Yesterday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed decision memo on electrical nerve stimulation for chronic low back pain. APTA is analyzing the proposal and will post a summary of the memo on its Web site next week.   

In October 2011, APTA submitted comments to CMS outlining the association's concerns with a national policy limiting local Medicare contractors' ability to assess the medical necessity of TENS. APTA included evidence in its comments to support TENS efficacy for chronic low back pain when used appropriately.

APTA member Michael Johnson, PT, PhD, OCS, recently was named to the National Advisory Council for Healthcare Research and Quality. The Council provides advice and recommendations to the director of the Agency for Healthcare Research and Quality (AHRQ) and the secretary of the Department of Health and Human Services on priorities for a national health services research agenda. The 21-member panel comprises private-sector experts who contribute a varied perspective on the health care system and the most important questions that AHRQ's research should address in order to promote improvements in the quality, outcomes, and cost-effectiveness of clinical practice. Johnson is the only physical therapist on the panel.

Johnson, regional director and chief clinical officer for the Home Health Practice at Bayada Home Health Care in Moorestown, New Jersey, has held numerous positions within APTA. He served as the Pennsylvania Chapter's chief delegate (2009-2011) and as a member of APTA's Government Affairs Committee (2005-2008). He is a member of the association's Workforce Consulting Group (2006-present) and PTJ's Special Feature Advisory Group (July 2009-present). He has been active in clinical and health policy-related research, resulting in the publication of multiple peer-reviewed abstracts and articles. In addition, Johnson has participated as a consultant on 2 expert work groups involved in developing quality measures for the Centers for Medicare and Medicaid Services for use under the Physician Quality Reporting System. He also is a member of the Steering Group for the Ambulatory Care Quality Alliance.

The high acuity of patients receiving glucocorticoid (GC) therapy for acute graft vs host disease may limit their adherence to an exercise-based rehabilitation program, which can slow their recovery, say authors of an article published in Support Cancer Care.

To test their hypothesis, researchers reviewed the medical records of 59 patients who received a hematopoietic stem cell transplant (HSCT) and who were receiving methylprednisolone (MP). They also measured patients' performance on the repeated sit-to-stand, 50-foot walk, and 6-minute walk tests before and after completing a 4-week progressive exercise rehabilitation program. Outcomes were compared by a paired t-test.

Thirty-two patients (54%) finished a treatment plan (adherent group), completing 80% of the prescribed sessions, and were reevaluated. Twenty-seven patients (46%) did not complete the rehabilitation program (nonadherent group), primarily because of readmission to the hospital (18 patients, 62%). The adherent group did not significantly improve their physical performance. However, a subgroup of 40% of these patients did experience clinically significant improvements in their physical performance.

Robust and lasting clinician-patient relationships are at the heart of every medical home, says a new report from the Commonwealth Fund that proposes 8 characteristics of the patient-centered medical home (PCMH). The report aims to provide general guidance for transforming a practice into this new model of care.  

The broad "change concepts," as the report calls them are: engaged leadership; a quality improvement strategy; empanelment or linking patients with specific providers to ensure the continuity of the patient-provider relationship; continuous and team-based healing relationships; organized, evidence-based care; patient-centered interactions; enhanced patient access to clinical information after office hours; and care coordination.  

For each of the 8 concepts, the authors suggested 2 to 6 specific practice modifications called key changes. For example, under organized, evidence-based care they propose that providers:

• use planned care according to patient need
• identify high-risk patients and ensure they receive appropriate care and case management services
• use point-of-care reminders based on clinical guidelines
• enable planned interactions with patients by making up-to-date information available to providers and the care team prior to the visit

Within the descriptions of the 8 characteristics, the report illustrates how the care of patients would differ between a fully transformed PCMH and a more typical primary care practice as seen through the health care experiences of 2 fictitious sisters—Ms G and Ms H.

Register by March 19 to get the best rates for PT 2012, APTA's Annual Conference & Exposition, June 6-9, in Tampa, Florida. The Annual Conference Web page has everything you need to preselect sessions, register, and book housing quickly and securely online. Belong, interact, and connect with your peers, recognized experts, and leaders for 3 days of valuable, relevant, invigorating professional development and networking.

State of the Science in the Prevention and Management of Osteoarthritis, the summary of a collaborative project on osteoarthritis (OA) that included experts in physical therapy, nursing, epidemiology, rheumatology, public policy, geriatrics, pharmacotherapy, and complementary modalities, is available in this month's American Journal of Nursing (AJN). 

In July 2011, association members Carol Oatis, PT, PhD, and Maura Iversen, PT, DPT, MPH, ScD, and Anita Bemis-Dougherty, PT, DPT, MAS, of APTA's Department of Clinical Practice, represented the US Bone and Joint Initiative at a symposium hosted by AJN, the Hospital for Special Surgery, and the National Association of Orthopaedic Nurses to recommended ways in which nurses could take on greater leadership roles in research, policy, education, and clinical practice for the early diagnosis and management of OA.

The objectives of the symposium were to:

• Identify gaps in the science and barriers to the early identification of OA and the implementation of interventions that promote mobility, decrease pain, and slow progression.
• Describe the state of the science of current interventions for preventing immobility and managing the effects of OA.
• Achieve consensus on the priorities for developing the best nursing practices—in the clinical, educational, research, and policy arenas—in order to meet the needs of diverse populations with OA in a variety of settings. 
• Disseminate the analysis and recommendations to clinicians, nurse leaders, educators, researchers, specialty nursing organizations, other health care professionals, policymakers, consumer advocacy groups, and the general public.

Five main themes emerged from the symposium that address the burden of OA, the need for national initiatives to raise awareness of OA, assessment of  risk and progression of OA, interventions that relieve symptoms and minimize disease progression, and support for self-management as an aspect of OA treatment.