King, Sondra L.
M.A. (Master of Arts)
School of Family, Consumer and Nutrition Sciences
Diet therapy for children; Children--Diseases--Nutritional aspects; Children--Rehabilitation
Third-party payer reimbursement for medical nutrition therapy (MNT), provided to children with special healthcare needs (CSHCN) in a rehabilitation setting, is a topic that has not been researched extensively. Statewide surveys have been performed investigating reimbursement for general MNT, but no known national survey has been documented. A mail and phone survey was conducted in March, 1999, to investigate practices of reimbursement for children and general MNT as well. A four-page survey was created by the investigator, utilizing past statewide surveys and literature on reimbursement. Four hundred and four surveys were sent to claims department managers of insurance carriers? home offices that were randomly sampled from a national health insurance directory. To increase total response rate the investigator selected another random sample of non-response participants, and conducted a posthoc telephone survey. Final response rate for this survey was twenty-eight percent, with the respondents representing seventy-six percent of the states in the nation, and a variety of types of third-party payers. Results revealed more than half of third-party payers in the United States are reimbursing for MNT in general, for children and for CSHCN in all settings specified, including rehabilitation centers. Limited past studies restrict determination of changes in coverage. However, it can be inferred that compared to statewide studies, rates for reimbursement have increased substantially over the years. The importance of reimbursement for MNT cannot be overstated, and it is essential for insurance carriers to realize the cost savings it can provide. Preventative and curative measures for CSHCN are fundamental for optimal outcomes, with services for these children no longer limited to inpatient care. MNT is an essential component of an integrated healthcare system for these children. Strong support for inclusion of MNT in the Medicare basic benefits package has led to an even stronger drive by the American Dietetic Association to ensure that this occurs. This study is evidence of a positive change in an ever-changing healthcare system.
Baranoski, Cynthia L.N., "Medical nutrition therapy for children with special health care needs in a rehabilitation setting : a survey of third-party reimbursement" (1999). Graduate Research Theses & Dissertations. 3938.
Northern Illinois University
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