Late yesterday, the Centers for Medicare and Medicaid Services (CMS) released the 2013 payment updates for inpatient rehabilitation facilities (IRF) and skilled nursing facility (SNF) settings. Both of these notices set forth payment rates for these settings in Fiscal Year (FY) 2013 and do not make any substantive changes to policies regarding the provision of physical therapy.
The IRF prospective payment system (PPS) update provides a 1.9% increase to the market basket rate for 2013 that results in an overall estimated economic impact of $140 million in increased payments to IRFs during FY 2013. The notice also includes the continued implementation of quality measures for IRF settings. Overall, no IRFs are estimated to experience a net decrease in payments as a result of the updates in this notice.
The SNF PPS update provides a 1.8% increase to the market basket rate for 2013, which results in an overall estimated economic impact of $670 million in increased payments to SNFs during FY 2013. In addition, the rule discusses recent data regarding the implementation of group therapy allocations and the change of therapy OMRA.
The updated payment rates for IRFs and SNFs are effective October 1. Both notices will be published in the Federal Register on August 2. In the coming week, APTA will conduct a full analysis of the notices and provide a summary to members.
APTA recently launched a Collaborative Care Models discussion forum in APTA Communities to allow members to discuss issues related to new collaborative care models under health reform, such as accountable care organizations (ACOs), patient-centered medical homes, and bundled payments. APTA is working to support members in their success within these models, and welcomes any questions for discussion within this community. In addition, the association wants to connect you with your peers who are working within similar models, allowing you to share both your opportunities and challenges.
Members who are participating in a health care model that incorporates a patient-centered medical home or ACO, or implements bundled payments are encouraged to share their experiences and best practices, including tools or processes that have led to their successful participation. Members who are not practicing in 1 of these models, but are interesting in doing so, can post any questions or discuss any barriers that they are experiencing. APTA also will provide answers to frequently asked questions in this forum.
To access the community, go to APTA Communities and click on the "Collaborative Care Models" link on the left-hand side. Don't forget to sign up to receive alerts when new postings become available. Additional information regarding these models of care can be found at www.apta.org/ACO. If you have further questions, contact advocacy@apta.org.
Authors of a recently published systematic review say it provides "good" evidence to support multidisciplinary rehabilitative intervention in adults with Guillain-Barré syndrome (GBS) and "satisfactory" evidence for physical therapy in these patients. Evidence for other unidisciplinary interventions is limited or inconclusive.
For this review, the authors searched Medline, EMBASE, CINAHL, AMED, PEDro, LILACS, and the Cochrane Library up to March 2012 for studies reporting outcomes of GBS patients following rehabilitation interventions that addressed functional restoration and participation. Two reviewers applied the inclusion criteria to select potential studies and independently extracted data and assessed the methodological quality. Included studies were critically appraised using the GRADE methodological quality approach. Formal levels of evidence of each intervention were assigned using a standard format defined by the National Health and Medical Research Council.
Fourteen papers (1 systematic review, 1 randomized controlled trial, 1 case-control study, 5 cohort studies, and 6 case series/reports) that described a range of rehabilitation interventions for people with GBS were evaluated for the "best" evidence to date. One high-quality randomized controlled trial demonstrated effectiveness of higher intensity multidisciplinary ambulatory rehabilitation in reducing disability in people with GBS in the later stages of recovery, compared with lesser intensity rehabilitation intervention for up to 12 months. Four observational studies further demonstrated some support for improved disability and quality of life following inpatient multidisciplinary rehabilitation up to 12 months. Evidence for unidisciplinary rehabilitation interventions is limited, with "satisfactory" evidence for physical therapy in reducing fatigue, improving function, and quality of life in people with GBS.
The gaps in existing research should not be interpreted as ineffectiveness of rehabilitation intervention in GBS, the authors say. Further research is needed with appropriate study designs, outcome measurement, type of modalities, and cost effectiveness of these interventions.
Editor's Note: According to the full text article, "multidisciplinary rehabilitation" may include physical therapy.
The National Library of Medicine (NLM) has released a new mobile app that is intended to make information broadly available and serve as the authoritative guide to NLM mobile resources. Users can find NLM mobile resources by type (website vs application), device (Android, Apple iOS, or Blackberry, or tag (descriptive tags assigned by NLM used to categorize the resource, such as "drugs" or "disasters").
Visit the NLM Mobile webpage to explore the app. Users can save the app to their home screen for those times when they have no wireless connection or cell signal. The index of NLM mobile resources is available for offline browsing. The app will be updated with the latest information once the device is reconnected to the Internet.