This is in Rehab Today online magazine. Their description of measurable
progress is what the patient uses as a device for ambulation. I'm frustrated
that it isn't common sense to see measurable goals through cognitive testing
and outcomes in fuctional skills. Is this in part due to OT not providing
enough evidenced based research? Angie Jones
January 29, 2007
NEWS
Health Insurers Do Not Cover Cognitive Rehabilitation
According to the Wall Street Journal, many brain injury patients who
experience problems with memory, mental processing, or behavior, do not
receive cognitive rehabilitation because their health insurers do not cover
the treatment.
Preliminary studies indicate the effectiveness of cognitive rehabilitation,
but research into the treatment remains limited because of a lack of funding
by pharmaceutical companies.
A committee established by the National Institutes of Health in 1998 to
evaluate cognitive rehabilitation concluded that the evidence supports the
use of certain cognitive and behavioral rehabilitation strategies as part
of a structured plan. In addition, an analysis of 87 studies published in
the Archives of Physical Medicine and Rehabilitation in 2006 found
substantial evidence to support cognitive rehabilitation for people with
traumatic brain injury.
However, many health insurers maintain that research to support the
effectiveness of cognitive rehabilitation remains insufficient. In 2002, the
BlueCross BlueShield Association Technology Evaluation Center said,
Available data are considered insufficient to make conclusions on whether
cognitive rehabilitation results in beneficial health outcomes. WellPoint
covers cognitive rehabilitation for patients involved in accidents but not
for those who experience strokes.
Thomas Watanabe, MD, professor of physical medicine and rehabilitation at
Drake Center University of Cincinnati says, Its hard to demonstrate
cognitive progress to the insurance company. If a patient starts out in a
wheelchair and then starts walking with a cane, you can measure that
progress.
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