“QUANTIFYING THE COST OF BT/RBT TURNOVER FOR PAYORS”

While our discussion of the negative impact of BT/RBT turnover has been limited to the impact on BTs/RBTs and ABA organizations, obviously, the ultimate victim are the children we are supposed to be helping as they churn through one RBT after another and the parents who can do nothing but stand by helplessly as their mental health is deteriorating from the constant stress.

Ultimately, in order to adjust for the inequities inherent in our system, all participants – BTs/RBTs, BCBAs, ABA Organizations, and even parents – need to be willing to change their behavior for any sustainable improvements to take place.

But the stakeholder group that can make the greatest impact are payors. We need a rational reimbursement system in place that pegs reimbursement rates on the difficulty of the cases. If the more challenging cases were reimbursed at a higher rate, there would be an incentive for organizations to not only invest in developing RBTs to take on these challenging cases, but also reverse the current industry-wide trend of “”cherry picking”” the “”easy”” cases. Cases that can be handled by someone with just 40-hours of RBT training.

So what does this current trend of cherry picking the easiest cases with highest reimbursement rates mean for clients and parents who have the greatest need for ABA services? Those with challenging behaviors that most agencies decide are not worth the trouble to take on? Or frankly, can’t take on because the financial risk/reward doesn’t make sense?

I’m looking to talk to some agency owners who would be willing to share their data with me. My goal is to start by quantifying the cost of turnover for payor organizations. Once we have data, we have a starting point with which to attempt to engage the funding sources to collaborate with us to create a sustainable solution.”