APTA: Working for You

APTA Submits Comments on Policy Options for Expanding Health Insurance Coverage 

APTA submitted comments today in response to the Senate Finance Committee's May 14 policy options document titled "Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans." The association recommended including strong nondiscrimination safeguards and the prohibition of pre-existing conditions as part of insurance reform; moving physical therapy, which currently is listed as an optional Medicaid benefit, to the mandated benefit category; phasing out the Medicare disability waiting period; repealing the Sustainable Growth Rate portion of the conversion factor for Medicare payments and the therapy caps; and including long term care services and supports in reform.   

"Rehabilitation services are an efficient, effective way to reduce overall health care spending for individuals and therefore must be an essential element of a standard benefit package in any proposal to reform the insurance delivery system," said APTA.

Responding to the committee's recommendation for the promotion of prevention and wellness, APTA said that it is "encouraged by and supports the Committee's consideration of innovative programs, grants, and options to encourage healthy lifestyles. Physical therapists stand ready to assist in the transformation of our disease identification and treatment system to one that prevents these conditions and seeks strategies to better manage them at the point of most influence."

Senate Finance Committee Releases Policy Paper on Financing Health Care Reform

On Monday, Senate Finance Committee Chair Max Baucus (D-MT) and ranking member Chuck Grassley (R-IA) released a 41-page document outlining policy options for financing health care reform. This is the third and final document to be released before the Senators draft health reform legislation. While the document states Baucus and Grassley do not support all the proposals included in the paper, it does not indicate which proposals are backed by the Senators.

The report outlines several ways to gain revenue by re-evaluating the tax exemption for employer-sponsored health care benefits, which will cost the government $194.2 billion in revenue in 2008. The options include capping the amount of health benefits that can qualify for the exemption; taxing benefits for higher-income residents; a combination of the two previous options, in which tax-exempt benefits are capped only for higher-income residents; or eliminating the exemption and creating a system based on deductions or tax credits.

The report suggests modifying or eliminating tax exemptions for itemized deductions for medical expenses, health savings accounts, and flexible spending accounts. It also calls for levying new taxes for not-for-profit hospitals that do not provide enough charity care or meet other requirements. One proposal would cut or reduce a special deduction for BlueCross and BlueShield companies.

Proposals for new taxes are included for alcohol and -- for the first time -- sugar-sweetened drinks, such as non-diet sodas, fruit and vegetable drinks, energy and sports drinks, iced teas, iced coffees, flavored milk, and dairy drinks.

Changes in the Medicare and Medicaid programs also are examined as a means to finance health care overhaul. The report suggests making MedPAC-recommended changes to the payment system by reducing, eliminating, or creating standards for annual increases for certain treatments and fee-for-service providers. The paper also proposes reducing Medicare spending by adjusting the payment formula for home health care, medical imaging and durable medical equipment. Additionally, the document calls for spending adjustments be made in Medicare Part A and Part B based on geographic variations.

2009 Federal Advocacy Forum Attendees Successfully Advocate on Behalf of Physical Therapy

More than 200 physical therapists, physical therapist assistants, and students of physical therapy gathered at APTA's headquarters and the nation's capital on May 17-19 to improve their advocacy skills and promote physical therapy issues to members of Congress at this year's APTA Federal Advocacy Forum.

Physical therapy providers from all 50 states visited more than 300 congressional offices to discuss health care reform as well as other issues important to the physical therapy profession and the patients it serves.

The Federal Advocacy Forum also featured a variety of speakers, including US Reps Jo Ann Emerson (R-MO), Joe Wilson (R-SC), Parker Griffith(D-AL), and Earl Pomeroy (D-ND). Additional speakers included political commentator Norm Ornstein; Mary Andrus, assistant vice president, government relations, Easter Seals; and Tim Nanof, federal affairs manager at the American Occupational Therapy Association. Several awards were presented during the forum including the 2009 Federal Legislative Leadership Award to Stephen Levine, PT, DPT, MSHA, and the 2009 Public Service Award to Rep Lois Capps (D-CA) and Sen Edward Kennedy (D-MA).

Read more about the forum on APTA's Moving Forward blog.

New "PT Perspective" Documents Now Available   

APTA recently developed two documents outlining the association's perspective on, and the profession's role in, health care reform. The first is a brief overview of the policy provisions that APTA believes should be included in any health care reform legislation that is considered by Congress. The second is a more comprehensive document that goes into detail about the physical therapist's role in health care reform. Go to APTA's Health Care Reform Resource Center for more information on APTA's actions related to reform.  

PT 2009 Attendance Set to Exceed Expectations

What with the economic downturn and daily news media waxing on about the ever worsening state of affairs, to be concerned over event registration is only natural. However, at a time when most meetings are experiencing sharp declines PT ’09 has, with a 9% increase, not just maintained but exceeded both its registration numbers year-on-year and our expectations. This is clearly indicative of the continued health of the PT/PTA profession and member enthusiasm.

As of Thursday registration for PT 2009 stood at 2,020. And, based on past numbers, we can expect to see another 300-500 onsite registrants next month in Baltimore, which will put us well ahead of last year’s final numbers.

PT ’09 is a place where you can learn and earn the CEUs you need -- in one place. Aside from that, with numbers expected to be up, what better place to network and catch-up with friends and colleagues? Consider this your mid-year refresher.  Watch the Video: See what PT ’09 and Baltimore have to offer you.

Practice Tips

Electronic Options for Submitting Records for Disability Claims  

Electronic Records Express is an initiative by Social Security and state Disability Determination Services (DDS) to offer electronic options for submitting records related to disability claims. Providers who receive a request for records about a disability claim can choose the method of sending the information either online to Social Security's secure Web site or by fax to the appropriate state DDS or to Social Security. The records sent are automatically associated with the applicant's disability claim folder.

Go to the Electronic Records Express Web site to learn more.

New in Research

Footnote: What's New in the Literature

A strategy for whole-body rehabilitation consisting of interruption of sedation and physical therapy and occupational therapy in the earliest days of critical illness is safe and well tolerated, and results in better functional outcomes at hospital discharge, a shorter duration of delirium, and more ventilator-free days compared with standard care, says an article published online May 14 in the Lancet. APTA members Amy Pawlik, PT, DPT, CCS, Rhonda Barr, PT, MA, CCS, and Mietka Franczyk, PT, PhD, coauthored the article.

Sedated adults 18 years of age and older in the ICU who had been on mechanical ventilation for less than 72 hours, were expected to continue for at least 24 hours, and met criteria for baseline functional independence were eligible for enrollment in this randomized controlled trial at two university hospitals. Researchers randomly assigned 104 patients by computer-generated, permuted block randomization to early exercise and mobilization (physical and occupational therapy) during periods of daily interruption of sedation (intervention; n=49) or to daily interruption of sedation with therapy as ordered by the primary care team (control; n=55). The primary endpoint—the number of patients returning to independent functional status at hospital discharge—was defined as the ability to perform six activities of daily living and the ability to walk independently. Therapists who undertook patient assessments were blinded to treatment assignment. Secondary endpoints included duration of delirium and ventilator-free days during the first 28 days of hospital stay.

All 104 patients were included in the analysis. Return to independent functional status at hospital discharge occurred in 29 (59%) patients in the intervention group compared with 19 (35%) patients in the control group. Patients in the intervention group had shorter duration of delirium (median 2 days, IQR 0—6 vs 4 days, 2—8), and more ventilator-free days (23.5 days, 7.4—25.6 vs 21.1 days, 0—23.8) during the 28-day follow-up period than did controls. There was one serious adverse event in 498 therapy sessions (desaturation less than 80%). Discontinuation of therapy as a result of patient instability occurred in 19 (4%) of all sessions, most commonly for perceived patient-ventilator asynchrony.

Patients Comfortable With Role of Computers in Health Care, Say BIDMC Researchers

Patients say that they not only want computers to bring them customized medical information, they fully expect that in the future they will be able to rely on electronic technology for many routine medical issues, says a research team at Beth Israel Deaconess Medical Center (BIDMC).

The qualitative study, which is published in the June 2009 issue of the Journal of General Internal Medicine, found that patients want full access to all of their medical records, are willing to make some privacy concessions in the interest of making their medical records completely transparent, and that, going forward, fully expect that computers will play a major role in their medical care, possibly substituting for face-to-face physician visits.

Focus groups for the study were held Boston, Denver, Portland, Maine; and Tampa, Florida. The locations were selected to represent various geographic areas, to include both rural and urban populations and to incorporate ethnic and cultural diversity, says BIDMC. Six of the eight groups (consisting of nine to 12 participants each) were made up of consumers. The last two groups were made up of health care professionals from Boston and Denver, assembled to provide their perspectives on the role of health information technology and to compare their opinions with those of consumers. In each case, participants were asked how they currently organize the information they need to manage their health and medical care, and explored how they would ideally like to manage and use this information, including how technologies could address any gaps.

"The discussions showed that, for the most part, consumers want computers to take into account their personal profiles in order to bring them customized information and advice," says the study's lead author Jan Walker, RN, MBA. "They also expect that technologies will 'watch' over them, monitoring their health and giving them real-time feedback, including communicating with clinicians when needed. Participants also said they expect computers to act as 'personal coaches,' and to foster self care."

New health technologies offer patients online access to parts of electronic medical records, options for maintaining their personal histories, and support for day-to-day management of chronic illness, the authors note. But when it comes to the future design and utility of these and other elements of care, teams of software engineers, graphic artists, and clinicians rarely solicit patient perspectives.

Membership Matters

Register for Onsite Daily Rate Today; Energize Your Thinking at PT 2009

If you have not been to APTA's Annual Conference & Exhibition this is your chance to attend. Join your colleagues in Baltimore, Maryland, June 10–13, for 19 tracks of advanced programming, nationally and internationally renowned speakers, Opening Ceremonies with keynote speaker Newt Gingrich, the Oxford Debate, Coffee with the Stars, the poster hall, mentoring opportunities, and much more. Register for the onsite or daily rate by calling APTA Member Services at 800/999-2782, ext 3395. Don't delay—earn 2.1 CEUs and enjoy Baltimore's Inner Harbor. For programming, housing and other information follow this link.

Click of the Week

Legal Resources

APTA does not provide legal representation or advice to members, nor can it provide referrals to specific attorneys. However, the association does provide members with general information on how to find an attorney on its Legal Resources page. The page offers general tips followed by a selection of resources to assist APTA members in finding an attorney. The information presented should not be interpreted as specific legal advice for any particular provider or for any particular practice setting.