Reimbursement has begun to dictate the occupational therapy profession, even altering the definition, ethics, practice, management, and professional response of the profession itself. Third party payers now control the profession, rewarding the medical model. In regards to ethics, several ethical abuses involving the reimbursement process may include overbilling, overpricing of services, providing services that are not necessary for functional goals, and overworking employees. One concern that I have seen in my placement is the pressure the Cleveland Clinic places on its employees for productivity. I have seen the stress this creates for my CI as she always worries about cancellations and no shows interfering with her productivity for any given day.
http://ajot.aota.org/article.aspx?articleid=1877089