In comments to the US Preventive Services Task Force (USPSTF) Draft Recommendation Statement on the Prevention of Falls in Older Adults, APTA commends the task force for its focus on the role that physical therapy plays in reducing falls and urges it to advocate that yearly falls assessments be included in Medicare beneficiaries' annual wellness visits.
While the Patient Protection and Affordable Care Act addresses falls prevention in a Medicare beneficiary's first annual wellness visit, it is not explicitly addressed for subsequent visits. "This seems contradictory to the proven evidence that the chance of falling, and being seriously injured in a fall, increases with age…" says APTA. "Efforts to advocate for falls screening with each annual wellness visit have been met with a statement that falls prevention screening was not recommended for subsequent visits but would be subject to review if the USPSTF found evidence of a need. APTA is of the strong belief that a falls screening … should not be a one-time occurrence and should occur at every annual visit as a Medicare beneficiary ages. Therefore, APTA strongly recommends the USPSTF emphasize the importance of falls prevention screening for all older adults at every visit, especially those over age 85."
APTA also recommends changes in the draft statement to clarify when multifactorial assessment and management is appropriate, suggests that the document attempt to address the difference between a screening and a full risk assessment, and urges USPSTF to offer providers "more explicit guidance to refer appropriate patients to those evidence-based physical therapy and community-based exercise programs cited in the USPSTF review."