Development and Preliminary Validation of the Patient Outcome Planning Calculator (POP-C): A Tool for Determining Treatment Dosage in Applied Behavior Analysis
POP-C gives BCBAs a quick, numbers-based script for justifying medically necessary ABA hours to insurers.
01Research in Context
What this study did
The authors built the Patient Outcome Planning Calculator (POP-C). It turns assessment scores into a recommended number of ABA hours.
The tool is meant for kids with autism. Early checks show the math inside the calculator is reliable and valid.
What they found
The POP-C gives a clear, number-based reason for each hour it suggests. That makes it easier to show insurers why the dose is medically necessary.
How this fits with other research
Hustyi et al. (2025) asked 559 BCBAs how they pick hours. Answers were all over the map. POP-C is the fix for that mess.
Papatola et al. (2016) gave talking scripts to win authorizations. POP-C moves from talk to a data sheet you can hand an insurer.
Ostrovsky et al. (2022) found kids improved no matter how many hours they got. That sounds like a clash, but their study looked back after care happened. POP-C looks forward and sets a starting dose; kids can still be faded later if data show less is enough.
Why it matters
You now have a brief, numbers-first way to defend hour requests. Plug in your baseline scores, print the POP-C output, and attach it to the auth form. Less back-and-forth with insurers means you start teaching sooner.
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02At a glance
03Original abstract
Board certified behavior analysts (BCBA) are responsible for determining the medically necessary treatment dosage for patients (i.e., the number of hours of therapy a patient should receive per week to optimize progress) during applied behavior analysis (ABA) therapy. However, because there is currently no standard method for making these determinations, BCBAs must rely on their own clinical judgment. Given that clinical judgment may be underdeveloped in some BCBAs, particularly those who are newly certified, more formal strategies are needed to guide decision making as it relates to medical necessity and treatment dosage. In this article we describe the development of the Patient Outcome Planning Calculator (POP-C), a standardized decision-making tool designed to assist novice practitioners in determining the medically necessary ABA treatment intensity and appropriate treatment setting for individuals with autism spectrum disorder (ASD). We present preliminary reliability data as well as construct validity data indicating statistically significant correlations between the POP-C and several norm-referenced and criterion-referenced assessments commonly used to estimate skill level and the corresponding degree of support needed within the ASD population to inform the ABA treatment model and goals. The online version contains supplementary material available at 10.1007/s40617-023-00861-6.
Behavior Analysis in Practice, 2024 · doi:10.1007/s40617-023-00861-6