DOTPA: Data Collection Phase and Provider Recruitment
The Developing Outpatient Therapy Payment Alternatives (DOTPA) project, which is currently underway, is designed to identify patterns in Part B therapy utilization and analyze the effectiveness of outpatient therapy services. The ultimate goal of the project is to develop recommendations to the Centers for Medicare & Medicaid Services (CMS) on payment method alternatives to the outpatient Medicare therapy cap (Benefits Improvement and Protection Act (BIPA) of 2000, § 545). DOTPA is administered by CMS through its contractor, RTI International (RTI).
The project is now in the data collection phase, during which RTI’s two assessment tools, CARE-C and CARE-F, will be used in different settings to identify the characteristics and outcomes of Medicare beneficiaries receiving occupational therapy, physical therapy, and speech-language pathology services on an outpatient basis. The assessment instruments can be viewed on the DOTPA project website: http://optherapy.rti.org.
RTI plans to collect data on approximately 30,000 patients from 190 therapy providers representing all therapy disciplines and all types of treatment settings (including hospital-based outpatient departments, Comprehensive Outpatient Rehabilitation Facilities (CORFs/ORFs), private practices (PT, OT, and SLP), and Part B therapists in nursing facilities). Each participating provider will be asked to collect data on up to 150 patients over a six-month period. The data collected will include patient assessments at admission and discharge for Medicare Part B beneficiaries. The assessment includes patient- and clinician-reported items. To reduce the administrative burden of data collection, participating providers may defer certain Recovery Audit Contractor (RAC) requests during active collection.
RTI is sending informational mailings to a statistical sample of practices, inviting providers to participate in the project. RTI also welcomes inquiries from practices that are interested in finding out whether they are eligible to participate. There is a particular need at this point for participation by OTs in private practice. Providers of occupational therapy who may be interested in participating in the project can find more setting-specific information here: Community-Based Providers and Nursing Facility and Day Rehabilitation Providers.
Participating providers will be responsible for collecting data either electronically or on paper forms. Participants will complete an assessment for Medicare patients at the start and end of care. The assessments consist of a patient-report section and clinician-report section. Provider-appointed on-site project coordinators will:
- Provide the patient self-report forms
- Pass assessment forms to clinicians for clinical assessment
- Manage form submission to RTI
- Participate in monthly coordinator calls with RTI for current update and assistance as needed.
AOTA and our member experts have worked closely with RTI on DOTPA over the past 2 years, including helping to draft each tool. AOTA's two sets of formal comments on the draft tools may be found here: Comments (December 8, 2009) and Comments (May 24, 2010).
For more enrollment information please visit the DOTPA project website at http://optherapy.rti.org or e-mail optherapy@rti.org. You may also contact Brieanne Lyda-McDonald, DOTPA Project Manager, at 919/541.6694 or via e-mail at blmcdonald@rti.org. For other questions, you may contact the AOTA Reimbursement and Regulatory Policy Department at rrpd@aota.org.
