Outpatient Facility Considerations

Introduction | Current Status of SLP Employment | Retention vs. Recruitment | 
SLPs' Prioritization of Job Satisfaction Factors | Recruitment and Retention Strategies | 
Home Care Recruitment and Retention | Hospital Considerations | Outpatient Facility Considerations | Skilled Nursing Facility Considerations | Appendix

Reward Yourself with a Career in Health Care Powerpoint presentation [PDF]

According to data collected by ASHA in 2008, approximately 9% of ASHA-certified SLPs work in outpatient facilities. There are unique challenges that come with working in the outpatient setting. The caseload may be more diverse in terms of clients' age and disorders and may require developing competencies in areas such as voice disorders or pediatric speech and language disorders. In addition, good clinical documentation skills and knowledge of coding for reimbursement are essential. In this setting, the majority of services may be billed to private insurers, requiring preauthorizations, careful tracking of approved visits, and documentation of progress toward functional goals.

The 2007 SLP Health Care Survey asked the following question: "What are the greatest challenges you face in health care?" In rank order, respondents from outpatient settings reported the following challenges:

1. Insufficient reimbursement (for clinical services; 66.3%)
2. Paperwork (clinical and reimbursement; 57.4%)
3. High productivity requirements (35.3%)
4. Keeping current with advances in clinical information (33.4%)
5. Unsatisfactory salary/benefits (21.3%)
6. Not being valued by other disciplines/administration (14.7%)
7. Managing caseloads at multiple sites (13.6%)
8. Resources to respond to diversity within caseload (9.1%)

In 2009, respondents were asked about undesired changes they had experienced in their work environment over the previous year. This question was asked, in part, because of the challenging economic times. In rank order, respondents from outpatient facilities reported the following:

• None of the above (40%)
• Increase in caseload/workload/productivity (23%)
• Reduction in salary or benefits (without changes in hours) (16%)
• Reduction in caseload/workload/productivity (16%)
• Reduction in work hours (11%)
• Increase in work hours (10%)
• Increase in the number of sites served (7%)
• Conversion from salaries to hourly or PRN pay (3%)
• Replacement by support personnel (2%)
• Job loss/layoff (1%)