Unlocking Insights: 5 Reasons to Opt for an AOTA Capstone Experience

During my occupational therapy doctorate (OTD) program, we often discussed how occupational therapists can address social determinants of health in practice. My program's curriculum and coursework emphasized occupational justice and our ability to address the occupational needs of clients, communities, and populations. This perspective on the occupational therapy process inspired me to explore how practitioners can address injustices and advocate at the macro level.  A Capstone experience with the American Occupational Therapy Association (AOTA)  would expand my understanding of the advocacy efforts to advance the profession through policy and regulatory measures. 

Throughout my Capstone journey, I had the privilege of attending a series of Congressional meetings centered around Medicare Advantage (MA), delving into research on innovative MA plans incorporating occupational therapy services, engaging in meaningful discussions with various AOTA staff members, presenting at AOTA’s INSPIRE | 2024 Annual Conference & Expo, and gaining insights into the operations of the Regulatory Affairs (RA) team, which ensures occupational therapy services are covered and included through reimbursement and policy. My Capstone project primarily focused on exploring opportunities for occupational therapy within MA and examining supplemental benefits. I compared two specific insurance plans that provide unique non-medical benefits and explored how occupational therapy services are or could potentially be integrated into some MA plans. While I initially anticipated merely enhancing my understanding of policy and regulation, I was pleasantly surprised by the profound impact both regulatory and non-regulatory matters had on my comprehension of leadership and occupational therapy advocacy.

Outlined below are five key benefits of completing a Capstone with AOTA:

1. Access to Resources and Learning Opportunities 

It can be challenging to navigate and identify resources to support a Capstone project that seeks to examine policy, regulations, or data from payers when you are not a licensed provider or insurance beneficiary. Fortunately, as an AOTA Capstone student, you have the opportunity to attend various webinars and AOTA team meetings, and to complete relevant AOTA learning modules that can help inform or guide your Capstone project. In addition, you have direct access to a team of experts who can support or redirect you in your research and project development.

2. Collaboration With Diverse Expert Leaders

Interestingly, our national Association’s staff does not primarily encompass expert occupational therapy practitioners (OTPs). While a handful of AOTA policy staff are trained as OTPs, many do not come from clinical backgrounds. Several individuals bring their diverse expertise and experiences as lawyers, lobbyists, and others in regulatory policy to effectively advocate for the profession. The RA team often consults with member experts or clinicians who provide crucial insights into the real-world impact policies and regulations have on occupational therapy practice. As someone delving into understanding the role and impact of MA, I found it highly beneficial to gain insight from a clinician's perspective. Their firsthand experience helped me understand the challenges that hinder reimbursement and patient access to occupational therapy services.

3. Opportunities for Input and Expertise 

Several ongoing projects, committees, and task forces are working together to bolster the Association's sustainability, growth, and membership. Through my experience, I gained insight into current membership trends. Upon discovering the declining retention of AOTA student memberships post-graduation, I became concerned. However, I was pleasantly surprised by the AOTA staff's appreciation of my input on student-centered issues. During discussions, I shared my perspectives on potential contributing factors affecting the decision to join AOTA and explored strategies to address this specific membership challenge.  

4. Development of Advocacy Skills

The RA team frequently engages with various payers and critical stakeholders to ensure equitable coverage and reimbursement for occupational therapy services. During my Capstone project, I had the opportunity to meet with senior directors from a health care company experiencing rapid growth. Meeting with these directors allowed me to understand how the company integrates occupational therapy services into its operations, mainly providing home modifications and aiding fall prevention for multiple insurance beneficiaries. These discussions highlighted potential avenues for further enhancing occupational therapy service utilization through supplementary benefits in MA plans. This could optimize the safety and well-being of MA beneficiaries through adaptable plan structures or benefit designs. Additionally, my Capstone focused on comparing MA plan supplemental benefits to highlight strategies and tools that OTPs can employ to address health disparities among the older adult client population. Participating in a Capstone with AOTA equips you with advocacy skills, whether through written communication or verbal engagement, enabling you to effectively communicate with key stakeholders.

5. Appreciation of Membership Benefits 

As a student, I initially needed clarification about AOTA's activities to advocate for the profession. Upon completing my Capstone, I can confidently affirm that staff across all departments are continuously engaged in developing and disseminating evidence-based practice resources, facilitating professional development opportunities, and advocating to safeguard the future of occupational therapy through initiatives related to payment and employment. During my experience, I found inspiration in learning about recent advocacy successes. These include the introduction of new CPT® codes that enable reimbursement for caregiver training, advocacy efforts with commercial payer Cigna to eliminate restrictive language in occupational therapy policies concerning support for behavioral health conditions, and advocacy for legislation leading to reduced Medicare Part B cuts for occupational therapy services.

Completing a Capstone with AOTA offers students a multifaceted learning experience, equipping them with essential skills and perspectives to thrive as leaders and advocates in the field. Since completing my Capstone, I have gained a deeper appreciation for the diverse and extensive work undertaken by AOTA to advance the profession. I am inspired by the ongoing advocacy efforts led by our national Association to ensure payment and employment opportunities for members of our profession. Overall, this experience highlighted the importance of leveraging our occupational perspective and clinical expertise by exploring both clinical and non-clinical practice areas. This approach can help us collectively address health disparities and create a more inclusive society where everyone has access to health-supporting occupations.

Madeline Garcia is a 2024 graduate of Duke University’s OTD program. She is a founding member of Duke’s Student Occupational Therapy Association (SOTA). Madeline is passionate about exploring the intersection between regulatory policy and OT practice. She hopes to work in a post-acute setting while continuing to advocate for OT at both the state and federal levels. 

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