O&P Ten Years Later: State of the Decade Reflections

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As an extension of the January article in The O&P EDGE that reflected on trends that impacted the profession over the last decade, "O&P Ten Years Later: Where Are We Now?," several O&P experts reflect on that period.

David McGill, JD, vice president, reimbursement and compliance, Össur Americas, Foothill Ranch, California: "It's been a pretty traumatic ten years if you just look at the transformative changes in U.S. healthcare system. We transitioned from the historical system of healthcare in 2009 to the passage of the Affordable Care Act, creation of insurance exchanges, the introduction of essential health benefits, prohibitions on pre-existing conditions, and the elimination of lifetime caps for prosthetics and orthotics. And just as we start to adjust to that new normal, we have the disruption caused by the 2016 election and the attempts to ‘repeal and replace' the ACA, which introduced an element of uncertainty into the entire health insurance marketplace. On the positive side, over the last decade we've seen a huge decrease in the number of uninsured individuals, which has improved patients' access to O&P benefits overall."

The uncertainty and marketplace confusion that developed in 2016 created instability, which is never a good thing. But, says McGill, "the actual impact has been less significant than most of the doomsayers predicted. In fact, the last few years have proven that the Affordable Care Act, whether you like it or not—and assuming it survives the current Supreme Court challenge—is probably more firmly entrenched than people initially thought it was."

Kevin Carroll, MS, CP, FAAOP(D), vice president of prosthetics, Hanger Clinic, headquartered in Austin, Texas: "We are well on the way to having the paperless clinic become a reality. Clinics across the nation are rapidly becoming paperless with data entry and retrieval more streamlined. This results in making life easier for clinicians, administrators, and especially the patient, who no longer has to fill out as much documentation when they come into a clinic."

Vinit Asar, CEO, Hanger Inc.: "Electronic health records (EHR) and electronic practice management (EPM) are a must today, however, there is also a high risk of failure if not implemented correctly. It's not simply about implementing a paperless system, it's also about significantly revamping the work flow and processes within a clinic so you can take advantage of the paperless environment and streamline the delivery of patient care. In addition to our EHR and EPM implementations, we have begun removing the administrative burden from our clinics by consolidating certain functions so that teams within our clinics can be focused on patient care. We believe that is a necessary step in the evolution of how O&P care is delivered to patients.

"Competitive bidding will likely affect services that include off-the-shelf products at some point and will probably force the delivery of these services to be completely re-engineered. The economics of some of our O&P services will not be viable in the traditional manner that we have provided care, especially in the off-the-shelf orthotics category."

Michelle Hall, MS, CPO, FAAOP(D), Gillette Children's Specialty Healthcare, St. Paul, Minnesota, believes that the answer to many of the challenges that face today's clinicians lies in a simple change of verbiage. "Ten and 20 years ago, people used the term ‘industry' a lot. I think those of us who have been educated since then refer to it as our ‘profession.' Clinicians providing patient care work in the O&P profession; manufacturers serve the O&P industry. That's a nuance difference that's incredibly important when we're talking about the image of our profession. As we name ourselves, so will others see us.

"Those of us who are highly involved in our profession outside of just the workplace are very sensitive to the use of ‘industry' versus ‘profession'—and I don't know that people 20 years ago would have been."