Date of Award

2017

Document Type

Dissertation

Degree Name

D.H.S. in Health Science

College/School

College of Health Sciences

First Advisor

Elizabeth S. Moore, PhD

Second Advisor

William H. Staples, PT, DHS, DPT

Third Advisor

Beth Ann Walker, PhD, OTR

Fourth Advisor

Laura Santurri, PhD

Fifth Advisor

Stephanie Kelly, PT, PhD

Abstract

Health care providers must have a clear understanding of regulatory guidelines to support successful payment of clinically appropriate and medically necessary services. Limited research has examined the knowledge of Medicare documentation and reimbursement guidelines for occupational therapy (OT), physical therapy (PT) and speech language pathology (SLP) clinicians functioning as clinician managers. A crosssectional, online survey was conducted to determine the perceived and actual knowledge regarding Medicare documentation and reimbursement guidelines specific to rehabilitation services in the skilled nursing facility (SNF) rehabilitation setting. A total of 374 surveys were completed. Respondents perceived their overall knowledge to be much higher than their actual knowledge (median scores of 80.0% versus 66.7%). This low percentage of correct responses highlights a persistent deficiency in knowledge across participants. Scores were significantly different by practitioner level, gender, and across categories of level of education, current clinician manager role, and hours of employer-sponsored formal training related to Medicare guidelines. Positive low correlations were found between overall Medicare knowledge score with years of experience in current role and with perceived knowledge score. Regression analysis showed that perceived knowledge score, level of education, current clinician manager role, years of experience in current role, and gender accounted for 20.9% of variance in overall Medicare knowledge score. While the results did not identify a strong single predictor for actual Medicare knowledge scores, having insight into how well clinician managers understand Medicare documentation and reimbursement guidelines can help guide educators and providers in structuring trainings to limit the spread of misinformation and keep clinicians well-informed.

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