Hi there...I've been busy working on research projects and writing up the
literature review and methodology of the fee-survey study.  I have the
ability to add more data ONE last time before I do my final data runs and
statistical analyses for my ILCA presentation.  Anyone who didn't answer and
still wants to, may do so now.  If you've changed your info or didn't
provide full info, you can do so now.  I've gone back through and formalized
certain parts since the earliest respondents answered.

Again, I want to thank all of you (now at an amazing 214) who responded and
I promise that you will receive a copy of the early results just as soon as
I've completed them.  As requested by a few respondents, the results will
NOT be posted on Lactnet, so if you want results please answer (or attend
the research poster sessions at ILCA).   Please make sure to put "Fees"
somewhere in the subject line so that my mail sorter will put it in the
correct folder.  TIA!

 Here is what I'm looking for...
    The methods employed in this study are standard to the field of Health
Services Research (HSR), a multidisciplinary field which has evolved over
the past decades to evaluate many facets of health service provision.
Medical, epidemiologic, economic, planning, legal, political, anthropologic
and sociologic data are frequently combined in HSR analyses to present as
complete a picture as possible for the purpose of improving services,
reducing costs, and hopefully, influencing public and private policy.
Again, because there has not been much ³cross-over² between HSR and
Lactation Research, brief yet explicit definitions are provided to minimize
confusion and educate for future research presentations.
     This self-funded study should be taken as a pilot study which lays the
descriptive groundwork for future reimbursement modelling research in this
field.   With modelling research, it is hoped that predictive equations will
be published for general use.  There are no potential conflicts of interest
with funding sources or sponsors.

Survey Methodology:
 In order to further the field of professional Lactation Consulting, this
study is an initial step in developing a  Resource-Based Relative Value
Scale (RBRVS)-type system of reimbursement comparison.  Based upon a
convenience sample survey of currently practicing LCs (mostly IBCLCs)
solicited from Lactnet during March through May of 2000, respondents were
asked the following questions:

€Whether they ³used a flat hourly fee, salary, or fee-for-service  (FFS)?²
€What level/amount were they reimbursed per particular unit ($/hour, FFS,
annual salary)?
€For which specific types of consultations:initial consult/workup,
follow-up, on-going care, telephone consult) and other services (e.g. pump
rental, pump instruction, pump cleaning, nipple shield sales and
instruction)?  Additionally, sucharge information was provided regarding
weekend, holiday, and night fees.

Qualitative data were collected on ³why or upon what rationale² their  fee
or reimbursement decisions were based,

Respondents were then queried as to their:
€ education
€ training
€ certifications
€ experience
€ geographic local
€ degree of competition within a 60 mile radius (perceived/reported, and as
calculated by registrants in the 2000 International Lactation Consultants
Association directory)
€ competing practitioners¹ fees
€ base of practice (i.e. independent vs. group private practitioner or
hospital based?)

 In addition, respondents volunteered large quantities of information beyond
what was requested.  Interestingly, every responded volunteered information
on how and when they decide to give free, charity or uncompensated care.

Thanks again to everyone who participated, will participate, and all who've
just taken the time to read my multiple calls for info.
Warmly,
Chris
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC    [log in to unmask]
mom, wife, educator, lactation consultant, researcher, scientist, author,
organic gardener, photographer, lapidary creator, lousy cleaner.

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