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  • New Model Sets Forth Principles to Guide Development of Physical Therapy Benefits

    APTA recently developed the Physical Therapy Model Benefit Plan Design (MBP) to ensure access to physical therapy services by informing decisions regarding coverage of physical therapy services in insurance benefit plans. The MBP describes the role and value of physical therapists and physical therapy services and sets forth principles to guide development of physical therapy benefits. It also provides definitions and references to support the position. The MBP should be used by insurers, employers, individual insurance plan subscribers, and public policymakers when considering insurance benefit plan design. It also is a tool for physical therapists to advocate for appropriate access to and coverage of physical therapist services for their patients and clients.

    A new APTA podcast and transcript provide background information about development of the MBP, which was adopted last month by APTA's Board of Directors, and an overview of what is in the model benefit plan.

    Fee Schedule, MPPR Calculators Updated

    APTA recently updated its Medicare physician fee schedule and its multiple procedure payment reduction (MPPR) calculators to determine payment amounts under Medicare for January and February to reflect the 2-month extension of the fee schedule update and other Medicare provisions signed into law December 23, 2011.

    If Congress does not take action by February 29, a 27.4% payment cut will go into effect. Sign up today for PTeam to receive the latest news on legislation to fix the Sustainable Growth Rate and extend the therapy cap exceptions process, which also expires February 29.

    Prospective Surveillance Model Emerges as Standard of Care for Breast Cancer Treatment

    Early diagnosis and treatment of breast cancer-related lymphedema by a physical therapist can significantly reduce costs and the need for intensive rehabilitation, according to an article published in the January issue of PTJ.  

    The study, led by APTA member Nicole Stout, PT, MPT, CLT-LANA, compared a prospective surveillance model with a traditional model of impairment-based care and examined the direct treatment costs associated with each program. Treatment and supply costs were estimated based on the Medicare 2009 physician fee schedule. Researchers estimated that treatment for breast cancer-related lymphedema costs $636.19 a year when the prospective surveillance model was used vs $3,124.92 for traditional treatment of advanced lymphedema.

    Read more about the study in APTA's press release.

    UF Study: Education Combined With Exercise Lowers Back Pain Rate in Soldiers

    A program of core strengthening exercises was no better than traditional sit-ups for preventing back pain in soldiers, according to a new University of Florida (UF) study. But combining both exercise programs with a brief educational session on back pain strategies did lower the incidence of treatment for back pain.

    The Prevention of Low Back Pain in the Military study involved 4,325 US Army soldiers stationed at Fort Sam Houston in Texas who were completing a program for combat medic training. Participants were randomized by company into 1 of 4 treatment groups of exercises alone, or exercises paired with educational sessions. The exercise programs were completed as a group under the supervision of a drill instructor once a day, 5 days a week for 12 weeks. The education program consisted of 1 45-minute group session led by study personnel that provided information on low back pain and strategies for recovering from mild back injury.

    The researchers tracked participants' incidence of low back pain for 2 years following the intervention. There was no difference in health care visits for back pain in the treatment groups that received exercises only, but among the groups that also received the education program, there was a 3% decrease in seeking health care for low back pain. The decrease may seem small, researchers say, but because back pain is such a common health issue in the military, even a small decrease could lessen the burden on the health care system.

    "It was our hypothesis that the core stabilization exercises would have some protective effect for back pain and maybe the combination of the core stabilization exercises and the education program would be the most effective, but as it turns out, adding the education to either of the exercise programs was the only place where we saw the benefit," said lead investigator and APTA member Steven George, PT, PhD, an associate professor in the UF College of Public Health and Health Professions' department of physical therapy.

    Low back pain is among the most frequent causes of medical visits and lost-duty time in the military health system, said co-investigator and APTA member Lt Col John Childs, PT, PhD, director of musculoskeletal research at Keesler Air Force Base and associate professor at the US Army-Baylor University doctoral program in physical therapy at the Army Medical Department Center and School in San Antonio.

    APTA members Lt Col Deydre Teyhen, PT, PhD, OCS, and Jessica Dugan, PT, coauthored the study. 

    NIDRR Seeks PT Reviewers for Standing Panels

    Physical therapists (PTs) are encouraged to apply to become peer reviewers for the National Institute on Disability and Rehabilitation Research (NIDRR) to evaluate Field Initiated Project (FIP) applications. NIDRR receives more than 250 FIP applications per year. NIDRR uses standing panels to enhance continuity, provide for more extensive feedback, and obtain the services of better-qualified reviewers, including those with disabilities and those from diverse backgrounds.

    Generally, peer reviewers serve for 3-year terms on the standing panels with 1 review per year.  Individuals may be qualified to be peer reviewers on the basis of education and training or some combination of personal and professional experience with disability. Federal government employees are not eligible to serve as peer reviewers for NIDRR.

    If you are interested in nominating yourself or someone else to serve as a reviewer, submit the following 3 items to David Keer at david.keer@ed.gov: 

    1. a statement indicating willingness to serve on an FIP standing review panel,
    2. a few sentences summarizing areas of expertise, and
    3. an attached copy of a CV or resume.

    The standing panels NIDRR uses are in the areas of: (1) employment outcomes; (2) health and function; (3) technology for access and function; (4) participation and community living; and (5) statistics, outcomes research, disability studies, rehabilitation science, and policy. Each panel has 7 reviewers. In any given year the dates of the review might not work for an individual reviewer, hence a large pool of potential FIP reviewers is needed.

    The review panel meets (via teleconference) for 3 consecutive full-time days to discuss the panel's assigned proposals. About 4 weeks prior to the review, NIDRR mails each reviewer the 16-20 proposals that the panel will discuss.