Access to Occupational Therapy - Extended Health Benefits



Snapshot

The absenteeism rate in Canada is 9.3 days per employee, or almost two full weeks in 2011. Lost productivity due to absenteeism cost the Canadian economy an estimated $16.6 billion in 2012, with one long-term absence costing an employer roughly $8,800. (Conference Board of Canada, 2018)

Workplace health and wellness is becoming increasingly important, given 70% of disability costs are attributed to mental illness (Mental Health Commission of Canada, 2018), and work-related illness and injuries account for 6% of work absences in Canada (Statistics Canada, Work absence of full-time employees by geography, annual).

 Occupational therapists have the knowledge and expertise to facilitate return-to-work after illness or injury and can collaborate with employers to implement cost-effective workplace accommodations. The involvement of an occupational therapist can cut lost work days in half, help to increase employee productivity, and decrease spending on disability leave.

Presently in Canada, most occupational therapy services are not universally accessible to individuals who want them because occupational therapy services aren’t covered in the majority of extended health benefits plans. Without coverage, Canadians may not choose occupational therapy or doctors and other health professionals may not refer their patients occupational therapy knowing that there may be financial implications. In fact, according to the 2013 National Physicians Survey by the College of Family Physicians, CMA and the Royal College of Physicians and Surgeons, 70% of physicians were unhappy about their difficulties in securing publicly funded occupational therapists (OTs) for their patients.

This lack of coverage of occupational therapy benefits means workers miss out on a host of practical return-to-work strategies that address all aspects of the person’s well-being – physical, emotional, spiritual, social, cultural, cognitive, and environmental. According to Statistics Canada (2016), Canadian public servants are absent from work an average of 12.4 days each year. Given the large number of public servants in Canada, and the importance of their productivity to support government priorities, the absentee measure is not only costly in terms of Canada’s competitiveness, but also reflects an unmet need for interventions designed to improve workplace productivity.

 A limited patchwork of coverage for occupational therapy in workplace health benefits also results in many Canadians being unable to access non-pharmacological health interventions and may rely on pharmaceutical options as a first line of pain management.

The Government of Canada has made removing barriers and accessibility a priority and has introduced Bill C-81, An Act to ensure a barrier-free Canada with the stated objective of enhancing the “full and equal” participation of all Canadians (especially persons with disabilities) in society (Library of Canada (2018)). OTs have a key role in removing functional barriers that impede engagement in everyday activities, and are experts in improving workplace participation, reducing absenteeism and accelerating recovery from illness or injury.  

Recent Initiatives

  • CAOT prepared a fact sheet on Return-to-Work.
  • The Canadian Association of Occupational Therapists (CAOT) provided input to the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities () regarding its study of Bill C-81 and put forward the recommendation that the Government of Canada include occupational therapy services as part of its extended health benefits.
  • CAOT’s 2019 Pre-Budget Consultation included an ask to improve the workplace health and wellness of public servants by running a pilot program that includes occupational therapy services as part of the Public Service of Canada extended health benefits plans.
  • CAOT launched the #AskforOT campaign to provide individual OTs with the tools and resources to ask their employers/insurance providers/unions to provide OT coverage as a flexible option as part of their workplace health benefits.
  • CAOT collaborates with like-minded organizations such as the Extended Health Professions Coalition (G11) to advocate collectively for occupational therapy as part of extended health benefits.
  • CAOT met with the Canadian Life and Health Insurance Association to continue to promote inclusion of occupational therapy services in public and private insurance plans.

CAOT Objectives

  • To increase knowledge and raise awareness of the benefits of occupational therapy as part of a holistic, client-centred health care solution.

  • To include universal or flex coverage of occupational therapy services in public and private insurance plans.

  • To provide non-pharmacological alternatives within health care benefit plans, starting with the Government of Canada in its role as an employer.

  • To advocate for all Canadians, regardless of age, sex, or geographical location to have access to occupational therapy solutions.

Occupational Therapy Value Proposition

  • According to the research study ‘Higher Hospital Spending on Occupational Therapy is Associated with Lower Readmission Rates’ (Rogers et al., 2016), occupational therapy is the only spending category where additional spending has a statistically significant association with lower admission rates for three medical conditions (heart failure, pneumonia, and acute myocardial infarction).

  • Occupational therapy interventions are both cost effective and clinically proven contributions to the positive health and well-being outcomes for Canadians. These interventions:
    •  accelerate recovery from illness or injury;
    •  improve management of illness and disability through personalized care strategies;
    •  regain independence through rehabilitation;
    •  decrease the risk of illness recurrence or need for hospital readmission;
    •  decrease the risk of disability through preventive strategies.
  • By including occupational therapy coverage in workplace extended health benefits employers:
    • reduce employee absenteeism in the workplace that can result from illness;
    • reduce lost work days;
    •  help to increase employee productivity;
    • decrease the time and spending on disability leave;
    • promote engagement and meaning in work;
    • assist with employee recruitment and retention; 
    • promote an organization as a company of choice
  • Occupational therapy as part of extended health coverage benefits employees:
    • better supports the holistic health and well-being of members;
    • provides comprehensive care that isn’t limited to primary care;
    • helps to increase employee productivity and meaning in work.
  • Occupational therapy as part of extended health coverage benefits insurers:
    •  reduces the number of claims and payout;
    • reduces costs related to sick leave and disability benefits;
    • reduces costs to the health care system.
Copyright 2016 Canadian Association of Occupational Therapists
powered by in1touch
100-34 Colonnade Road
Ottawa, ON K2E 7J6 Canada