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QUANTITATIVE SURVEY RESULTS

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QUANTITATIVE SURVEY RESULTS. For the BOARD FOR CERTIFICATION IN PEDORTHICS March 5 - 6, 1998. QUANTITATIVE SURVEY RESULTS. These are the answers! The findings of the Smith, Bucklin quantitative survey used a sample of 1,400 pedorthists. 535 responses were received (38 %).

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  1. QUANTITATIVE SURVEY RESULTS For the BOARD FOR CERTIFICATION IN PEDORTHICS March 5 - 6, 1998 Smith, Bucklin & Associates

  2. QUANTITATIVE SURVEY RESULTS These are the answers! The findings of the Smith, Bucklin quantitative survey used a sample of 1,400 pedorthists. 535 responses were received (38 %). Smith, Bucklin & Associates

  3. RESEARCH OBJECTIVES • Assess the needs of pedorthists. • Understand the attitude of certificants towards BCP. • Level of satisfaction with the benefits and services provided by BCP. • Understand the benefits and services pedorthists value. • Assist in identifying the strategic priorities of BCP. Smith, Bucklin & Associates

  4. PROFILE OF RESPONDENTSAge of BCP Members Smith, Bucklin & Associates

  5. PROFILE OF RESPONDENTSGender of BCP Members Smith, Bucklin & Associates

  6. PROFILE OF RESPONDENTSOwners vs. Non-owners/Employee Smith, Bucklin & Associates

  7. Q1. NUMBER OF YEARS SPENT FILLING PEDORTHIC PRESCRIPTIONS Smith, Bucklin & Associates

  8. Q1. NUMBER OF YEARS SPENT FILLING PEDORTHIC PRESCRIPTIONS By Credentials/Certifications Currently Held CO/ BOCO/ C.Ped CPO/ BOCP/ C.Ped Total Only CP ROF DPM (C) % % % % % % < 2 years 17 18 2 6 68 18 -4 years 17 19 15 12 11 - 5-8 years 17 14 32 14 11 18 9-15 years 18 16 18 33 - 9 16-20 years 9 9 12 15 - 19 20+ years 21 23 18 20 11 36 No Response - 2 - - - Average # of Years 11.15 11.17 11.68 13.02 4.37 14.82 (Base) (535) (345) (40) (66) (19) (11) Smith, Bucklin & Associates

  9. Q2. YEARS OF EXPERIENCE AS A CERTIFIED PEDORTHIST Smith, Bucklin & Associates

  10. Q2. YEARS OF EXPERIENCE AS A CERTIFIED PEDORTHISTBy Owner vs. Non-owner Smith, Bucklin & Associates

  11. Q2. NUMBER OF YEARS EXPERIENCE AS A CERTIFIED PEDORTHIST By Primary Practice Setting Ped. O&P Hosp./ Phys. Shoe Shoe Total Facility Facility Clinic Office Store Repair % % % % % % % < 2 years 28 18 30 38 41 20 51 -4 years 27 25 34 22 29 21 9 5-8 years 18 22 18 22 21 15 23 9-15 years 13 19 10 10 6 14 6 16-20 years 5 6 2 2 - 14 3 20+ years 8 10 4 6 3 15 9 No Response 1 - 2 - - - - Average # of Years 6.87 8.31 5.22 5.64 4.22 9.92 5.64 (Base) (535) (132) (163) (50) (34) (118) (35) Smith, Bucklin & Associates

  12. Q3. CREDENTIALS/CERTIFICATIONS CURRENTLY HELD (By Primary Practice Setting) Ped. O&P Hosp./ Phys. Shoe Shoe Total Facility Facility Clinic Office Store Repair % % % % % % % C.Ped 94 95 92 90 91 97 94 BOCO 11 4 28 4 6 - 3 C.Ped(C) 7 8 9 10 3 5 6 DPM 5 2 - 14 47 1 - CPO 4 1 13 - - - - CO 4 2 10 6 - - - ROF 4 5 7 6 - - - CP 3 1 8 - - 1 3 BOCP 2 - 7 2 - - - PT 2 - 1 12 3 - - All Others 20 16 20 22 29 14 40 Smith, Bucklin & Associates

  13. Q4B. WHERE PRESENT OWNERS AND NON-OWNERS SEE THEMSELVES IN 5 YEARS Smith, Bucklin & Associates

  14. Q5A-B. PRIMARY PRACTICE SETTING NOW VS. WHERE SEE MOST C.PEDS IN FIVE YEARS Smith, Bucklin & Associates

  15. Q5B. FIVE YEARS FROM NOW, IN WHAT PRACTICE SETTING DO YOU SEE MOST C.PEDS? OTHER: • Medical health care/enhancement facility • Nursing homes • Combination shoe store and ped facility Smith, Bucklin & Associates

  16. Q6. CREDENTIALS PLANNING TO ADD DURING NEXT FIVE YEARS By Age of Member Total < 35 36-45 > 46 % % % % CO 13 20 14 7 BOCO 11 14 15 7 C.Ped(C) 7 4 7 8 BOCP 6 7 5 6 CP 4 6 4 4 CPO 4 5 4 3 ROF 1 3 1 1 DPM 1 2 1 - PT 1 2 1 - Other(s) 6 9 6 5 No Response 55 44 52 64 (Base) (535) (118) (196) (218) Smith, Bucklin & Associates

  17. Q9. LOCATION OF PRACTICE Smith, Bucklin & Associates

  18. Q10. AMOUNT OF IMPACT THE FOLLOWING FACTORS ARE HAVING ON THE PEDORTHIC PROFESSION a) Managed care and the change in referral sources 83 % b) State Provincial Licensure 36 % c) The O&P profession 65 % d) The podiatric profession 66 % e) Other health care professions dispensing orthoses, footwear, and modifications 65 % f) Comfort footwear retailers 52 % Smith, Bucklin & Associates

  19. Q11. HOW DISPENSING OF PRESCRIPTION PEDORTHIC DEVICES IS DIVIDED BY THE AVERAGE BCP MEMBER Smith, Bucklin & Associates

  20. Q12. SOURCE OF PRESCRIPTION-BASED PEDORTHIC REVENUE(Response by facility owners/managers only) Smith, Bucklin & Associates

  21. Q13. PREDICTION FOR AMOUNT OF GROWTH OPPORTUNITIES FOR PEDORTHIC PROFESSION IN NEXT 5 YEARS Smith, Bucklin & Associates

  22. Q14. OPINION OF STRATEGIC POSITION FOR PEDORTHIC PROFESSION REGARDING THIRD-PARTY REIMBURSEMENTS By Member Opinion of How Third-Party Reimbursements Affect Business Positively Negatively Affect Affect Their Their No Total Business Business Effect % % % % a) Take a position that actively seeks greater third-party reimbursement for pedorthics 65 73 66 55 b) Take a position that moves the profession toward more self-pay reimbursement 18 11 21 26 c) Remain at about the same level of third-party reimbursement as it is today 7 10 4 8 d) Take a position that moves the profession away from third-party reimbursement 5 3 6 7 No Response 5 3 3 4 Smith, Bucklin & Associates

  23. Q15. AMONG MEMBERS WHO FEEL PEDORTHICS SHOULD SEEK GREATER THIRD-PARTY REIMBURSEMENT, RANKING OF OPTIONS Ranked 1st or 2nd Ranked Ranked Ranked Ranked No (Net) 1st 2nd 3rd 4th Response % % % % % % 1. Educate referral sources about pedorthics 59 38 21 19 14 8 2. Attempt to convince regulators to add more pedorthic devices as covered items 49 22 27 25 18 8 3. For quality assurance purposes, request that providers of pedorthic devices meet minimum standards (via certification, education experience and/or inventory) 41 18 23 20 32 7 4. Attempt to convince regulators to increase reimbursement for pedorthic devices 35 15 20 28 28 8 Smith, Bucklin & Associates

  24. Q16-17. HOW THIRD-PARTY REIMBURSEMENTS AFFECT BUSINESSNow vs. Prediction for five (5) years from now Smith, Bucklin & Associates

  25. Q18-19. IN REGARD TO 3RD PARTY REIMBURSEMENT ISSUES AND MEDICARE/ MEDICAID REGULATIONS AND POLICIES, SHOULD ADDITIONAL PEDORTHIC DEVICES BE ADDED IF CURRENT PRICING STRUCTURE... % YES Smith, Bucklin & Associates

  26. Q20. LEVEL OF CONCERN REGARDING STATE/PROVINCIAL LICENSURE’S AFFECT ON THE PEDORTHIC PROFESSION Smith, Bucklin & Associates

  27. Q21. RANKING OF ACTIONS THE PEDORTHIC FIELD SHOULD TAKE REGARDING STATE/PROVINCIAL LICENSING LAWS/REGULATIONS Ranked 1st or 2nd (Net) 1st 2nd 3rd 4th Resp. %%%%%% 1. Add pedorthics to state/provincial licensure, creating OP&P licensure (C.Peds would be licensed under separate standards as part of an O&P law) 59 32 27 21 9 12 2. Promote separate pedorthic state/ provincial licensure not in conjunction with O&P licensure 46 25 21 26 17 11 3. Add pedorthic definitions to O&P state/ provincial licensure (C.Peds would be licensed as part of O&P industry) 45 15 30 26 17 12 4. Exempt C.Peds from need to be licensed for foot orthoses(if shoes are not regulated) 30 19 11 15 43 12 Smith, Bucklin & Associates

  28. Q22. WITH RESPECT TO PEDORTHIC PRESCRIPTIONS FILLED, AVERAGE PERCENTAGE OF PATIENTS REFERRED BY... Smith, Bucklin & Associates

  29. Q23. AT CURRENT REIMBURSEMENT LEVELS, LEVEL OF CONFIDENCE IN BEING ABLE TO PROVIDE ADEQUATE AND PROFESSIONAL SERVICE Smith, Bucklin & Associates

  30. Very Very Satisfied/ Very Dissatis- Dissatis- Satisfied Satisfied Satisfied fied fied (Net) (+4) (+3) (+2) (+1) (Base) % % % % % a. State/provincial licensure 63 24 39 26 10 (535) b. Recognition by referral sources 96 76 21 2 1 (535) c. Standing within allied health community 96 65 30 3 1 (535) d. Recognition by patient 95 70 25 3 1 (535) Q24. AS A C.PED, VALUE OF VARIOUS ASPECTS OF THE PROFESSION Smith, Bucklin & Associates

  31. Q25. DOES CURRENT PRE-CERTIFICATION EDUCATION PROCESS PREPARE C.PED FOR ENTRY-LEVEL PEDORTHIC CARE Smith, Bucklin & Associates

  32. Q26. IF FEEL PRE-CERTIFICATION EDUCATION PROCESS DOES NOT ADEQUATELY PREPARE C.PEDS, AREAS THAT SHOULD BE IMPROVED Smith, Bucklin & Associates

  33. Q27. WOULD BE WILLING TO GO THROUGH ADDITIONAL EDUCATION/EXAMINATION TO EXPAND C.PED’S STANDARD OF PRACTICE Smith, Bucklin & Associates

  34. Q28. IN THE PRACTICE OF PEDORTHICS, WHAT TYPES OF ADDITIONAL SERVICES WOULD YOU LIKE TO BE ABLE TO PROVIDE FOR YOUR PATIENTS AS A C.PED? - AFOs (57) - Currently provide - Compression stockings (12) all I need to provide. (17) - Ankle braces (8) - Above ankle bracing (6) - Knee braces (6) - Wound care (6) - Cam walkers (4) - Lower extremity - Nail care (4) physical therapy. (4) - Braces (4) - Gait analysis. (4) - KOs (3) - SMOs (3) - Below knee orthotics. (3) - Build orthoses without - Air casts. (2) prescription. (3) - Additional gait systems for lower extremity. (2) Smith, Bucklin & Associates

  35. Q29. SHOULD THERE BE A LEVEL OF CREDENTIALING FOR PEDORTHISTS WHO DO NOT PROVIDE PATIENT CARE, BUT INVOLVED IN FABRICATION/ TECHNICIAN WORK? Smith, Bucklin & Associates

  36. Q30. RATING OF THE VALUE OF FACULTY ACCREDITATION Very Not Not at Valuable/ Very Very all Valuable Valuable Valuable Valuable Valuable (Net) (+4) (+3) (+2) (+1) % % % % % 1. Increase credibility to referral sources 70 35 35 20 8 2. Increase credibility of patients 66 31 35 24 8 3. Use as a marketing tool to managed care 73 35 38 17 8 Smith, Bucklin & Associates

  37. Q31. SATISFACTION WITH VARIOUS ASPECTS OF BCP Very Very Satisfied/ Very Dissatis- Dissatis- Satisfied Satisfied Satisfied fied fied (Net) (+4) (+3) (+2) (+1) % % % % % a. BCP Board Structure 96 30 65 1 1 b. BCP Administrative Staff 95 34 61 3 1 c. Continuing Education Requirements 79 17 62 15 4 d. Precertification Standards 72 13 59 21 4 e. Faculty Accreditation Standards 79 11 68 14 3 f. BCP Marketing of Profession 72 11 60 21 4 Smith, Bucklin & Associates

  38. Q32. FEELINGS ABOUT THE COST OF MAINTAINING CERTIFICATION Smith, Bucklin & Associates

  39. Q34. IF YOU WOULD LIKE TO SEE ADDITIONAL PROFESSIONAL ASSISSTANCE, WOULD YOU SUPPORT INCREASED FEES? Smith, Bucklin & Associates

  40. Q35. RATING OF METHODS FOR MARKETING PEDORTHICS AND THE C.PED (+4) Extremely important Extremely (+3) Important Important/ (+2) Not very important Important No (+1) Not at all important (Net) (+4) (+3) (+2) (+1) Response % % % % % % 1. Exhibiting at medical and allied health conferences 96 54 42 3 * 1 2. Providing and placing articles on pedorthics in trade journals, public magazines and newspapers 93 53 40 6 * 1 3. Answering requests/inquiries from the public 93 38 55 6 - 1 4. Distributing free directories of C.Peds to medical communities and referral sources 88 43 44 10 1 1 5. Distributing free information on getting certified 49 12 37 45 6 1 Smith, Bucklin & Associates

  41. Q36. RANKING OF AREAS OF PEDORTHICS IN WHICH BCP CAN HAVE THE GREATEST IMPACT AND SHOULD EXPAND EFFORTS % 1. Educating physicians to have C.Ped as part of the health care team 70 2. Informing managed care organizations about pedorthics 42 3. Seeking allied health referrals for C.Peds 26 4. Changing reimbursement levels for Medicare services 20 5. Educating the consumer regarding pedorthics and the C.Ped 18 6. Educating and providing materials to assist the C.Ped in marketing his/her practice 9 7. State/Provincial licensure 9 Smith, Bucklin & Associates

  42. Q37. DO YOU BELIEVE C.PEDS WOULD BE BETTER SERVED IF ... 1. BCP remained the same. 54 % 2. BCP formed a collaborative alliance with another certifying agency. 29 % 3. BCP merged with another certifying agency. 13 % 4. BCP was managed by another administrative agency. 1 % No Responses 5 % (multiple responses allowed) Smith, Bucklin & Associates

  43. Q38. WHAT DO YOU SEE AS THE PROS AND CONS OF AN ALLIANCE OR MERGER BETWEEN BCP AND ANOTHER CERTIFYING AGENCY? PROS: - Credibility (27) - Greater recognition. (26) - Cost savings. (16) - Stronger legislative practices. (14) - Strength in numbers. (10) - Increased visibility. (10) - More clout with bigger - More income. (7) organization. (8) - Sharing knowledge and cost - More cooperation for HMO would benefit everyone. (7) coverage as C. Peds are - More qualified referrals (5) accepted with group - Better service to patient. (4) (i.e. company’s & C. Peds). (6) - More credibility with Medicare reimbursement and physicians. (4) Smith, Bucklin & Associates

  44. Q38. WHAT DO YOU SEE AS THE PROS AND CONS OF AN ALLIANCE OR MERGER BETWEEN BCP AND ANOTHER CERTIFYING AGENCY? CONS: - Loss of identity (41) - Loss of control (28) - Loss of autonomy (11) - May dilute the field of C. Peds. (8) - Loss of focus (7) - Cost increases (5) - Higher dues (5) - Increased certification fees. (4) - Other agencies, such as ABC, placing greater priority on their members. (3) - Dependency on others who do not understand our needs. (2) Smith, Bucklin & Associates

  45. Q39. WHAT OTHER GROUPS AND/OR CERTIFYING AGENCIES SHOULD BCP CONSIDER FOR AN ALLIANCE OR MERGER 1. American Board for Certification in Orthotics and Prosthetics 49 % 2. American Orthopaedic Foot and Ankle Society 43 % 3. American Podiatric Medical Association 26 % 4. American Orthotic and Prosthetic Association 26 % 5. Pedorthic Association of Canada 22 % 6. Board for Orthotist Certification 21 % 7. National Commission on Orthotic and Prosthetic Education 12 % Others 4 % No Response 14 % (multiple responses allowed) Smith, Bucklin & Associates

  46. MAIN FINDINGSThe Demand for Government Relations At present, 34 percent of BCP certificants feel third-party reimbursements positively affect business, 23 percent feel third-party reimbursements have no effect on business, and 40 percent feel third-party reimbursements negatively affect business. In five years, 41 percent of BCP certificants feel third-party reimbursements will positively affect business, 13 percent feel third-party reimbursements will have no effect on business, and 42 percent feel third- party reimbursements will negatively affect business. Smith, Bucklin & Associates

  47. MAIN FINDINGS • The industry is growing. • The practitioners are “young”. • The certificants are satisfied - no major changes or mergers are desired. • There is a demand for - Government Relations - Education - Marketing • Members are ready to pay more for additional substantive member services. Smith, Bucklin & Associates

  48. MAIN FINDINGSGeneral The average BCP certificant is 44 years old, and the range of ages is normally distributed. Eighty-five percent of BCP certificants are male. More than three-quarters of BCP certificants feel there will be an increasing amount of opportunities for growth in the pedorthic profession in the next five years. This opinion was relatively consistent across various segments and demographics of BCP certificants. Smith, Bucklin & Associates

  49. MAIN FINDINGSThe Demand for Changes or Mergers Fifty-four percent of BCP certificants feel BCP would be better served by remaining the same, versus 29 percent who feel BCP should form a collaborative alliance with another certifying agency and 12 percent who feel BCP should merge with another certifying agency. Smith, Bucklin & Associates

  50. MAIN FINDINGSBCP - Administration Level of Satisfaction & Costs BCP certificants are very satisfied with BCP Board structure and BCP administrative staff. Only four percent of BCP certificants feel the cost of maintaining certification is ‘Very Reasonable’, though 50 percent feel the cost is ‘Reasonable’. Forty-five percent feel the cost is ‘Expensive’ or ‘Too Expensive’. Smith, Bucklin & Associates