Matthew Johnson, MPT, CEEAA

Championing Care for Aging O&P Patients

Therapist plays key role in advocating for fair O&P reimbursement in New York

New for 2022, the O&P Advocate column focuses on individuals who go above and beyond to advocate on behalf of the O&P profession. Here, you will get to know colleagues and O&P stakeholders who champion issues of importance to O&P practitioners, business owners, and patients, and who foster relationships with decision makers to ensure equitable access for individuals with limb loss and limb impairment.

TWO YEARS AGO, Matthew Johnson, MPT, CEEAA, jumped into O&P advocacy after connecting with Ted Drygas, CPO, FAAOP, and others as part of the New York State Chapter of the American Academy of Orthotists and Prosthetists (NYSAAOP). “There have been decades of unchanged reimbursement rates within the New York Medicaid system that created care disparity for those on Medicaid/ managed Medicaid programs,” says Johnson, who recently became Hanger Clinic’s area director in Philadelphia after serving as regional director for the New York Metro Area for several years. “We collected patient testimonials, data from AOPA, information from New York Academy members, and feedback from other care providers and organizations to better understand the care disparity.” Johnson’s group also interviewed lobbyists, “which was a learning experience,” to shape the team’s overall plan.

“Through patient contacts, we were able to get initial Zoom meetings with New York legislative leaders and their teams to educate on this disparity and seek guidance on steps to take for improving,” Johnson explains. “The key was aligning our message with legislative leaders having interest in healthcare or taking part in related committees.” Johnson notes that partnering with those champions has been instrumental in navigating legislative processes designed to secure additional funding to increase the New York Medicaid O&P fee schedule and reduce some of the stress in creating access to care issues.

The team’s efforts are reaping some benefits: For the 2023 New York fiscal year budget, approximately $4 million has been allocated to increasing O&P reimbursement and adding in missing codes from the fee schedule. Additionally, a bill has passed the New York Senate and is making its way through the Assembly (S 7023/A 7892); it will require the state health commissioner to look further at rate adequacy for the O&P profession in New York.

Well-Rounded Advocate

Johnson, whose responsibilities at Hanger include supporting O&P professionals in evolving healthcare environments and delivering evidence-based patient care, is well-suited to his role as a champion for O&P. His background is in physical therapy, specifically addressing care needs for the senior adult population, and he is certified as an exercise expert for aging adults.

“My patient-care experience was in a variety of areas, such as acute hospital, inpatient rehab, subacute rehab, home health, and outpatient over an eight-year span before working as a therapy program consultant,” he explains. Early in his career, Johnson worked for a therapy technology and clinical program consulting company that was acquired by Hanger in 2010. That move inspired his clinical interests in O&P. “Over the next 10 years, various projects further exposed me to O&P as a profession, and I eventually transitioned into an area leadership position for Hanger Clinic in 2019.”

Johnson leveraged his clinical expertise in several advocacy initiatives over the past few years. “Improving access to O&P services to those with New York Medicaid is the most important advocacy initiative I’ve been involved in,” he says. “Many patients and families have to wait longer, travel further, or may not have access to the same O&P services as those covered by other insurances. Educating other care providers about these challenges, partnering with other patient advocacy organizations, and networking with legislative leaders has been a core part of my role in the NYSAAOP project.”

Johnson also took part in a Washington, DC, Hill Day in 2019 as part of the National Association for the Support of Long-Term Care. Participants sought to increase legislative awareness of issues affecting the therapy industry in caring for aging adults. “The goal of the advocacy was to sustain marketbased updates to reimbursement levels within the industry, provide flexibility in delivery of care given the Patient-Driven Payment Model [a case-mix classification reimbursement model implemented for Part A skilled nursing home stays starting in October 2019], and further clarify care delivered by supervised therapy students in skilled nursing settings,” Johnson says. He and other participants helped to ensure a smooth transition of the reimbursement model in skilled nursing homes as well as continued access to valuable services for patient populations across the United States.

Johnson also is eyeing future Medicaid reform. “We’re currently learning more about changes being made to the New York Medicaid O&P fee schedule, which will allow us to analyze the impact on access to care and formulate next steps,” he says. “Based on the results, we will focus on partnering with our legislative champions in the New York Assembly, Senate, and Department of Health to make further suggestions to improve the New York Medicaid structure as it relates to O&P reimbursements.”

In addition, he plans to assist in establishing benchmark reimbursement for the S1040 cranial remolding helmet codes, as well as adding codes to the fee schedule that have been previously omitted.

The Power of Partnerships

Successful advocacy stems from collaboration among different stakeholders and organizations, according to Johnson, who serves on Hanger’s Advocacy Council, a group of professionals from across the company that meet quarterly to keep apprised of industry trends and needs for national and state-level advocacy projects.

“Since most of my professional career has been in physical therapy rehabilitation and not O&P, networking has been critical for getting others involved with advocacy initiatives,” he says. He has attended state conferences, leveraged contacts from more tenured O&P professionals, and asked for others to become involved—all of which spurred additional momentum for advocacy. Additionally, “the team at AOPA has been a great partner for helping broadcast messages for calls to action that help us reach additional O&P stakeholders on important legislative initiatives in an efficient manner.”

O&P professionals should get involved in advocating on behalf of the profession, according to Johnson. “Healthcare has fully shifted to a ‘triple aim’ of improving patient experience, achieving better outcomes, and reducing costs,” he explains. “It’s important to take an active approach with educating key stakeholders in the healthcare payment system about the value and impact of our profession. Without it, there will be continued pressures that will impact patient access to O&P services.”

He calls on O&P clinicians and business owners to participate in state association meetings and join state professional organizations, and to engage with AOPA’s Co-OP. “These are places to connect with others who are facing similar challenges, share experiences, expand contacts, and plan actions leveraging the organization’s collective expertise.” Networking with allied healthcare providers and patient groups helps amplify messaging and assists clinicians in seeking guidance from their advocacy efforts. “I’ve found that hearing from different stakeholders— including patients and families—helps to add to the overall message, gain commitment at a higher level, and move actions along the path to positive change.

“Staying connected with other healthcare professional groups, and reading monthly newsletters to see where overlapping topics may be of interest, is critical,” Johnson adds. “Collaborating as a profession helps amplify advocacy messages and provides a stronger platform for enacting change.”

Increasing advocacy participation often involves tapping into a dedication and passion for the profession that goes above and beyond everyday responsibilities, according to Johnson. “Advocacy takes time, patience, organization, collaboration, and perseverance, and is often done after hours on top of other professional and personal responsibilities in an increasingly busy world,” he says. “I appreciate all of those involved with healthcare advocacy efforts to support specific populations or groups in need, and encourage those who are interested to take part. The O&P profession will continue to strengthen its role in the healthcare continuum through collective efforts at the state and national levels.”

Matthew Johnson, MPT, CEEAA, presents during a recent virtual webinar at Hanger Clinic.