Revisions about Statutory Accident Benefits Schedule (SABS) are set on the anvil in June 2016 about how rehabilitation therapy is going to be done. If you are looking to find more information about how it will affect the business of independent therapy clinics, read on.
Well, to start with the license will still be required from the Financial Services Commission of Ontario (FSCO). This is needed to get the payments directly from the various insurance companies. The therapists working at the clinics will still need the various certifications and licenses as before. Though scaling back of coverage is one of the things that might lead to the therapy clinics balancing the financial stability and needs of the patients.
Coverage scaled back
The major issue that is going to affect the patients and the clinics is the scaling back of the insurance coverage. When it comes to complex therapies, most of them will not be covered by Ontario Health Insurance Program, and that will leave the patients half-way through therapy as their money runs out. The independent clinics will need to put in policies about handling a lot of patients whose insurance ran out or will run out, irrespective of whether they are cured or not. The clinics might refer them for debt management or other sources of funding to complete the therapies.
Rehabilitation time frame
The next changes are considered to be reduction of rehab time from 10 years to 5 years. Though the first five years would have little impact on the therapies, but later most clinics will need to take in long-term patients to increase the revenue.
Another main factor to consider is the impact of the changes on non-traditional services like massage therapy and acupuncture. Now the clinics will need to show the insurance companies how it will benefit the patient. This in turn will mean that the funding will be cut for such therapies and patients might have to pay from their own pockets for these therapies. The patients might be in no financial situation to pay for them. Thus, the independent clinics might need to look at the services they offer outside of the Statutory Accident Benefits Schedule specifications.
Change in the term ‘catastrophic’
Based on what can be funded, the definition of ‘catastrophic’ is set to change. Those patients that suffer from chronic pain or those with marginal mobility yet not completely incapacitated may not fall under the provisions of the tern ‘catastrophic’. This in turn will lower the funding and insurance cover for treatment of such patients. The fact remains that clinics will need to reevaluate their services. The best will be if the patients can avail the therapies but it might be needed that the clinics reduce the number of therapy sessions when they cannot take on the overhead costs. The impending changes in Statutory Accident Benefits Schedule might require the independent therapy clinics to reevaluate the business model and funding of offered therapies and treatments.