ALEXANDRIA, VA, May 8, 2008 — Pending cuts to the Medicare
physician fee schedule could severely hamper the ability of physical
therapists to serve the rehabilitation needs of seniors and people with
disabilities, driving up overall costs while decreasing quality of care,
according to the American Physical Therapy Association (APTA) and its
Private Practice Section.
In testimony May 8 before a hearing of the U.S. House Committee on
Small Business, Tom DiAngelis, PT, vice president of APTA's Private
Practice Section, commented that a scheduled 10.6 percent cut in
Medicare physician payments could have an especially devastating impact
on PTs in private practice, who are faced with not only the rising costs
of running a small business, but also decreases in revenue due to a
variety of government payment and policy challenges (Video). The hearing on "Medicare Physician Fee Cuts:
Can Small Practices Survive?" provided an opportunity for the committee
to examine the potential impact of fee cuts on the practices of
physicians and other allied health professionals. Unless Congress
intervenes, the cuts will go into effect July 1, 2008, and could also
have significant ramifications on the services offered to Medicare
patients, according to APTA.
"These Medicare beneficiaries are individuals who have suffered from
stroke, had joint replacements or chronic diseases that impair their
ability to move, walk and perform their daily tasks," DiAngelis
testified. "Physical therapist small businesses address these
beneficiaries' health care needs throughout the United States and
contribute to the health status of our country, including its economic
health."
Physical therapists, in particular, are being hit especially hard,
according to DiAngelis. Not only will they experience the overall 10.6
percent reduction in payment under the fee schedule, they also will be
subject to an arbitrary annual cap of $1,810 per beneficiary on
outpatient services beginning July 1.
"This cap will not save the Medicare program money," added DiAngelis.
"It would only shift the cost of care away from outpatient facilities
and small business to more costly settings. Small businesses in physical
therapy will be impacted as the therapy cap policy includes an exemption
for hospital outpatient departments. This exemption will do nothing more
than encourage patients to seek services in the hospital setting to
avoid having to change providers over the course of their physical
therapy treatment when they reach the cap." APTA is advocating for a
repeal of the therapy caps or an extension of the current exceptions
process that maintains access to clinically appropriate physical therapy
services under Medicare.
In addition to the problems posed by the pending payment cuts and
therapy caps, physical therapists in private practice have significant
limitations on how patients may access their services and the
marketplace, DiAngelis explained. Currently, Medicare requires that
patients be under the care of a physician as a prerequisite for payment
of therapy services, along with a physician certification of the therapy
plan of care. "If the payment cuts go into effect and physicians stop
taking Medicare patients or limit the accessibility or availability of
physician services, then access to physical therapy services will be
impacted as a ripple effect," DiAngelis added. APTA is lobbying for
passage of the Medicare Patient Access to Physical Therapist Act (HR
1552) as one strategy to provide relief to physical therapist small
businesses.
"The health care delivery system needs physical therapist small
businesses to meet patients' rehabilitation needs," testified DiAngelis.
"If those needs are unmet, then health care costs will be transferred to
more intensive, costly environments, compounding the existing crisis in
health care spending. Physical therapist small businesses are a
cost-effective, efficient delivery model for physical therapy services,
and efforts to maintain and enhance this setting are essential."
APTA is asking its members and consumers to contact members of
Congress and urge them to prevent the implementation of policies that
would severely impact rehabilitation coverage for Medicare
beneficiaries. For more information on these and other APTA advocacy
efforts, visit APTA's Patient Action Center.
Physical therapists are health care professionals who diagnose and
manage individuals of all ages, from newborns to elders, who have
medical problems or other health-related conditions that limit their
abilities to move and perform functional activities in their daily
lives. Physical therapists examine each individual and develop a plan of
care using treatment techniques to promote the ability to move, reduce
pain, restore function, and prevent disability. Physical therapists also
work with individuals to prevent the loss of mobility by developing
fitness- and wellness-oriented programs for healthier and more active
lifestyles.
The Private Practice Section of APTA represents 4,200 practitioners
who are the owners or operators of physical therapy private
practices.
The American Physical Therapy Association (www.apta.org) is a
national organization representing physical therapists, physical
therapist assistants, and students nationwide. Its goal is to foster
advancements in physical therapist education, practice, and research.
Consumers can visit www.findapt.us to find a physical therapist in their
area, as well as www.apta.org/consumer for physical therapy news and
information.