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  • Ohio Workers' Comp Program Requires Nonsurgical, Nonopioid Treatment of LBP as a First Step

    In what the Associated Press (AP) describes as "a groundbreaking guideline," the Ohio agency that oversees that state's workers' compensation program has rejected spinal fusion surgery and opioid prescriptions as an early response to back pain. Instead, the state now requires that all workers with work-related back injuries undergo at least 60 days of nonsurgical care, including physical therapy, while avoiding opioids, before pursuing other treatments.

    According to an AP article published in The New York Times, Ohio isn't the first state to restrict payments for surgery, but its approach includes a new twist: including a warning on the use of opioids. The Ohio rule stipulates that the 60 days of "alternative" treatment must be accomplished while avoiding opioid use if possible, an approach that NYT says is "more aggressive than other states that also decline to pay right away for the surgery."

    In the report, the Ohio Bureau of Workers' Compensation defended the move by citing research showing that spinal fusion surgery is "often ineffective," can lead to complications, and may result in increased opioid use postsurgery. The policy went into effect on January 1.

    APTA Physical Therapy Outcomes Registry Again Receives CMS Designation for MIPS Reporting

    APTA's Physical Therapy Outcomes Registry (Registry) has been approved again by the US Centers for Medicare and Medicaid Services (CMS) as a qualified clinical data registry (QCDR). The designation for 2018 means that physical therapists (PTs) who participate in the Merit-based Incentive Payment System (MIPS) program can submit their data directly from the Registry, but the CMS approval is also an acknowledgment that APTA offers a robust, reliable system for tracking and benchmarking patient outcomes.

    Although voluntary for now, PT participation in MIPS could be mandatory as early as 2019, making it important to become familiar with the system (APTA encourages eligible PTs to voluntarily participate in MIPS now).The Registry’s QCDR status will be particularly helpful for practices whose electronic health records (EHRs) do not have the capability to report directly to MIPS.

    According to Heather Smith, PT, MPH, APTA's director of quality, the value of the Registry goes well beyond MIPS data submission.

    "Registry data will allow physical therapists to understand their treatment patterns, interventions, and outcomes for specific patient populations," Smith said in an APTA news release. "In everyday practice, PTs then use the information objectively to evaluate how a patient, a group of patients, or a population of patients are cared for."

    Registry users can access nonproprietary outcomes measures supported by CMS, as well as measures specific to particular EHR systems. In addition, APTA has begun the process of developing its own quality measures. The Registry also will include region/disease-specific treatment and outcome modules to help PTs treat patients according to established clinical practice guidelines. The first such module, focused on congenital muscular torticollis, is now under development through a partnership between APTA and the Academy of Pediatric Physical Therapy.

    The Registry enables PTs to make improved, data-informed clinical decisions, track and benchmark outcomes against industry data, and demonstrate the value of physical therapist services to payers and fellow providers. It directly integrates with multiple third-party EHR systems. For more information about the Registry, visit www.ptoutcomes.com.

    Headed to the APTA Combined Sections Meeting in February? Check out the Registry booth at the APTA Pavilion, the Registry poster session on February 23, and 2 related presentations: "A Multi-Dimensional Data Collection System (#2145)" and "Balancing Inclusion and Use of Outcomes Instruments in the Registry (#2144)."