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COTA Thoughts

The Future of the COTA

Published October 22, 2009 3:46 PM by Tim Banish
 

Healthcare reform, the economic depression, reduced insurance reimbursements, Medicare and Medicaid cutbacks, how will this affect the future of the COTA?

            Some people are quite nervous right now, thinking that Obama's healthcare reform will eliminate the COTA position. Others are worried that the reduced reimbursement rates will decrease salaries. Some have indicated that continued layoffs and company closings would reduce caseloads, thereby reducing the number of hours available to work. And several prospective students have written me recently asking if they should still consider enrolling in an OTA program, will there be a need in the future?

            Well, just as I told one person, job security does not seem to be a part of American language anymore. I can't predict the future but I do have a few thoughts from the trends I've seen.

           Today, companies close and relocate for economic gain leaving hundreds of people unemployed. Most are also left with no healthcare, placing further strain on an already tight public system. With fewer people able to afford medical benefits, including therapy, this does indicate fewer jobs.

            This is where healthcare reform would change the future. With healthcare for all, medical treatments would probably increase as more people are able to utilize the system. More people using the system mean more jobs. That's good, however as I see it, to maintain financial control rates will be set for every treatment much the same as we have now with CPT codes. But I also expect to see these rates reduced to a figure lower than current levels, significantly decreasing payment for therapy. Less reimbursement indicates reduced salaries.

           Next we have cutbacks on Medicare funding looming in the near future. Stricter policies on treatment minute calculation, effectively forcing one-on-one treatments. This will make productivity fall, and require more therapists to see the same caseload. More staff with the same reimbursement sounds like there has to be a cut somewhere. I predict salaries will take another hit when this takes effect, or possibly sooner.

          So no, I don't see healthcare reform or reimbursement cuts eliminating the COTA position.  I believe that there will be an increase in the number of COTA jobs in the future, but again more than likely at a reduced salary from today's level. This could be the determining factor of the COTA future though. If salaries are cut to a point that it no longer is economically feasible to obtain a two year degree to earn just a bit more than your local hamburger flipper, no one will enter the field and it will slowly die.

             

Until next time, hope all your "Thoughts" are Good-

Tim

5 comments

I'm considering a change in my job. I work in a local hospital right now and thinking about going with a contract company with all the changes and the push for government health care I'm really not sure if I should.  I haven't seen the what they want to do with therapy yet put it usually means cuts cuts cuts

Judy Jayne, COTA/L November 13, 2009 9:01 AM
Salem OH

Jan-

No one can say what the economy is going to do in the future. My fear is that with the new regulations coming next October, revenues will remain the same but additional staff will be needed to see the same caseload.

So it just figures to me that with more staff needed and the same revenue coming in, it has to mean cuts somewhere. PPS hit therapy hard, with some companies reducing salaries up to 50%. I hope we don't see a similar scenario, but......

Tim Banish, LTC - COTA/L November 9, 2009 12:50 PM
Cincinnati OH

Hello, I am currently employed with a Public school system as a one-on-one aide for a cerebral palsy student making less than $10 an hour. I am seriously considering going back to school to become a COTA. I found a local school that just recently added this certification. Do you suggest spending thousands of dollars to obtain? How does the Phoenix,AZ job market look for this career? If I stay with the school system, with reduced pay and cutbacks, not sure if outlook is good. Please give thoughts.

Thanks,

Jan

Jan Guthrie November 6, 2009 7:01 PM
Phoenix AZ

Hi Blake, Thanks for your comments. PPS was a major cut to some therapists who, as you say, would leave a diathermy unit on for two hours then log eight units of therapy. Companies did not object because they profitted also. Similar things are happening now in some LTC facilities. Therapists are being given 500+ minutes of treatment per day and expected to complete them under the "threat" of being replaced. New regulations to take effect next October will again cause a major cut in revenue to therapists and companies alike, much like PPS.

Tim Banish, LTC - COTA/L October 31, 2009 8:23 AM
Cincinnati OH

I know Tim and supervised him at one time. He is a good COTA. I just wanted to add one comment. I think Tim will remember when President Clinton was in office there was a sharp drop in the number of hours Therapists in LTC could work. My work hours dropped to as low as 20 hours per week. I was not let go, but it was "tough times" for at least 6 mos. The drop was due to the Medicare PPS that was adopted. This new reimbursement for service system frankly frightened most contract companies and there was an anticipatory angst. The angst dissipated once the providers saw that their profits would be sustainable albeit not at the same levels as they had previously benefited from. The PPS was necessary as I can recall the abuse I witnessed as some Therapists would frankly place a diathermy unit on a patient for 2 hours and then collect their reward. The companies never objected to this.

Thank You, Blake Weyrich, OT/L.  

Blake Weyrich, Industrial and Hand Therapy - OT/L., NovaCare Rehab October 27, 2009 10:29 PM
Cincinnati OH

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