"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Monday, February 27, 2012

The Value of Physical Therapy: Reimbursement Can Increase 160% Before We Hit a "Break Even"

A new 6-month cost-effectiveness study of 515 musculoskeletal pain patients treated in a self-referred, direct access Welsh system found that the gains from primary physical therapy treatment of injured workers dramatically outstripped the costs.

The costs varied from £194 to £360 (about $300 to $569) per episode of care.

The gains received were £1,386 to £7,760 ($2,180 to $12,261).

Note that the gains DID NOT include wider societal effects of physical therapy rehabiliation, including:
  • reduced sickness benefits costs
  • reduced costs to employers attributed to improved production
  • reduced absence rates from work
All measured outcomes improved over the 6 month treatment period, including...
  • standardized functional scores
  • psychosocial vartiables
  • pain
  • work loss and
  • medical resource use
However, since this was a small study with no control group and no randomization the treatment effect could not be exclusively attributed to the physical therapy.

The authors results, however, indicated that, based on prevailing payment rates for physical therapists in Wales and the social value of preventing musculoskeletal injuries on workers' quality of life the following conclusion could be made:
"Sensitivity analyses demonstrated that the service would remain cost effective until the service costs were increased to 160% per user."
More studies like this need to be done that measure the cost effectiveness of surgery, injections and pharmaceuticals in the treatment of musculoskeletal pain syndomes affecting workers.

This study was published on the 23rd of February, 2012 by BMC Musculoskeletal Disorders.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.