Joint Statement on Direct-to-Consumer Delivery Models of O&P Care

Joint Statement on Direct-to-Consumer Delivery Models of O&P Care

This week, NAAOP, in conjunction with its O&P Alliance partners, AAOP, AOPA, BOC, and ABC, issued a joint statement on direct-to-consumer delivery models for custom orthotic and prosthetic care.  The full consensus statement can be read here.

NAAOP believes that the provision of limb prostheses and custom-fabricated and custom-fitted orthoses to individuals with limb loss or limb difference requires care from a trained clinician following a prescription from a treating medical provider. This clinician should be a certified and/or licensed orthotist or prosthetist who provides care as part of an overall treatment plan. This constitutes the optimal, time-tested system of orthotic and prosthetic care.

NAAOP has a long history of embracing technology and strongly supports the adoption of innovations that can assist practitioners in providing safe, effective, high-quality care.  While O&P technology has improved dramatically over the past several decades, improvements in technology alone cannot and should not replace the patient-provider relationship.

Advances in technology include additive manufacturing, 3D printing, new material applications, and new ways to take impressions and measurements of patients’ anatomy.  Orthotists and prosthetists routinely utilize these technological innovations; however, these developments have fueled a growing trend toward direct-to-consumer models in the provision of custom O&P care.

Direct-to-consumer delivery models tend to omit the involvement of the physician, the certified or licensed O&P clinician, and largely operate outside of the medical care continuum.  They also shift the burden to the patient or caregiver to perform clinical tasks and tend to commoditize O&P care.  Another characteristic is reliance on cash payments from patients rather than third party payments.

NAAOP and the other four national organizations that comprise the O&P Alliance stand in strong opposition to any direct-to-consumer delivery model for the provision of custom prostheses or orthoses as they circumvent the necessary, direct working relationship between the patient and an appropriately credentialed O&P clinician as part of an overall plan of care.

For these reasons, NAAOP:

  • Supports the delivery model that preserves the meaningful person-to-person relationship between the patient and an appropriately credentialed O&P clinician.
  • Rejects direct-to-consumer delivery models for the provision of custom O&P care.
  • Supports the use of technology but does not believe that technological advances should replace the clinical expertise of the orthotist and/or prosthetist.
  • Recommends that third-party payers reject claims for O&P care provided through direct-to-consumer models.
  • Encourages the enforcement of state O&P licensure laws requiring a licensed O&P practitioner to provide orthotic and prosthetic care.
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National Association for the Advancement of Orthotics and Prosthetics (NAAOP)