A new initiative announced by the US Centers for Medicare and Medicaid Services (CMS) will offer $850 million in funding to provider networks, professional associations, and other organizations that are providing education and training in the transition to value-based health care.
The "Transforming Clinical Practice Initiative" unveiled by the CMS Innovation Center is a 4-year project that aims to "support clinician practice through nationwide, collaborative, and peer-based learning networks that facilitate practice transformation," according to a CMS fact sheet.
Funding will be awarded in 2 general areas: "practice transformation networks" that involve peer-to-peer learning, and "support and alignment networks" that involve learning opportunities created by professional associations, societies, and other organizations.
CMS envisions successful practice transformation network applicants as those that have relationships and share data with multiple clinician practices, and can lead "clinicians and their practices through the transformation process." CMS-funded support and alignment networks will be organizations that generate evidence-based guidelines, promoting measurement, supporting efforts to reduce unnecessary testing and procedures, and "effectively incorporating safety and patient and family engagement," according to CMS.
CMS encourages applicants to submit a letter of intent by November 20, with completed applications due by January 6, 2015. The awards are scheduled to be announced in spring or summer of 2015.
The US Department of Health and Human Services Office of Inspector General (OIG) has issued a proposed rule (pdf) on civil monetary penalties and exceptions to the anti-kickback statute, and APTA is helping members understand how the changes could affect physical therapists (PTs).
APTA posted a summary of the proposed rule (under the "Patient Protection" header) from OIG. Many of the proposals deal with carving out new "safe harbors" for the anti-kickback statute, and refining—and in some cases, loosening—rules around what activities would be considered illegal remuneration. Some of the proposed changes codify existing statutory provisions of the Affordable Care Act (ACA).
Of particular importance to PTs, according to the APTA summary, are the "safe harbor" proposals, which would permit some forms of free or discounted patient transportation services. Also of note: a proposal to define what is meant by ACA-mandated remuneration exceptions allowing activities that "promote access to care" and have a "low risk of harm."
Comments on the proposed rule are due on December 2. APTA will provide comments to the proposals, and will post those comments in the coming weeks.
Early-bird registration for the 2015 APTA Combined Sections Meeting (CSM) in Indianapolis is heading for the final turn. Are you ahead of the pack?
November 5 is the deadline for saving on registration fees for CSM, set for February 4–7, 2015. Registering now will ensure you're on track for a 1-of-a-kind event that will feature 300 forward-thinking sessions, multiple social events, and a host of lectures, platforms, and poster presentations.
Start your planning engine: grab an early-bird discount before November 5, take advantage of special rates on housing and travel, then explore the programming coming your way.
Think of it as a 1-stop shop for all your debunking needs: APTA's National Physical Therapy Month webpage at www.apta.org/NPTM/MediaCampaign has just about everything you'll need to help knock down "7 Myths About Physical Therapy."
The page contains ideas for educating patients and clients, infographics, and downloadable artwork that you can use to help spread the truth about how physical therapy can transform society. You can also do double debunking by referring patients and community members to www.MoveForwardPT.com for consumer-oriented information on the myths.
Think you have another myth about physical therapy that needs a good busting? E-mail it to APTA!
The "top 15" physical therapy clinical trials include 5 trials related to low back pain, and 1 trial on Bell palsy that dates back to 1958, according to a list based on nominations from physical therapists (PTs) around the world. The list is the focus of the October 22 PTNow blog.
The list was developed by the Physiotherapy Evidence Database (PEDro), an Australia-based project and collaborative partner with PTNow, in celebration of its 15th anniversary. PEDro solicited nominations from PTs for the clinical trials that had the most impact on the field of physical therapy, then turned over those nominations to an expert panel for final selection.
Among other trials that made the list: a 2009 trial on early physical therapy in mechanically ventilated, critically ill patients, a comparison of approaches to tennis elbow from 2006, and results of a trial published in 1999 that looked at management of genuine stress incontinence in women.
For a complete linked list of the trials, check out the PTNow blog—then let PTNow know what you think of the list.
It's accepted wisdom that 21st century Americans generally mistrust Congress but feel good about their own representatives. Apparently, the same seemingly paradoxical views are true for the medical profession, and in a big way—the US ranks near the bottom among 29 countries in level of trust in the overall medical system, and near the top in satisfaction with individual care.
A study published in the October 23 issue of the New England Journal of Medicine (summary available for free) reports on polling data that show a dramatic drop in Americans' confidence in the medical profession between 1966 and 2014. The decline is significant: in 1966, nearly 3 quarters (73%) of Americans expressed "great confidence in the leaders of the medical profession," but that rate is now 34%.
Americans' lukewarm level of confidence in the medical profession in general puts the US near the bottom of 29 countries surveyed from 2011 to 2013, tied for 24th place with Croatia in terms of the percentage of respondents who agreed with the statement, "All things considered, doctors [in your country] can be trusted." A total of 58% of Americans agreed, putting the US behind countries such as the Philippines (#17), Turkey (#5), and Portugal (#16). Switzerland ranked highest in this category, with an 83% rate of agreement. Only Chile, Bulgaria, Russia, and Poland scored lower than the US.
But in a shift that authors describe as "unique among the surveyed countries," Americans tend to rate their satisfaction with their own medical treatment higher than all but 2 other countries, with 56% of American respondents reporting that they were "completely" or "very" satisfied with their last visit to a physician. Switzerland had the highest rate (64%), followed by Denmark (61%). Lithuania (13% rate) and Russia (11% rate) were at the bottom of the list. Authors note that the rate of institutional trust and personal satisfaction tends to be similar in nearly all countries, and that the US is an "outlier."
Authors of the study write that the lack of trust in the medical institution puts doctors at risk of losing political clout as the future of US health care is shaped.
"If the medical profession and its leaders cannot raise the level of public trust," they write, "they're likely to find that many policy decisions affecting patient care will be made by others, without consideration of their perspective."
Authors suggest that public trust could be improved "if the medical profession and its leaders deliberately take visible stands favoring policies that would improve the nation's health and health care, even if doing so might be disadvantageous to some physicians."
Other findings in the study related to Americans' perceptions:
Americans' steadily increasing rate of walking and biking is definitely good news—but that healthy shift needs to be accompanied by more attention to safety, according to a new initiative from the US Department of Transportation (DOT).
This fall, the DOT launched "Safer People, Safer Streets (.pdf)," an effort to curb a recent uptick in the rate of fatalities among bicyclists and pedestrians, which accounted for 16% of all traffic-related fatalities in 2012.
The initiative will begin with a survey of pedestrian and bicyclists "gaps" across the country—places where safety is compromised by lack of sidewalks or other safety infrastructure. With gaps identified, DOT and its agencies will work with state, local, and private industry partners to help create so-called "road diets" that are more attentive to safe space allocation for pedestrians and bicyclists.
The initiative will also include public education campaigns on safety, according to DOT.
Encouraging healthy, active lifestyles is central to the physical therapy profession's ability to transform society. Keep up with the latest resources at APTA's Prevention, Wellness, and Disease Management webpage.
A Bulgarian man whose spinal cord was completely severed has regained limited mobility and feeling in his lower extremities after a surgical procedure that used nerve-supporting cells taken from his nose. Once completely paralyzed in both legs, he can now walk with a walker and drive a car.
According to an article in the Guardian, Darek Fidyka is believed to be the first person to recover from a complete severing of the spinal cord, an injury he sustained in a knife attack in 2010.
Polish surgeons accomplished the recovery by transplanting olfactory ensheathing cells (OECs) from Fidyka's nose into the severed ends of his spinal cord. The cells connected and allowed nerve impulses to once again travel through the entire spinal cord. The technique was developed by the University College of London's Institute of Neurology.
Although Fidyka's recovery is not complete, 1 of the authors of a study on the procedure published in Cell Transplantationdescribed the technique as one that "opened the door to a treatment of spinal cord injury which will get patients out of wheelchairs," according to an article in the Washington Post.
In the wake of 2 Dallas nurses contracting Ebola from the first person to die of the disease in the US, the US Centers for Disease Control and Prevention (CDC) has issued "tightened" guidance for health care workers interacting with infected patients. The announcement was one of several Ebola-related developments occurring recently.
The new guidelines focus on better training, more extensive personal protective equipment (PPE), and more rigorous monitoring of donning and doffing. The enhanced recommendations are informed by practices at Emory University Hospital, Nebraska Medical Center, and the National Institutes of Health Clinical Center—facilities that have had success in handling patients with the disease. The CDC reports that the guidelines are similar to those developed by Doctors Without Borders.
A story in Modern Healthcare (free access with one-time registration) quotes CDC Director Thomas Frieden as describing Ebola care as "hard," saying that "the way care is given in this country is riskier than in Africa. There's more hands-on nursing care, and there are more high-risk procedures."
CDC is recommending all of the same PPE included in the August 1, 2014, guidance, with the addition of coveralls, disposable hoods, and full-face shields instead of goggles. Also recommended:
The CDC warns, however, that "focusing only on PPE gives a false sense of security of safe care and worker safety," and urges extensive training and practice, as well as a careful monitoring process as health care workers put on and take off PPE.
Other recent Ebola-related developments:
The American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) is seeking members with diverse clinical expertise to serve on the Accreditation Services Committee, a group of trained experts who review applications and visit physical therapist education program sites undergoing accreditation.
Members interested in being considered to serve on the committee should complete the application on the ABPTRFE website by November 30, 2014. The Accreditation Services Council will make appointments in December 2014. Notification about appointments will be sent in January 2015.
Appointed members must be available for training at APTA headquarters in Alexandria, Virginia, on March 2, 2015. APTA will reimburse all travel expenses for this meeting.
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