Medicare B changes

I was looking for some feedback from both traveling companies and therapists about the upcoming changes.
 
So far from what I can see is that the changes are really going to improve patient care without interrupting the business of traveling therapy.  As most of you know these changes will only be affecting SNFs.  My company has not seen any real changes to the industry from a business stand point.  We’ve had some long time travelers go perm in fear that the changes will decrease job opportunities but we’ve not seen anything like that at all.  Business seems to be as usual for us.  We’ve seen maybe 2 companies lower bill rates in anticipation but that’s it.
 
With group therapy changing so that you will not be able to bill individually for a full hour in group therapy is a great idea for patient care.  What I expect to see out of this from a business stand point will be a rise in assistant hiring.  I think SNFs may start hiring PTAs and COTAs more to run group therapy while having PTs and OTs focus on one on one care.  
 
The EOT changes may affect your schedule a little.  This new change will force a discharge after no therapy for 3 days.  This will likely result in more weekend shifts for traveling therapist.  If you do have a regular M-F schedule and call in sick you may be required to make up the day on the weekend to avoid discharging the patient. 
 
And lastly, proposing to eliminate the distinction between 5-day and 7-day facilities for purposes of setting the assessment reference date for the EOT OMRA will have little impact for travel therapy in my opinion.
 
What do you guys think?     

Just to be clear, the changes regarding EOT are related to skilled (Med A) patients, not Med B.  Right?

And I think you are right about hiring more assistants, Jeremy.  We might see more states certifying SLP assistants too.

I’m pretty sure all of these changes are affecting med b only.      

  
These are Medicare Part A changes. SNFs can do group but will have to divide the time by four (the most a single therapist can have in a group). So if the therapist did an hour group, each patient can only be billed for 15 minutes. Therefore, therapists will probably do less groups and more individual care. This can be both good and bad for patient care because group therapy is sometimes beneficial depending on patient needs; just as individual care is important. The clinic I am in already would do a discharge after 3 missed visits whether the patient was Part A or B. One reason for these Medicare Part A changes is due to the utilization of group therapy when CMS set guidelines for October 2010. A good addition to the Medicare change is that two different disciplines can bill the same time when co-treating. For example, if a PT was instructing on transfer/balance and an OT was doing some form ADLs simutaneously, both therapist can count that time.