In a recently recorded podcast, APTA member Jose Kottoor, PT, MS, provides his perspective of accountable care organizations (ACO) and their relevance to physical therapists. Kottoor addresses strategies to reduce costs by decreasing the length of stay in acute care hospitals, such as early mobility of patients, weekend therapy, evening shifts for therapies, and using telehealth. He also discusses improving outcomes and quality measures, and reducing readmissions. Kotoor wraps up his presentation by highlighting the various opportunities for physical therapists who participate in programs aimed at disease risk management, health promotion, prevention, and fitness, in addition to those that reduce repeat emergency department visits, hospital admissions and readmissions, the incidence of falls, and the need for surgery. 

A PowerPoint presentation accompanies this podcast.

Cost estimates for legislative proposals to address obesity use a time period that is too short to capture the potential economic value of preventing related diseases such as diabetes and heart disease, concludes a study released Wednesday by the Campaign to End Obesity. This failure limits policymakers' ability to consider effective policies to address these costly conditions.

The study, Assessing the Economics of Obesity and Obesity Interventions, addresses how policymakers measure the benefits of policies to address chronic diseases. The authors describe how Congressional Budget Office cost estimates, which generally cover a 10-year period, do not capture the costly complications of chronic diseases, including those associated with obesity. Because those complications often take more than 10 years to manifest themselves, the authors suggest that a 25-year budget window would be more appropriate and effective when there is strong and reliable disease modeling to inform longer-term estimates. In assessing how cost estimates are conducted, the study also examines the large and still-growing health care costs associated with obesity and catalogues an array of programs to prevent and treat it.

Data included in the study indicate that past increases in obesity rates are responsible for $34.3 billion and $27.6 billion in additional spending in Medicare and Medicaid, respectively. Obesity also contributes to $74.6 billion in higher spending by private health insurers.

The authors also conducted an extensive examination of peer-reviewed programs aimed at addressing or preventing obesity, including government, community, and workplace wellness programs. They found that certain interventions can be both clinically successful and cost effective. The authors say it is extremely important to use both clinical and cost-effectiveness data to inform future policy action.

PT 2012, APTA's Annual Conference & Exposition, offers a variety of courses on wellness, including sessions on the PT's role in physical activity and fitness promotion; promoting positive behavioral change in patients and clients; and managing health, wellness, and disease reduction across a young adult to senior lifespan of their patients.

To study the isolated effect of physical therapy on total joint arthroplasty hospital length of stay (LOS), researchers from the University of Pittsburgh conducted a prospective cohort study on 136 patients with primary total joint arthroplasties (58 hips, 78 knees). LOS was determined by the operative start time until the time of discharge. On postoperative day (POD) 0, 60 patients remained in bed, 51 moved to a chair, and 25 received physical therapy (22 ambulated, 3 moved to a chair). LOS differed for patients receiving physical therapy on POD 0 (2.8 ± 0.8 days) compared with POD 1 (3.7 ± 1.8 days). There was no difference in physical therapy treatment based on nausea/vomiting, pain levels, or discharge location. Isolated physical therapy intervention on POD 0 shortened hospital LOS, regardless of the intervention performed.

This article was published online March 2 in The Journal of Arthroplasty.

The US Department of Defense (DoD) has awarded UnitedHealth, the nation’s biggest health insurer by revenue, its western military health contract valued at as much as $20.5 billion, says an article by Bloomberg. TriWest Healthcare Alliance Corp has held the contract since 2003.  

UnitedHealth had $102 billion in revenue last year. In June 2011 it lost a separate challenge for a $23.5 billion contract for the south region, covered by Louisville, Kentucky-based Humana Inc.

"It's a huge strategic win for them because they're not in the military space," said Ana Gupte, an analyst with Sanford C. Bernstein & Co in New York. "It just extends the reach of United into every part of health benefits in the United States."

TriWest, Humana, and HealthNet Inc currently are the main managed care providers for Tricare, the military's health care program. The DoD contract replacing TriWest with UnitedHealth is effective April 1, 2013. The loss of the new contract essentially would erase much of TriWest's revenue stream, says Bloomberg. 

The award comes after TriWest agreed to pay a $10 million fine in September to settle a federal whistleblower lawsuit. The suit, filed in US District Court in San Francisco by 4 former employees, accused the company of submitting claims to the government without including discounts negotiated with service providers.

Registration is open for the 2012 Transforming Fall Management Practices Conference, to be held May 23‐24 in Clearwater Beach, Florida. Upon completion of this program, participants will be able to:

• identify 3 best practices for safe patient mobility
• evaluate technological solutions for safe patient mobility
• successfully network with national, regional, and local experts across the settings of care
• discuss special challenges associated with safe mobility in vulnerable populations
• gain new insights in education, practice, administration and technology initiatives that can be transferred into current practice settings to improve patient safety

Poster presentations for the meeting will be accepted until April 2. Abstracts should be 250 words or less and provide a brief, clear summary of the research/project/program. Content should include timely and relevant topics related to all aspects of patient safety (falls, wandering, and bed safety). Authors of selected abstracts will be notified by April 15. Submission information can be found on the Department of Veterans Affairs Web page. 

APTA is a cosponsor of the conference. 

The Foundation for Physical Therapy is seeking individuals to serve on its Scientific Review Committee (SRC). Qualified physical therapist researchers will review doctoral, fellowship, and research grant applications received by the Foundation. To be considered, individuals must meet the criteria for SRC membership, posted on the Foundation's Web site. Self-nominations are welcome. E-mail your recommendations to info@foundation4pt.org.