Tag Archives: Rehab

Cuts to outpatient rehab costly — Stroke report

Cuts to outpatient rehab services are short sighted says Dr. Mark Bayley, author of a report on stroke services released this week by the Institute for Clinical Evaluative Sciences and theOntarioand Canadian Stroke Networks.

The lack of outpatient and CCAC rehab services mean many patients who would normally be able to go home end up in more expensive long term care facilities Bayley recently told the Toronto Star.

According to the 2011 Ontario Stroke Evaluation Report, patients are receiving far less visits than recommended from physiotherapists, occupational therapists and speech language pathologists.

Best practices suggest two visits per week from each of these professions. Instead over a two month period patients are averaging between three and four visits in total from each.

The report also notices considerable differences between the LHINs, calling for a more standardized approach for access to, and outcomes for, the rehabilitation sector.

InOntario only one in three stroke victims arrive at hospital in time to be considered for therapy that would dramatically improve outcomes.

While there was a reduction in overall wait times to stroke services, the report says there was also a reduction in access to inpatient rehabilitation among severly disable stroke patients.

The report also recommends the Ministry of Health Promotion continue to fund the warning signs of stroke television campaign.

The report did note that those taken to specialized stroke centers were more likely to receive care based on stroke best practices.

Between 2003/04 and 2009/10 there was also a reduced rate of emergency department visits and hospital stays for stroke or transient ischemic attack (TIA). TIAs are usually involve short term stroke-like symptoms and are considered to be a warning sign of a stroke.

New Ontario hotline for complaints about extra billing

Have you been illegally charged for a public health service that should have been insured under the Ontario Health Insurance Plan (OHIP)?

Yesterday the Ontario government launched a phone line and e-mail address for complaints about extra billing.

In its release, the government says there were 189 new investigations into illegal billing in 2010/11. Since 2007, about $1.3 million in illegal billing has been recovered either through reimbursements or cancellation of charges. This is on a $47 billion a year public health system.

For the average patient, figuring out whether their service should be covered or not will be a challenge, with health care providers deciding what is medically necessary and what is theoretically voluntary.

In the examples the government gives on its web site, it suggests that block fees are acceptable if payment is voluntary, does not cover insured services, and must be for a specific period of time. Users must also be given the option to pay for services that are not insured on a per-use basis.

The Ontario Health Coalition issued a release yesterday applauding the crackdown on extra billing.

“We are asking each of the provincial political party leaders to make a clear commitment to roll back the expansion of for-profit clinics and institutions, the majority of which charge patients illegal fees and undermine public Medicare in Canada,” says Natalie Mehra, Director of the Ontario Health Coalition.

Recently OPSEU raised the question of Rouge Valley Health System charging a block fee of $500 for patients in their cardiac rehab program who wish to continue past six months. The fee is not broken out by type of service, such as access to the indoor track and exercise equipment, stress tests or ongoing counselling.

Under the Canada Health Act, hospital services are insured health services. The Act defines hospital insured services as services provided to in-patients or out-patients at a hospital, if the services are medically necessary for the purpose of maintaining health, preventing disease or diagnosing or treating an injury, illness or disability. It would be difficult for a hospital to maintain that cardiac rehab is not medically necessary for the purpose of maintaining health.

It is particularly difficult for Rouge to maintain these are not covered services when its new partner in the program is Lakeridge Health, which provides a year-long cardiac rehab program.

Will the government order Rouge Valley to reimburse the $500? We can only wait and see.

To access the phone line: Call 1-888-662-6613

Or e-mail complaints to: protectpublichealthcare@ontario.ca