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Study: higher standards of care for O&P services could save CMS money

Medicare patients who received necessary O&P care and services had lower costs in the long term and experienced more independence compared with patients who did not receive O&P care, according to a study commissioned by the Amputee Coalition.

The study, which was conducted by researchers at Dobson/DaVanzo & Associates LLC, investigated the impact of receiving an O&P device, specifically lower extremity orthoses, spinal orthoses and lower extremity prostheses, on patient outcomes and Medicare payments.

The researchers collected claims from the Medicare database filed between 2007 and 2010 for patients who received and did not receive O&P services and created approximately 42,000 pairs of similar beneficiaries. They also created patient episodes that related health care diagnoses, utilization and expenditures prior to and after receipt of the O&P service.

The researchers found that patients who received orthotic or prosthetic services had lower or comparable Medicare costs than patients who needed but did not receive the same services. They also found that these patients had fewer hospital-based or facility-care admissions, more outpatient rehabilitative therapy and greater independence and ambulation.

“Looking at full costs and other outcomes, including use of outpatient therapy, number of falls, ER admissions and acute hospitalizations, over a 12-18 month period, our study concludes that patients who received the orthotic and prosthetic services experienced greater independence than patients who do not with better or comparable health outcomes and generally lower Medicare payments,” Allen Dobson, PhD, the lead author and president of Dobson/DaVanzo and Associates, stated in a press release.

The researchers also found that device cost across all three O&P services was nearly, if not completely, amortized over the study period.

“This study conclusively proves that both from an economic perspective, as well as from a health and wellness perspective, an O&P intervention really is efficient and helps the patient. I think the idea from a historical perspective was that this was just a cost. We’ve clearly shown in this study that it’s an investment that pays back, in addition to all of the soft side benefits,” Thomas F. Kirk, PhD, president of the American Orthotic and Prosthetic Association, added during a press conference held on August 27.

Disclosure: This study was commissioned by the Amputee Coalition and funded by a grant from the AOPA.

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