My areas of expertise include occupational therapy, rehabilitation medicine, telehealth, and mental health. With nearly 10 years of healthcare experience, I am also qualified to write on topics such as exercise, health insurance, nutrition, orthopedics, geriatric care, pediatric therapy, neurology, and health tech.
Gender-Affirming Care (AOTA-approved continuing education course)
The occupational therapy profession is grounded in equitable, inclusive, and patient-centered care. This extends to individuals who are gender nonconforming or genderqueer. As a result, all of occupational therapy practice should be accommodating of gender-specific needs. Gender-affirming care is also within an OT’s scope of practice, as gender identity is considered a client factor that can impact meaningful occupational engagement.
Should Your Health Plan Cover GLP-1 Agonists?
With the new year upon us, many people are focused on weight loss and weight management. This is an apt resolution for many, as the Centers for Disease Control and Prevention found obesity rates are over 39% in each adult age group. Understandably, many insurers are striving to expand covered services for weight loss due to their role in preventing many chronic health conditions such as cancer, hypertension, and diabetes.
Weight loss drug coverage
Reimbursement for drugs such as GLP-1 agonist...
Sensory Regulation Across the Lifespan (AOTA-approved continuing education course)
Sensory-based interventions are a common modality in pediatric occupational therapy. This is mostly because of how often sensory concerns co-occur with developmental delays and neurodevelopmental conditions such as Autism Spectrum Disorder, Attention-Deficit / Hyperactivity Disorder, and intellectual disabilities. As a result, much of the evidence surrounding sensory integration is focused on children and adolescents. However, therapists know that sensory factors can impact the well-being of patients of any age and with any condition.
Decoding the New Mental Health Coverage Rules for Private Health Plans
Just a few weeks ago, new legislation was finalized that stands to impact subscriber benefits in the behavioral health arena. This set of regulations is closely aligned with federal legislation, namely, the Mental Health Parity and Addiction Equity Act (MHPAEA), as well as state-specific laws, such as the Mental Health Parity Act in California, which was expanded in 2021.
Many patients report encountering a range of barriers in accessing mental health care since the MHPAEA was enacted in 2008...
Motor Coordination: Midline Crossing and Bilateral Coordination (AOTA-approved continuing education course)
As an essential performance skill, motor coordination is a trending topic in occupational therapy. Individuals of any age may experience motor incoordination, either as a developmental delay or a health condition. When this presents as a deficit, motor coordination must be addressed in the occupational therapy plan of care. Motor incoordination stands to impact anyone’s occupational engagement and can impact an individual’s quality of life. In order to effectively address motor deficits of all varieties, occupational therapists should be aware of the smaller skills that fall under this heading
How Payers Can Use Network Intelligence to Boost Profits
With 2024 behind us and year-end calculations being shared, many payers found the numbers are not in their favor. In particular, seven major players in the health insurance industry saw their profits decline an average of 3.3% during Q3 of last year.
Several factors have contributed to these higher medical loss ratios, including increased pharmaceutical spending (specifically for specialty drugs), the continually rising cost of medical care, and higher utilization rates – which have steadily ...
Palliative Rehabilitation for Occupational Therapists (AOTA-approved continuing education course)
Many lay persons may assume occupational therapists and other rehabilitation providers don’t have a place in a practice area such as palliative care. And, even within the healthcare field, the work OTs do within palliative care is often misunderstood. However, OTs have an essential role in palliative care: improving quality of life and continuing to promote independence as well as occupational engagement for individuals with life-limiting conditions. Occupational therapists may use remediatory and compensatory approaches for individuals who receive palliative care OT services.
Community Health Plan Losses May Impact Premiums
Experts predict community health insurance providers will lose a substantial amount of funds as the year comes to a close. The Alliance of Community Health Plans expects these insurers to miss out on hundreds of millions in reimbursement resulting from a lack of recent Medicaid rate adjustments.
Rates have remained the same
Reports show that many states used pre-pandemic data to inform their Medicaid rates. According to Nick Felici, Director of Network Development & Analytics at TOG Network S...
Caseload Vs. Workload (AOTA-approved continuing education course)
The discussion of caseload versus workload hones in on the job duties of school-based therapists, including OTs, SLPs, PTs, audiologists, assistive technology providers (ATPs), psychologists, and other related service providers. More specifically, caseload and workload have become distinct approaches to treatment in a school-based setting. There is a growing basis of evidence that the workload approach is more effective than the caseload approach for a variety of reasons.
Presentation Matters: Telehealth Settings Impact Patient Satisfaction
Since its rise in 2020, it’s safe to say telehealth is now a fixture of many people’s medical care.
However, there is a lot of variation in telehealth visits – often more than patients get (or expect) from in-office visits. From using different platforms and messaging in patient portals to adopting specific pre-visit protocols and scheduling entirely online, many patients have come to learn what they like and dislike in virtual visits.
One telehealth feature that is often highly variable is t...
Social Determinants of Health (AOTA-approved continuing education course)
Social determinants of health apply to patients across the lifespan, with any medical conditions, and in any practice setting. Evidence shows that social determinants of health have a major impact on a person’s well-being and quality of life. For this reason, OTs and many other healthcare professionals are trained to assess the social determinants of health that pertain to each of their patients. By looking at social determinants of health in all situations, therapists are better equipped to understand and address the full scope of their patient’s health concerns.
Technology & Aging in Place (AOTA-approved continuing education course)
With an aging United States population, there is a significant need to support older adults. This means there is a high demand for healthcare professionals and support workers to care for individuals in institutions such as hospitals, nursing facilities, assisted living, and long-term care facilities. However, many older adults are increasingly interested in remaining in their homes as they age. Therefore, they require a range of environmental modifications and assistive technology in this setting to ensure their safety and well-being.
Health Plan Strategy is Key During Open Enrollment Period
For nearly every state, November 1st marked the start of open enrollment season. This was met with mixed responses from some since many subscribers are still adjusting to the news of upcoming Medicare changes. In September, Medicare recipients learned their premiums would be rising in the new year, but they will see some savings in prescription medications with a new out-of-pocket maximum and caps on some of the priciest drugs.
Who is impacted?
It appears that Medicare Advantage (MA) members ...
What the Rise in Male Cancer Rates Means for Your Network
A new study led by the American Cancer Society has pointed out an alarming trend in the incidence of cancer among men. This research found that new, worldwide cancer cases in men are projected to rise by 84% between now and 2050. This evidence also states that the amount of cancer deaths in men is expected to skyrocket by 93% in the same time frame.
How much of an increase?
When compared to existing cancer cases, this amounts to 8.7 million new cancer diagnoses in men alone. There is an even ...
Oncologist Shortage: Is Your Network Adequacy at Risk?
The health care industry has been grappling with staffing shortages in recent years, but the field of oncology is facing a particularly critical challenge. The number of oncologists, especially in rural areas, has been dwindling, creating a ripple effect on patient care and network adequacy challenges. What are the driving forces behind the shortage?
Several factors converged to make the oncologist shortage particularly pressing:
Medical Advancements: Improved early detection and treatment op...