A March 20 and 21 meeting of the Federal Trade Commission (FTC) examined activities and trends related to cost, quality, access, and care coordination that may affect competition in the US health care industry. APTA representatives attended the event and provided pre-workshop comments (.pdf) that pressed for greater patient access to physical therapists (PTs), the elimination of physician self-referral, and expanded health care networks under the Affordable Care Act (ACA), among other issues.
The meeting, "Examining Health Care Competition (.pdf)," was attended by APTA staff and included panel discussions and presentations on the professional regulation of health care providers, measuring the quality of health care, and the interplay between quality and price transparency, among other topics.
In the pre-workshop comments submitted to the FTC, APTA President Paul A. Rockar Jr, PT, DPT, MS, wrote that even though some form of direct access to PTs is allowed in 48 states, certain state restrictions enacted for political reasons are an obstacle to effective treatment. These restrictions, which include visit caps, time limits, or rules about the number of days a PT can treat before referring a patient to a physician, "are not based on evidence, clinical need, patient safety, or the best interest of the patient," Rockar wrote.
Rockar also described to the FTC how physician-owned physical therapy services restrict trade and limit “the consumer's right to choose his/her physical therapist," a limitation that the consumer might not even perceive, "as no other option is offered." Other portions of the letter urged the FTC to work toward expansion of health care provider networks to include nonphysician providers, and to carefully review new models of service delivery such as accountable care organizations (ACOs) to ensure that the new systems do not disenfranchise patients by limiting choice.
The association will also submit follow-up comments after the workshop.
FTC's meeting follows the release of a policy paper (.pdf) that questions regulatory frameworks that it feels limit consumers' ability to seek treatment from Advance Practice Registered Nurses, particularly by way of restrictions on independent practice. In that paper, agency analysts propose that limited practice scopes and burdensome requirements for physician supervision or approval effectively dampen competition and leave consumers with fewer choices, a situation that "can have serious health and safety consequences."
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