ASHA’s Strategic Pathway and You: Focus on Objective 5 Did you know ASHA has a roadmap for achieving the association’s vision and mission? The association’s “Strategic Pathway to Excellence” sets out eight strategic objectives and a number of operational priorities to do just that. The goal is to move forward the way audiologists and speech-language pathologists provide services, the ... ASHA News
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ASHA News  |   December 01, 2015
ASHA’s Strategic Pathway and You: Focus on Objective 5
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ASHA News & Member Stories / ASHA News
ASHA News   |   December 01, 2015
ASHA’s Strategic Pathway and You: Focus on Objective 5
The ASHA Leader, December 2015, Vol. 20, 56-57. doi:10.1044/leader.AN1.20122015.56
The ASHA Leader, December 2015, Vol. 20, 56-57. doi:10.1044/leader.AN1.20122015.56
Did you know ASHA has a roadmap for achieving the association’s vision and mission? The association’s “Strategic Pathway to Excellence” sets out eight strategic objectives and a number of operational priorities to do just that.
The goal is to move forward the way audiologists and speech-language pathologists provide services, the way others perceive and value those services, the science underlying service delivery, and the composition of ASHA membership. ASHA staff are guiding work toward these objectives through the year 2025, when ASHA will be 100 years old. The Envisioned Future document describes this centennial vision.
You—the members—are integral to working toward the strategic objectives and realizing the Envisioned Future: 2025 outcomes. Starting last month with Objective 6 and continuing through June, the Leader will showcase, one by one, how members are already addressing these eight objectives.
Objective 5: Increase influence and demonstrated value of audiology and speech-language pathology services.
George Lyons, ASHA government relations and public policy director and staff “owner” of the effort, describes the objective: “All indications are that future payment models and coverage determinations for reimbursement for services will be based on the documented value of those services. Audiologists and SLPs will have to demonstrate the value of their services to payers, administrators, consumers and families to avoid exclusion from payment models and restrictions on services.
“To demonstrate value, ASHA members need to play an active role in reimbursement processes, and empower and educate patients and clients to understand access and reimbursement.”
Here’s the story of an SLP who demonstrated the value of speech-language services by successfully securing previously denied insurance coverage.
Lorraine Salter, MS, CCC-SLP, private practice, Reading, Massachusetts
Two summers ago, I had an interesting experience with a major insurance provider. The company initially approved treatment for a 3-year-old client, whom I evaluated and diagnosed with severe apraxia of speech. This little guy had maybe five words in his lexicon, all unintelligible to an unfamiliar listener. He could not even consistently attempt to imitate monosyllabic words. His receptive language skills and cognition were at least at age level.
After several months of treatment with a motor-planning and sound-sequencing approach, the insurer notified the parents that the treatment was denied because “it was not medically necessary” and the child’s apraxia was deemed “developmental.” The communications stated that my client would “outgrow” his issue in time.
I have been in private practice for almost 28 years and ardently disagree with the insurance company’s reasoning. I consulted with Janet McCarty, ASHA director of private health plan reimbursement, who provided me with solid evidence to fight for my client. With the green light from the family, I went all-in to battle this decision with the big insurance company’s medical director.
Step by step, I explained to the medical director that apraxia is not a developmental disorder, but rather a neurologically based disorder that results in disruptions to a child’s ability to sequence the necessary motor movements to produce speech sounds.

I explained to the medical director that apraxia is not a developmental disorder, but rather a neurologically based disorder.

Although our exchange made some positive impact, he called in a third-party pediatric neurologist for further consultation. I knew this medical professional was going to be in my corner. I answered the neurologist’s questions about my client’s treatment and progress and, sure enough, she recommended in favor of my client’s speech disorder being neurologically based and his treatment medically necessary. She agreed that he would not outgrow it in time or improve through weekly sessions in small groups.
This example goes to show that although it is often frustrating to deal with insurance companies, you have to fight for your clients. When you meet, evaluate, and work with a child and family, and you know a child needs treatment, you must advocate and spend the time to fight for this child, no matter how big the insurance company or how much it tries to shut you down.
My client was approved for intensive therapy to treat his motor-planning disorder. He is making remarkable progress, and I am quite confident he can use a complete sentence to tell Santa what he wants for Christmas.
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December 2015
Volume 20, Issue 12