Medicare has never been a perfect system, and has had changes inserted every few years as a result. Whether those changes are good or bad might depend on who you ask, but it’s certain that the chronically ill pay more due to the consistent cost of their illnesses. In 2015, Congress passed legislation for certain changes in Medicare in an attempt to eliminate unnecessary costs. Some of those changes already came into effect on October 1, 2019. Sadly, therapists and their associations feel that the changes are doing anything but helping patients.
According to many physical and occupational therapists throughout the country, the changes that came a few months ago are cutting down on time spent with patients, meaning a 60-minute therapy session must now take place during a 20-minute interval. Paula Span, writer for the New York Times, interviewed Susan Nielson, an occupational therapist, about the change. Nielson expressed frustration with the new policy by saying, “I’m not able to do my job. This person had the potential to do more, and I couldn’t help her.”
Many therapists suspect that patients and their families will be forced to pay for in-home therapy services since they’ll still need physical therapy upon returning home due to receiving insufficient therapy at care centers. But why did these changes occur? It all has to do with the payment system for such services.
For-profit, not for patient
Sadly, a majority of nursing homes and care facilities are for profit and so many administrators take advantage of new policies to be in their favor, financially. Anyone who works in healthcare is all too aware of how certain hospitals and companies are focused on their own bottom lines, rather than patient care. This isn’t a new problem, but the most recent changes in Medicare could mean higher out of pocket costs for those using it for more reasons than one.
Not only do healthcare systems take advantage of new policies to reduce the amount of care available (or the amount of care allowed per patient), but everyone is also dealing with higher costs to start with, including rising premiums and deductibles.
More changes to come
Along with billing and payment system adjustments for physical, occupational, and speech therapy this past October, more changes are on their way. January 1, 2020 will bring even more adjustments, including the discontinuation of first-dollar coverage plans C, F, and High Deductible Plan F. These are all Medicare Supplement Plans (sometimes called Medigap plans), which provide coverage where Medicare does not, minimizing out of pocket costs. In addition, certain plan premiums, deductibles, and coinsurance will also be higher. Here is the breakdown of those changes, as seen on medicaresources.org:
Whether you’re faced with paying for in-home therapy services or you’re not sure how to cover the ever-increasing premiums, Live Care Foundation is dedicated to helping people and their loved ones cover the costs of life. Request a complimentary consult from Live Care Foundation today.
Ms. Harris is a freelance writer and editor who enjoys reading, triathlons, and baking.