and innovative perspective as an O&P credentialing organization. Through ongoing advocacy and legislative efforts, the organization works to advance the profession, while remaining focused on improving the quality of life of those who ultimately depend on the services provided by its certified professionals and accredited businesses. At every opportunity, BOC engages its expert board, certificants, accredited facility personnel, and stakeholders to advance Alliance efforts. "And consistent with the BOC mantra, it is our pledge to be with those who depend on us every step of the way," says Board Chair L. Bradley "Brad" Watson, BOCO, BOCP, LPO.

NAAOP is engaged in both education and advocacy with a patient-centered focus. Its founding and current Executive Director George Breece and Thomas, its general counsel, work with an active board led by President David McGill, JD, to direct NAAOP's efforts toward government relations with a focus on healthcare legislation and regulations that affect O&P patients and professionals. The association brings expertise and experience in these realms to the Alliance.

Full-Force Strategy

The strength of the Alliance and its member organizations was seen in full force last year, when the Draft Local Coverage Determination (LCD) for Lower Limb Prostheses was introduced in July 2015. They worked together to raise awareness of the threat the policy posed to the provision of lower-limb prosthetic care. The response elicited by the Alliance and its member organizations was unprecedented- and it worked, for now. The Draft LCD has been placed on hold- not rescinded. In the meantime, a multidisciplinary interagency workgroup, comprised solely of federal employees, is reviewing the clinical evidence that defines best practices in lower-limb prosthetic care in order to develop a consensus statement that informs Medicare policy in this area.

The importance and work of the O&P Alliance and its member organizations (and their stakeholders) is relevant now more than ever.