Poster 34: Changes in Physical and Occupational Therapy Services Across Settings Before and After the Balanced Budget Act

Abstract

Objective: To investigate changes in the provision of physical (PT) and occupational therapy (OT) in skilled nursing facilities (SNFs), home health agencies (HHA), and outpatient settings before and after the 1997 Balanced Budget Act. Design: Nationwide surveys conducted in 1995 (N=7978) and 2001 (N=7973). Settings: SNF, HHA, and outpatient. Participants: Adult Medicare recipients with 1 of 5 conditions: stroke, acute myocardial infarction, chronic obstructive pulmonary disease, arthritis, or mobility problems. Interventions: Not applicable. Main Outcome Measures: Proportion of people surveyed receiving PT or OT, and the mean of the total units of PT and OT received. Results: The proportion of people receiving PT or OT from an HHA did not change (5.4% for both years), while the proportion increased in SNF (3.8% to 5.8%) and outpatient (10.7% to 13.9%) settings. Mean total PT and OT units also increased across all 3 settings from 1995 to 2001. Conclusions: Despite changes in rehabilitation funding after the Balanced Budget Act, the proportion of Medicare recipients receiving PT and OT and the amount of therapy they received stayed the same or increased across SNF, HHA, and outpatient settings.