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  • CSM Prints and Digital Downloads Now Available

    Save yourself thousands in words—grab a picture or two from the 2014 Combined Sections Meeting (CSM) photo gallery now posted for download.

    Visit www.davidbraun.photoreflect.com and select "APTA-CSM-2014" under "Recent Photos." Enter the password quadriceps. Click on the photo group you want to view and purchase images or downloads through the shopping cart.

    Questions? Contact photographer David Braun at info@davidbraun.com.

    HHS Improves Access to Benefit Plan Information in Marketplaces

    Physical therapists (PTs) hoping for a little more light to be shed on the details of health plans available through state health insurance marketplaces can take heart: the Department of Health and Human Services (HHS) may have just what they need.

    Recently HHS launched a new website with state-by-state charts that include copayment and other benefit information for the health plans available in states that did not set up their own exchanges. Many providers had complained about inadequacy of earlier information from HHS.

    The site lists the plans for each state alphabetically. Scrolling to the right of the list reveals copayments next to each plan and plan level. This data is only for plans offered in the marketplaces and could take time to extract, but it does represent an improvement over previous information.

    APTA reminder: for current patients or for those awaiting evaluation, it's always best to verify an enrollee’s benefit with the payer.

    CMS: ICD-10 Will Be Implemented on October 1

    The Centers for Medicare and Medicaid Services (CMS) will be sticking to its October 1, 2014, date for implementation of the new International Classification of Diseases, 10th Edition (ICD-10) codes, with no rollback of compliance dates and only limited "hardship exemptions" from the requirement. The announcement puts new emphasis on the importance of the new system's Medicare testing week set for March 3-7.

    The announcement was made by CMS Administrator Marilyn Tavenner during remarks at a meeting on February 27. Modern Healthcare quoted Tavernner as saying "Let's face it guys, we've delayed this several times, and it's time to move on."

    The ICD-10 codes will replace the ICD-9 codes used to report diagnoses and inpatient procedures. The changes will affect all entities and providers covered by the Health Insurance Portability Accountability Act (HIPAA), and are a key component in reimbursement, quality, utilization review, and other data management activities.

    To prepare for the change CMS has requested all Medicare administrative contractors (MACs) to participate in a week of testing the new codes, March 3 – 7. Registration information was forwarded to providers by all MACs earlier this month, and registration is required to participate in the testing week. APTA encourages all physical therapist practices and facilities to register and participate in the testing week. Although no dates have been released, CMS indicated in a webinar last week that there will likely be future testing dates for providers who are not yet ready to test ICD-10 claims.

    APTA has been helping physical therapists (PTs) prepare for the shift by creating resources that explain the new system and its impacts. Additionally, the association hosted a webinar on the move to ICD-10 in December, and will host another on March 27. A recording of the December presentation is available for download. Access to the live version of the March 27 webinar is on a space-available basis, and a recording of the webinar should be available approximately 1 week after the event.

    PT's Movie Review on ESPN Also Educates on Consecutive TBI

    An APTA member's review of a new documentary on traumatic brain injury (TBI) has been featured on ESPN. Stephania Bell, PT, CSCS, OCS, senior writer for ESPN, gave a strong, positive review for the new documentary "The Crash Reel," but perhaps just as important, seized the opportunity to provide readers with valuable education on consecutive TBI and its impact on developing brains.

    "The Crash Reel" follows the rise, devastating injury, and recovery of elite snowboarder Kevin Pearce, who at age 22 suffered a head injury during training for the 2010 Vancouver Olympics. Pearce's recovery continues, and he is now a motivational speaker and sports equipment consultant. Earlier this month he carried the torch at the opening ceremonies of the Winter Olympics in Sochi.

    In her review, Bell writes that "the film's strengths lie in its simultaneous beauty and tragedy. Stunning visual elements … and the inspirational love of an amazing family are contrasted with … the raw, often gut-wrenching emotions evoked alongside the physical pain of head injuries." She describes the film as an honest work that "neither glorifies nor glamorizes Kevin's brain injury and his subsequent path."

    Bell expands her review to include a discussion on some of the issues at the heart of "The Crash Reel," including wide misunderstanding of concussion, and the dangers of consecutive TBI. She explains the ways in which brain injuries differ from other injuries associated with sports, and how consecutive TBI can impact decision-making abilities that need to be keen in order to avoid another injury. In Pearce's case, he believes that symptoms from a previous concussion may have contributed to the injury that would end his snowboarding career.

    "The Crash Reel" is available on DVD, iTunes, and video-on-demand services and is being screened in selected theatres. More information can be found on the film's website.

    CMS Launches Website on Health IT

    The Centers for Medicare and Medicaid Services (CMS) has unveiled a new website designed to help providers of all experience levels understand federal health IT requirements.

    Called eHealth University, the site features information on the meaningful use program, ICD-10 implementation, quality measures, alternative payment models, and HIPAA, all scaled to "beginner," "intermediate," and "advanced" levels. Features include webinars, help desks, checklists, and links to guidance documentation.

    Want more background on health IT from a physical therapy perspective? Check out APTA's online resources on electronic health records, HIPAA, and payment.

    Toddler Obesity Rates Drop, Most Other Rates Unchanged

    A glimmer of good public health news: obesity rates among 2– 5-year-old children have dropped by 43% over the past 10 years. Unfortunately, that's about all the glimmer to be found in a recent report from the Centers for Disease Control and Prevention (CDC), which also states that there has been no significant change in obesity rates in the general population, and that the rate of obesity in women 60 and over is actually on the rise.

    The findings are based on a CDC analysis (abstract only available for free) of the National Health and Nutrition Examination Survey that included 9,120 participants across all age ranges. Researchers compared data from the 2010–2012 survey with the study conducted in 2003–2004 and found that "overall there was no significant change" in most age categories. Authors reported that "more than one third" of adults and 17% of youth in the US are obese, a rate unchanged from 10 years before.

    The bright spot in the study is that obesity rates for toddlers have declined dramatically from 13.9% to 8.4%--a finding that received wide media attention. In news reports of the CDC findings, researchers described the drop as "exciting" and said that the change was the first time any significant decrease in obesity had been reported by any age group.

    Less encouraging—and less prominent in most news stories—were CDC findings that indicated unchanged obesity rates in other age groups, and an increase in rates among women 60 and older, from 31.5% to 38.1%. The full report will be published in an upcoming issue of JAMA, the journal of the American Medical Association.

    APTA offers several resources on obesity, including continuing education on childhood obesity, and a prevention and wellness webpage that links to podcasts on the harmful effects of inactivity.

    March APTA Webinars Focus on Health Care Reform, ICD-10

    APTA members can get the latest information on what's been happening in health care reform and what's going to be happening in diagnostic coding by signing up for 2 free webinars coming in March.

    On Thursday, March 20, from 2:00 pm to 3:30 pm ET, APTA experts will bring attendees up-to-date on the progress of health care reform, with an emphasis on policy provisions including accountable care organizations (ACOs), bundled payment systems, Medicaid expansion, and fraud and abuse initiatives.

    On March 27, from 2:00 pm to 3:30 pm ET, attendees can learn about the International Classification of Diseases coding system, with specific focus on how the latest version, ICD-10, differs from its predecessors. The federal government has mandated that ICD-10 be implemented by October 1, and the APTA webinar will help physical therapists understand what this means for their practices.

    Both webinars are free to APTA members, but space is limited. Registration information is available on the webinar pages linked above.

    Can't make the webinars? Visit the list of  available APTA Learning Center courses after the event to download a recording.

    APTA Advocacy Sparks Medicare Advantage Beneficiary Protections for PT Services in 2015

    The Centers for Medicare and Medicaid Services (CMS) announced greater cost-sharing protection for Medicare Advantage beneficiaries receiving physical therapy services in 2015, a change adopted as a result of APTA advocacy efforts.

    The association's work to reduce copayments for physical therapist services in Medicare Advantage plans resulted in the addition of physical therapy to the list of services that will be protected by maximum out-of-pocket (MOOP) spending limits for beneficiaries. In its Advance Notice and draft Call Letter (.pdf), CMS mandates that the MOOP cost sharing for all in-network physical therapist services be set at $40. This cost-sharing requirement includes copayments, coinsurance, and service category deductibles.

    CMS has also announced that there will be cuts made to the 2015 Medicare Advantage program, although the extent of those cuts is not yet clear. According to information released in the call letter, the cuts will be based in part on projections that anticipate a 3.55% decline in the program's growth rate and an estimated 1.65% drop in per capita expenditures in 2015.

    CMS will accept comments on the call letter until March 7. APTA plans to submit comments on behalf of its membership. The final 2015 Rate Announcement and Call Letter will be published April 7.

    The association offers resources that help explain the program at its Medicare Advantage webpage.

    'Polio-Like Illness' in California Children Still a Mystery

    The "polio-like illness" found in 5 California children "appears to be very, very rare," according to the author of a study on these cases, but could point to an "emerging" infectious syndrome. In a recent press release the study's authors stated that 20–25 similar cases are now being investigated.

    The illnesses involve paralysis of 1 or more limbs with rapid onset and a peak in severity at about 2 days. Of the 5 children affected, 3 had respiratory illnesses before the polio-like symptoms began. All 5 had been vaccinated against the polio virus.

    Despite treatment, the children's symptoms did not improve, and though all are still alive none returned to normal limb function after 6 months. The children who experienced the illness were clustered in California over a 1-year period.

    Of the 5 children, 2 tested positive for enterovirus-68, which the US Centers for Disease Control and Prevention describes as a "very common" virus that tends to produce few or "very mild" signs of illness. Rarely, however, the virus can produce myocarditis, pericarditis, encephalitis, and paralysis. Providers were unable to find a cause for the illness in the other 3 children.

    The study of the 20–25 additional cases is focused on children with paralysis of 1 or more limbs and abnormal MRI scans, with no presence of botulism or Guillain–Barré syndrome—2 conditions that can also generate polio-like symptoms. The study will be discussed in detail in a case study that will be presented at the American Academy of Neurology's annual meeting April 26–May 3.

    CMS Transition Means Temporary Changes to Manual Medical Review Processes

    The Centers for Medicare and Medicaid Service's (CMS) transition to new recovery audit program contracts will temporarily change pre- and postpayment manual medical review processes for therapy services over $3,700, and will likely create delays in the typical 10-day review cycle.

    CMS is procuring the next round of recovery audit program contracts, and the agency is planning "a pause in operations" while old contracts are closed out and new ones started. The pause will have different ramifications depending on whether a particular state is subject to prepayment review or postpayment review of therapy services exceeding $3,700.

    In postpayment states, February 21, 2014, was the last day that Additional Documentation Request Letters (ADR) for postpayment review were sent to providers. In prepayment states, February 28 is the last day that Medicare administrative contractors will send out letters for prepayment reviews of therapy claims until new contracts are awarded. After February 28, prepayment reviews will not be conducted; instead all claims will undergo postpayment review after the new contracts are in place. Because of the volume of claims CMS anticipates will accumulate during the transition, the 10-day reviewing timeframe will not apply to these reviews. The new recovery auditors will review claims in the order that they were paid.

    If a provider has received an ADR letter, the provider must comply with the request and submit the records. Any records that were previously submitted to the recovery auditor will continue to be reviewed, and the provider will receive a review results letter, as usual. Providers can monitor progress of the transition at the CMS Recovery Audit Program Recent Updates webpage.

    Researchers Reel In New Artificial Muscle

    Want to witness the power behind the next generation of artificial muscles for prosthetics and exoskeletons? Look in your fishing tackle box.

    According to a recent announcement from researchers at the University of Texas – Dallas, a process that twists and coils fishing line results in an artificial muscle that can lift more than 100 times the weight of a similar-sized human muscle and can be controlled by relatively simple temperature changes. The research has been reported in Discovermagazine, Health24, and WebMD, among other outlets.

    The twisted polymer filament process was developed at the NanoTech Institute at the university. Researchers believe that the technology has immediate applications for exoskeletons but could also be commercialized to create clothing that adapts to changes in temperature. While far less efficient than human muscle, the fibers can generate more than 5 times the energy of an automobile engine.

    Walking Can Reduce Hip Fracture Risk By 43%-62% in Older Men

    A study of nearly 36,000 men over a 24-year span has revealed that walking significantly contributes to prevention of hip fractures to an even greater extent than more strenuous activity. Researchers also found that "contrary to expectation," sedentary behavior can serve a preventive role too—particularly when accompanied by 2 or more hours of walking per week.

    In the study, e-published ahead of print in the American Journal of Public Health (.pdf), researchers examined data from the Health Professionals Follow-up Study, a project that uses biennial questionnaires to track the health and lifestyle of about 51,000 men. Authors of the hip fracture study focused on reports of 35,996 men aged 50 to 75 from 1986 through 2010.

    Over the 24 years of study, 546 hip fractures were reported, and after excluding fractures attributable to malignancy or a major traumatic event such as an automobile accident, researchers were left with 490 cases of fractures, with 85% of those fractures occurring because of a slip, trip, or fall from chair height. Mean age at the time of hip fracture was 77.

    In the end, researchers found that after controlling for strenuous activity and all other risk factors, men who reported walking 4 or more hours a week had a 43% lower risk of hip fracture than men who walked for fewer than 4 hours a week. Walking pace also had a dramatic effect: men who spent 4 or more hours walking at a brisk pace experienced a 62% lower risk of fracture.

    Authors related the risk reduction associated with walking to improved muscle strength and balance, but they did not see the same relationship when they looked at strenuous activity. Researchers wrote that "in contrast to walking, more time spent in strenuous activity did not reduce risk of hip fracture." In fact, they speculated, the increased risk of falls associated with activities such as running may offset potential risk reduction.

    The other major factor in risk reduction is somewhat more problematic. According to the study, "more time spent sitting was associated with a lower risk of hip fracture even after adjustment for total activity and all other risk factors." Researchers wrote that men who sat for 50 or more hours a week reduced their risk of fracture by 38% and could gain a 45% reduction in risk if they also walked for 2 or more hours a week. Authors were careful to note that the analysis was focused on hip fracture only and did not study the effects of sedentary behavior on overall health (see an earlier News Now story on a study highlighting the negative impacts of sedentary behavior).

    Authors acknowledged limitations in the study, which focused only on white men who were not institutionalized.

    APTA offers its members evidence-based resources on falls through its PT Now webpage as well as through APTA ArticleSearch. In addition, APTA provides physical therapists (PTs) and patients with education on exercise prescriptions for balance and falls prevention, a pocket guide on falls risk reduction (.pdf), an online community where members can share information about falls prevention, and a webpage on balance and falls.

    CMS Cardiac Rehab Policy Expands, Leaves Physical Therapy Coverage Unchanged

    The Centers for Medicare and Medicaid Services (CMS) finalized its policy decision to expand coverage of cardiac rehabilitation (CR) to patients with stable chronic heart failure (CHF) but made no significant changes to policies on physical therapy.

    In a decision memo issued February 18, CMS states that the evidence is sufficient to expand coverage for CR services to beneficiaries with stable CHF. "Stable" patients are defined as those who have not had recent major cardiovascular hospitalizations or procedures in the past 6 weeks, and those who have not had planned major cardiovascular hospitalizations or procedures in the past 6 months. The CMS definition of "chronic heart failure" includes left ventricular ejection fraction of 35% or less and New York Heart Association (NYHA) class II to IV symptoms despite being on optimal heart failure therapy for at least 6 weeks.

    APTA supported access to rehabilitation for CHF patients but advocated for coverage of physical therapy for patients outside of the cardiac rehab benefit when medically necessary. The final decision memo does not address physical therapy provided outside of the CR program.

    As in the past, physical therapy will not be covered separately when provided as part of a cardiac rehabilitation exercise program, according to the National Coverage Determination for Cardiac Rehabilitation Programs. Physical therapy will remain covered when there is also a diagnosed noncardiac condition requiring such therapy—for example, when a patient who is recuperating from an acute phase of heart disease suffers a stroke requiring physical therapy for rehabilitation.

    APTA will post a summary of the final policy in the coming weeks.

    APTA 2014 Strategic Plan Now Posted

    The 2014 APTA Strategic Plan has been posted on the association website and features updated objectives for each of 4 goals that have been carried over from 2013: effectiveness of care, patient- and client-centered care across the lifespan, professional growth and development, and value and accountability.

    Approved by the APTA Board of Directors during its December 2013 meeting, the 2014 plan is a bridge to the new vision that APTA adopted at the June House of Delegates—"Transforming society by optimizing movement to improve the human experience." As in 2013, the 2014 plan places highest priority on objectives related to the development of the physical therapy outcomes registry (PTOR) and advancement of a more appropriate payment system, proposed as the physical therapy classification and payment system (PTCPS).

    Other important priorities contained in the 2014 Strategic Plan include efforts to reduce unwarranted variation in care, to encourage the development and use of clinical practice guidelines by PTs, and to continue work to expand direct access and investigate the effects of physician self-referral arrangements.

    To see the full discussion on the 2014 Strategic Plan at the December Board of Directors meeting, watch the archived livestream of all open sessions.

    Discounted Registration for NEXT Still Available

    APTA members have until April 2 to get in on early registration discounts for the inaugural NEXT conference, the association's spring meeting with a focus on the future of physical therapy, being held June 11-14 in Charlotte, North Carolina.

    NEXT evolved from the meeting formerly known as the Annual Conference and Exhibition. Though the focus and tone of NEXT will be on what's ahead for the profession, the event will also feature many of the popular elements of past annual conferences including the McMillan and Maley lectures and the Oxford Debate. As with past annual conferences, NEXT will occur immediately after APTA's House of Delegates.

    Registration and housing information can be found on the NEXT webpage along with a tentative schedule of presentations and preconference sessions.

    Results of New Study on Sedentary Behavior Ring True for PTs and PTAs

    A recently released article that points out the dangers of inactivity among older adults is receiving wide media attention for its conclusion that regardless of time spent in moderate-vigorous activity, each hour spent in sedentary behavior significantly increases the odds of disability in 1 or more activities of daily living (ADL). For physical therapists (PTs) and physical therapist assistants (PTAs) the findings include big news about how the damage of sedentary behavior is independent of activity level—but the study also confirms what they've always known about inactivity and reinforces the importance of PTs and PTAs as agents of change.

    Since its February 19 advance e-publication in the Journal of Physical Activity & Health, "Sedentary Time in U.S. Older Adults Associated With Disability in Activities of Daily Living Independent of Physical Activity" (.pdf) has received attention from Reuters, National Public Radio, CBC, and NBC, among other media outlets. The reason for all the notice is fairly simple: the study's title just about says it all, and the study's contents definitively support the assertion.

    Researchers based their conclusions on an analysis of data from the National Health and Examination Surveys (NHANES), a cross-sectional study that combined household interviews with a physical examination and accelerometer monitoring of daily activities. For the purposes of the just-released article, authors focused on results from 2,286 adults over 60 that represented a wide range of demographic and health variables.

    Researchers analyzed accelerometer data to gauge average daily sedentary time in both hours spent and as a percentage of waking hours. They found that among older adults, during an average 14 waking hours per day, 8.9 hours on average were spent in sedentary behaviors, with 63.4% of the study group being sedentary at least 9 hours a day.

    By linking sedentary data to reports on ADL disability in the NHANES, authors found a dramatic relationship between hours spent in sedentary behavior and the odds of an ADL problem at the rate of more than 50% for every additional hour of inactivity. More significantly for the study, researchers were able to tease out the kinds of nonsedentary activity and found that the risk was not mitigated by engaging in moderate or vigorous activity. "For example, if 2 women of the same age engaged in identical moderate-vigorous hours, but 1 spent an additional hour each day being sedentary, the odds of ADL disability would significantly increase by 60%," the authors write.

    Lisa Culver, PT, DPT, MBA, senior specialist for clinical practice at APTA, says the results should not be too surprising for PTs and PTAs. "I believe PTs have always recognized risk inherent in limited mobility, whether the limited mobility is due to injury or because of voluntary sedentary behavior," she said. "It's a key reason why our focus is to increase an individual's capacity for safe functional movement."

    "The study highlights an important fact—that being active is just one factor to being healthy," Culver said. "Other studies have shown that physical activity is an independent indicator compared to obesity for all-cause mortality, so the study further strengthens the value of an overall healthy and active lifestyle."

    Getting older adults to engage in a more active and healthy lifestyle is addressed in what turns out to be one of the brighter spots in the study. Researchers noted that even minor changes in activity time can make a significant impact on health, and that often these changes can be sparked by brief education and counseling, or by simply incorporating an element of physical activity "before or after social programs." Overall, authors write, "reducing sedentary behavior may be a more attainable goal than increasing moderate-vigorous activity, particularly in persons with chronic illness, pain, and … preexisting disabilities."

    Culver believes that PTs and PTAs can play a key role in lifestyle change. "As with other areas of prevention, health, wellness, and chronic disease management, PTs are key to communication and behavior change in the individuals we see," she said. "PTs typically follow patients and clients for longer periods of time than most health care professionals, and we have the ability to educate them while understanding their readiness and physical capacity for change."

    APTA offers educational resources that address the role of the PT in health and wellness in older adults and provide insight into older adults and exercise adherence. Additionally, APTA's consumer-focused MoveForwardPT.com website includes a webpage featuring videos addressing the importance of fitness across the lifespan. The association also offers a prevention and wellness webpage that includes videos, podcasts, and educational resources.

    Opportunity to Participate in CMS Bundled Payment Initiative Now Open

    The Centers for Medicare and Medicaid Services (CMS) has opened the window for participation in its Bundled Payments for Care Improvement (BCPI) initiative, and will host a webinar to explain the program and discuss how to get involved. The "Winter Open Period" began on February 13 and will run until April 18.

    The BCPI initiative was created in response to the Affordable Care Act, which directed CMS to investigate new payment methods. In bundled care arrangements, instead of making payments to individual health care professionals, CMS makes lump sum payments to a group of providers for a defined episode of care. CMS offers 4 models of BCPI payment, but only models 2 (retrospective acute and postacute care episode), 3 (retrospective postacute care only), and 4 (prospective acutecare hospital stay only) are open for participation. Information on models of bundled payment in general and the BCPI initiative in particular are available at the APTA bundled payment models webpage.

    The deadline for submission of all documents to CMS is April 18. To help interested providers better understand the initiative and requirements for participation, CMS will offer a webinar on March 4 at 12:00 pm (ET). Reservations for the webinar can be made online by using the password BPCI234 (the fourth character in the password is a capital letter "I"). Participants interested in joining by teleconference can call 650/-479-3207 and use access code 668 481 872.

    Questions about the BPCI initiative can be e-mailed to BundledPayments@cms.hhs.gov.

    Team USA PT Discusses Skiing and Snowboarding Injuries With Move Forward Radio

    Listeners to APTA's Move Forward Radio can get a firsthand account of how Team USA prepares to go for gold on the slopes of Sochi, Russia, at the Olympic Winter Games—all from a physical therapist's perspective.

    In an episode that aired last week, Amber Donaldson, PT, DPT, SCS, CSCS, describes the training and treatment regimens for Olympic and Paralympic athletes at the United States Olympic Training Center in Colorado Springs, Colorado, before providing injury prevention tips for recreational skiers and snowboarders. In conjunction with the segment, MoveForwardPT.com published tips for “Preventing Skiing-Related Injuries,” and APTA issued a press release about these resources.

     Move Forward Radio airs approximately twice a month. Episodes are featured and archived at MoveForwardPT.com, APTA's official consumer information website, and can be streamed online via Blog Talk Radio or downloaded as a podcast via iTunes. Ideas for future episodes and other feedback can be e-mailed to consumer@apta.org.

    APTA members are encouraged to alert their patients to the radio series and other MoveForwardPT.com resources to help educate the public about the benefits of treatment by a physical therapist. Follow MoveForwardPT on Facebook, Twitter, and Pinterest, and share these resources with your friends and followers.

    PT Will Oversee $25 Million Translational Research Program

    A physical therapist (PT), researcher, and educator will be leading a program that has received over $20 million in National Institutes of Health (NIH) funding to foster clinical and translational research. Stuart A. Binder-Macleod, PT, PhD, FAPTA, will serve as principal investigator and director of the Delaware Clinical and Translational Accel program, 1 of only 4 winners of an NIH Institutional Development Award (IDeA).

    The program, known as Delaware-CTR ACCEL, combines expertise from the Christiana Care Health System, Nemours/A.I. duPont Hospital for Children, the Medical University of South Carolina, and the University of Delaware (UD) to create opportunities to link research to practice by creating 1 regional home for translational science. During its first year of operation, Delaware-CTR ACCEL intends to create infrastructure, raise public awareness, and facilitate the recruitment and training of clinicians, scientists, and engineers to "synergistically develop outstanding clinical and translational research programs," according to a press release from the program.

    Binder-Macleod is associate vice provost for clinical and translational research at UD and Edward L. Ratledge Professor and chair of the UD Department of Physical Therapy. He is also a former editorial board member for APTA's Physical Therapy journal and a widely published author (link is to full text articles available for free).

    The NIH IDeA awards program is intended to build research capacities in states that have had low levels of NIH funding in the past. In addition to the $20 million in support from NIH, the Delaware-CTR ACCEL program also received $5 million from the state of Delaware and $3.3 million in matching funds from the participating institutions.

    APTA helped lead the effort to enhance the presence of rehabilitation research as part of NIH's translational research agenda through work with the National Center for Advancing Translation Sciences (NCATS).


    Lawmakers Urged to Seize Opportunity to End Therapy Cap

    The Therapy Cap Coalition recently sent a letter to House and Senate leadership urging legislators to add permanent repeal of the therapy cap to the current sustainable growth rate (SGR) reform proposal.

    Sent to House Ways and Means Committee, House Energy and Commerce Committee, Senate Finance Committee, and House and Senate leadership, the February 14 letter from the coalition describes the group's disappointment that the SGR compromise reached in early February did not contain other legislative provisions, specifically language repealing the therapy cap, and suggests that existing proposals could be included in a final package. Specifically, the coalition recommends language in the original Senate version of the bill, which contained a repeal of the cap and replacement policies for the delivery of outpatient therapy.

    The letter emphasizes that lawmakers need to act soon. "The first quarter of 2014 provides an opportunity to end the pattern of yearly extensions that puts patient access to medically necessary therapy services at risk," the letter states.

    The Therapy Cap Coalition, led by APTA, is a group of health care stakeholders that includes patient, consumer, provider, and facility organizations such as the American Heart Association, the American Occupational Therapy Association, the American Speech-Language Hearing Association, the Arthritis Foundation, the National Stroke Association, and the Brain Injury Association.

    APTA's advocacy team is now encouraging grassroots efforts to members and supporters to urge their legislators to include a repeal of the therapy cap in the final bill. Find out how you can take action.

    Post-Mastectomy Physical Therapy 'Widely Improves' Quality of Life

    Postoperative physical therapy that begins as early as 2 days after surgery significantly improves joint mobility and "widely improves the quality of life" for women who underwent mastectomies, according to a new study. Researchers found that women who received physical therapy regained normal glenohumeral function 1 year after surgery and reported less pain, while an untreated control group continued to report limitations.

    Italian researchers focused on women scheduled for Madden's modified radical mastectomy or segmental mastectomy with axillary dissection, dividing a group of 70 women into 2 groups: 1 that received postoperative physical therapy and 1 that did not. Women in the treatment group began physical therapy on the second postoperative day and participated in 40-minute rehabilitation sessions 5 times a week for the duration of the drainage, followed by 20 hour-long sessions after the drainage was removed.

    Researchers observed "considerable" improvements in flexion as early as the fifth postoperative day for the treatment group over the control group, and noted continued progress at 1-month, 6-month, and 1-year evaluations. According to the study's authors, the treated group "regained normal function at 1 year after rehabilitation treatment while [the control group] was unable to do so for flexion, abduction, and internal rotation movements."

    Additionally, the researchers write that physical therapy resulted in "statistically significant differences" in pain perception for the treatment group and even contributed to higher quality-of-life reports from the women who participated in rehabilitation. "Treating and reducing postoperative symptoms, especially pain and functional limitation, helped the patients to have a fast and complete physical and … psychosocial recovery ensuring a significant improvement in terms of quality of life," the report states. The study is e-published ahead of print at the European Journal of Physical and Rehabilitation Medicine.

    The role of the physical therapist (PT) in pre- and postoperative care of women with breast cancer is featured in a Move Forward Radio podcast and is addressed in the Prospective Surveillance Model for breast cancer treatment developed in 2012 by a multidisciplinary group that included APTA members.

    Revised CPT Codes Delayed Until 2016

    The magnitude of proposed changes to an entire family of physical medicine and rehabilitation codes has prompted the editorial panel for the American Medical Association's (AMA) Current Procedural Terminology (CPT) document to postpone finalization of the revisions. Instead, the committee agreed to allow additional time for pilot testing and refinement and has targeted a January 2016 implementation date.

    APTA representatives participated in the most recent editorial panel meeting February 6–8, where the group discussed options for revisions to the 97000 series of the CPT codes (physical medicine and rehabilitation). The panel expressed support for the direction of the coding proposal and made some suggestions for refinements. The codes are set to be pilot tested during the coming weeks.

    APTA is committed to refining the definitions of the new codes and will issue a request for proposals for carrying out the pilot project. Association members can access background information and resources on CPT at APTA's coding and billing webpage, and can also access APTA information on payment reform.

    New Report on Blast Injuries Cites Research Gaps

    Despite the prevalence of blast-related injuries among returning war veterans there are still big gaps in research into long-term effects, according to a newly released study by the National Academy of Science's Institutes of Medicine (IOM). These gaps exist not only in research into specific injury types, but also in understanding the ways in which blast injuries can involve multiple systems and create "cross system interactions" such as mild traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD).

    The new publication,Long-Term Effects of Blast Exposure (.pdf available for free, login required), is the ninth volume in a series of congressionally mandated studies focusing on the health effects of military service. The newest report focuses on blast injury effects present after 6 months, and is based on reviews of nearly 13,000 titles and abstracts and approximately 400 full peer-reviewed journal articles. The report estimates that between 2001and 2011, more than 31,000 soldiers were injured by explosive devices in the Iraq and Afghanistan wars.

    The committee conducting the review focused its efforts on determining what links exist between sustaining a blast and specific health outcomes. Using a classification system developed for previous military health studies, the report group placed various long-term conditions along a range of linkage levels from "sufficient evidence of a causal relationship" to "inadequate/insufficient evidence of an association." The report identified permanent eye injury and damage to genitourinary organs as highly linked, while pulmonary function, vertigo, and exercise limitation were described as insufficiently linked to the initial blast injury.

    The report emphasizes that that committee's work was limited by significant gaps in evidence and that any analysis that focuses on one type of injury provides an incomplete picture. "A fundamental feature of exposure to blast is that it can result in complex, multisystem injuries," the report states. "Attention to those complexities has often been lacking in research studies. It is important that research on blast [injuries] emphasize multisystem injury patterns and seek to understand the clinical importance of cross-system interactions."

    The report also includes 10 recommendations for further study, mostly directed at the US Department of Defense (DOD) and Veterans Administration (VA). The recommendations focus on the need for further research and longitudinal studies as well as analyses of institutional barriers to collaborative studies, and an investigation into biomarkers of blast injury.

    APTA has been a strong advocate for more research into the blast injuries, and offers resources related to the physical therapist and physical therapist assistant role in treatment of blast-related injuries at the association's Management of Wounded Warriors webpage. The association has also been active in the Joining Forces Initiative that highlights the needs and strengths of military families.

    Innovation 2.0 Update: Proposal Deadline Feb 13

    Thursday, February 13 is the deadline for Innovation 2.0 proposals. Get more information at the Innovation 2.0 webpage.

    Reminder: A formal proposal needs to be submitted even if you sent a letter of intent.

    The PTJ App Is Here

    Editor's Note: The PTJ app was discontinued when the journal begain its publishing arrangement with Oxford University Press in 2016.

    Physical Therapy (PTJ) now offers a new app that allows subscribers to access journal content through any iOS device, and to store some of that content for offline use. The free app allows users with personal or institutional subscriptions to use their iPhone, iPad, or iPod Touch devices to access articles published ahead of print as well as current and recent issues of PTJ.

    In addition to the ability to download and store content, the PTJ app makes it possible to read and cache PDFs, listen to PTJ podcasts, and save full-text articles using the "favorite" function. The app also allows access to the full journal archive through PTJ's mobile site.

    The PTJ app is available at the iTunes app store. Set up instructions are available at the PTJ website.

    APTA Offers Support for Clinical Practice Document Development

    APTA sections have until March 17 to submit proposals for clinical practice guidelines (CPGs) and clinical practice appraisals (CPAs) for possible financial support from the association.

    Through financial support the association hopes to better enable physical therapists (PTs) to consistently use best practices to improve the quality of life of their patients and clients. The program will provide structure, process, and resources for the development of clinical practice documents and other high-quality evidence summaries that translate research into PT practice.

    Proposals for CPG/CPA development must be supported and submitted by an APTA section, and must focus on clinical practice areas that are important and relevant to the practice of physical therapy. Each proposal will be considered individually and will be awarded in part or in full depending on the strength of the proposal and the priorities of the association.

    Proposals for the current review cycle are due March 17. For more information or a copy of the proposal submission document, e-mail Anita Bemis-Dougherty, director, practice department, or call 800/999-2782, ext. 3176.

    Innovation 2.0 Proposals Due Feb 13 – Even If You Submitted a Letter Of Intent

    Thursday, February 13, is the deadline for submitting a proposal for the APTA Innovation 2.0 program that will offer up to $150,000 to support innovation in service delivery and payment in a wide range of areas. In addition to the deadline announcement, potential participants are reminded that the letters of intent they may have submitted cannot be substituted for an official proposal.

    All proposals must be submitted using the online proposal submission form. For more information on the models types that will be considered, visit APTA’s Innovation 2.0 webpage.

    Contact the Innovation 2.0 staff with questions.

    APTA Photo Contest Winners Announced

    The winning entries in the 2013 APTA photography competition have been announced, and combined they make a moving statement on how physical therapy's transformative powers begin with the individual patient or client.

    Last year, members submitted photos that evoked the power of physical therapy practice, education, and research. The photos were reviewed by a panel of judges, which selected the following winners:

    • First place - Jed Jacob Droge, PT, DPT, OCS, ATC, CSCS
    • Second place and honorable mention (2 photos) - A. Sanvictores, PT, DPT
    • Third place - Bridget M. Teele, SPT
    • Honorable mention - Marcia Mattson, PT

    All winning photos have been posted on the contest webpage. APTA's next photography contest will be held in 2015.

    Virtual Town Hall February 20 for Motions to the 2014 House of Delegates

    APTA continues its series of virtual town halls that enable APTA members and delegates to discuss motion concepts and language for the 2014 House of Delegates. The next virtual town hall will take place Thursday, February 20, 8:00 pm–9:30 pm, ET.

    Led by the Reference Committee and House officers, virtual town hall participants will be able to share motion topics and provide input on topics shared by others. Participation is open to all APTA members.

    Participants can sign up for the town hall via the “Virtual Town Hall Sign-Up Sheet” posted to the House of Delegates Community in the Shared Documents Folder. The deadline to add a concept to the discussion lineup or sign up as an attendee is February 19 at 5:00 pm.

    The APTA House of Delegates will take place June 9–11 in Charlotte, North Carolina.

    Hayes, Hillegass Named To Influential Measures Evaluation Committees

    APTA members Marcie Harris Hayes, PT, DPT, MSCI, OCS, and Ellen Hillegass, PT, EdD, CCS, FAACVPR, FAPTA, have been named to National Quality Forum (NQF) steering committees overseeing reviews of musculoskeletal measures and cardiovascular conditions for the US Department of Health and Human Services (HHS).

    Hayes and Hillegass will join multi-disciplinary, multi-stakeholder teams charged with evaluating new measures and reviewing established measures undergoing maintenance review. The committees will make recommendations for which measures should be endorsed as consensus standards, and will work to identify and endorse new performance measures. Hayes has been selected for the musculoskeletal group; Hillegass will serve on the group focused on cardiovascular conditions and measures.

    Hayes is associate professor of physical therapy and orthopedic surgery at the Washington University School of Medicine in St Louis. Hillegass is an adjunct professor at Mercer University in Atlanta, Touro University in Las Vegas, and Western Carolina University, and is also the president and CEO of Cardiopulmonary Specialists, a private consulting firm.

    NQF is a nonprofit, nonpartisan public service organization focused on the review and endorsement of standardized health care performance measures. The organization is under contract with HHS to conduct endorsement projects.

    Bill to End SGR Lacks Language on Therapy Cap

    A bipartisan, bicameral proposal unveiled on February 6 would end Medicare’s flawed sustainable growth rate (SGR) formula, but it does not contain any language around the therapy cap. APTA's advocacy team is now encouraging grassroots efforts to turn legislators' attention to extenders such as the therapy cap for inclusion in the final bill.

    The SGR Repeal and Medicare Provider Payment Modernization Act (HR 4015) would permanently repeal the SGR and provide annual increases of 0.5% from 2014 through 2018. For the next 5 years after 2018, rates would remain unchanged, but providers could receive additional payments through a quality incentive system. The agreement is the product of the Senate Finance, House Ways and Means, and House Energy and Commerce committees.

    Still lacking from the agreement, however, is any mention of repeal of the outpatient Medicare therapy cap—something included in the Senate committee's original version of the legislation. If Congress passes legislation permanently addressing the SGR formula but does not include a repeal of the Medicare therapy cap, patients could face a hard cap on outpatient therapy services after the current therapy cap exceptions extension expires on March 31.

    “Congress has indicated it will now turn its attention to which Medicare extenders to include in the legislation, so it is imperative that APTA members use APTA’s advocacy resources in favor of repealing the cap," said Justin Moore, PT, DPT, vice president of public policy, practice, and professional affairs for APTA.

    The APTA advocacy team has issued an action alert calling for members and supporters to urge their legislators to include a repeal of the therapy cap in the final bill, and members interested in the latest news on the SGR and therapy cap reform can now download a new "Heard On The Hill" podcast that provides more details about the proposal. APTA members can take action via the Legislative Action Center and nonmembers and the public can take action via the Patient Action Center.

    APTA will continue to work the members of Congress to ensure the final reform package includes policies that reflect the interests of physical therapists and the patients and clients we serve. Members interested in joining APTA's advocacy efforts to reform SGR and repeal the therapy cap can sign up for PTeam.

    Editor's note: This story was updated at 3 pm ET (February 10) to correct a typo in Justin Moore's quote. News Now regrets the error.

    Committee Call Closing February 11

    Some very special opportunities for professional growth and leadership are available, but not for long: APTA will close its call for committee volunteers at midnight on February 11.

    There's still time to respond to the call by completing a volunteer interest profile found on the Volunteer Interest Pool webpage. Once you create your profile, you can apply to serve on the specific committees that interest you.

    The deadline is February 11. Complete details on all committees can be found on APTA's Volunteer Groups webpage.

    ICF Accepting Suggestions for Changes

    The current version of the International Classification of Functioning, Disability and Health (ICF) is now open for suggested updates and corrections, and physical therapists (PTs) can get involved.

    Produced by the World Health Organization (WHO), the ICF was endorsed by the APTA House of Delegates in 2008, and the association's upcoming third edition of the Guide to Physical Therapist Practice will use the ICF framework. Additionally, the Centers for Medicare and Medicaid Services' functional limitations reporting is based on the ICF components.

    Anyone interested in suggesting a change or reviewing proposals can access the information by way of a free registration at the ICF website. The system also allows users to comment on posts from others.

    User suggestions have been a part of the ICF update process for several years. The updates for 2013 have been published and are available online.

    A draft of a manual on how to use the ICF (.pdf) is available for download at the WHO website.

    International Physical Therapy Congress to Feature PTs From the US

    A total of 18 physical therapists (PTs) from the US will be among the main speakers at the World Confederation for Physical Therapy (WCPT) Congress to be held in Singapore May 1–4, 2015.

    The American PTs will be contributing to focused symposia on a wide range of topics including rehabilitation and Parkinson disease, maximizing augmented mobility for children, pain education, advocacy, physical therapy in the intensive care unit, and the use of interactive technology in rehabilitation for young people, among others. A complete list of all participants and presentations (.pdf) is available at the WCPT Congress website.

    In a press release from WCPT, International Scientific Committee Chair Aimée Stewart said, “We’ve had more proposals for focused symposia than ever before, which means we have been able to select topics with high-caliber speakers that physical therapists all over the world will be excited to hear from." Each focused symposium is organized by a convener who leads an international group of speakers through linked research-focused presentations.

    Details about the symposia and the program for WCPT Congress 2015 may be found at the WCPT congress webpage.

    Innovation 2.0 Proposal Deadline February 13

    APTA members have until Wednesday, February 13, to submit a proposal for APTA's Innovation 2.0 program, a project that will offer up to $150,000 to support innovation in service delivery and payment in a wide range of areas.

    Proposals must be submitted using the online proposal submission form, and a complete list of model types that will be considered can be found on APTA's Innovation 2.0 webpage.

    Questions? Need more details? Contact the Innovation 2.0 staff.

    From CSM: Portney Calls for Disruptive Change in Physical Therapy Education

    Stating that the physical therapy community has not adequately dealt with change in physical therapy education, Leslie Portney, PT, DPT, PhD, FAPTA, said that disruptive change is needed. Portney delivered the 17th annual Pauline Cerasoli Lecture February 5 on “Choosing a Disruptive Path Toward Tomorrow.”

    “If we don’t move away from the same tools and frameworks that we have always used,” Portney said, “we will find ourselves being forced to when tomorrow comes.”

    She explained that disruptive innovation explains how new products or services become adopted when they serve a new market, are cheaper or more efficient than older products, and effectively change the culture of the product’s use. The printing press, personal computer, retail health clinics, and the first use of anesthesia are disruptive innovations. In contrast, sustaining innovations seek to improve the status quo—such as car engines with better mileage.

    Portney said that most of the changes in physical therapy education during the past 50 years have been sustaining, rather than disruptive. Sustaining is no longer sufficient, she said, and, meanwhile, the sustainability of current business models in higher education is being challenged by “the perfect storm” of tuition increases, student debt, and tuition discounting. These “could make the financial foundation of our institutions untenable.”

    Portney proposed a series of potentially disruptive innovations for physical therapy education, including online education, faculty and curriculum changes, and evidence-based teaching.

    Following Portney’s address, it was accounted that Cecilia Graham, PT, PhD, would be the 2015 Cerasoli lecturer.

    For further coverage of the Cerasoli Lecture and other sessions from CSM 2014 in Las Vegas, watch for the CSM Daily News highlights issue, to be delivered electronically to members after the close of the meeting. Past issues are posted on www.apta.org/CSM.

    From CSM: Crane Lecturer Envisions a New Kind of PT 'Trailblazer'

    If physical therapists (PTs) are to hold on to their reputation as trailblazers, they'd better realize that they're lighting out to some very different territory from that of their counterparts years ago, according to Linda Crane lecturer Dianne V. Jewell, PT, DPT, PhD. Jewell's remarks were delivered February 4 at the APTA Combined Sections Meeting.

    For Jewell, the new "wild country" that PTs need to navigate is one in which the profession needs to move beyond its "white hat" reputation and actively engage all health care and policy stakeholders in understanding the value proposition that PTs bring to the table.

    Jewell, president of the Rehab Intel Network consulting group and past member of the APTA Board of Directors, challenged the lecture audience to not only embrace the outcomes-based realities of a changed health care landscape, but to move beyond even those realities and realize that simply producing data isn't enough.

    Referencing APTA's new vision statement "Transforming society by optimizing movement to improve the human experience," she told the audience that "our ability to fulfill our new vision depends on skilled negotiation regarding our value proposition." In other words, PTs will need to engage in careful self-reflection, informed by data, to understand how to best present the argument for the profession to a health care world driven by interests that will probably not be the same as the PT's. "That is the trail we have to blaze," she said. "It's going to be more than just making patients better."

    More details on Jewell's remarks can be found in the daily CSM report available online.

    Consumer Engagement Webinar Coming February 13

    Physical therapists (PTs) and physical therapist assistants (PTAs) can get insight on the role of consumers in the health care marketplace and learn about technology available to support that role through a webinar being held February 13.

    "Consumer Engagement in a Rapidly Evolving Healthcare Environment" is an hour-long event that will focus on how quality and cost outcomes can be affected by the ways in which consumers connect with the providers, payers, and others in the health care system. The webinar will begin at noon eastern time, and will feature presentations by Rose Maljanian, Chairman and CEO of HealthCAWS Inc, and Gary Ozanich, senior research fellow at the Center for Applied Informatics, Northern Kentucky University. Speakers will also discuss the use of the Consumer eHealth Readiness Tool (CERT) in supporting engagement.

    The event is sponsored by the Patient Centered Primary Care Collaborative, and registration is now available online. Participants can also learn more about the CERT tool prior to the webinar.

    Get Active for PT Research With Log 'N Blog

    It's that time again when getting fit, staying fit, or simply having a good time can benefit both your own wellbeing and physical therapy research, thanks to the Foundation for Physical Therapy's second Annual Log ’N Blog.

    Created and led by students from the University of Pittsburgh, the Log 'N Blog program allows physical therapist and physical therapist assistant education programs, clinics, corporations, APTA sections, chapters, or even groups of friends to create teams to help promote the importance of physical activity while raising funds for research.

    Teams compete by tracking individual swimming, biking, running, and other fitness activities. This year, new features in the program include a way to track by the hour or minute, an online supporting comments section, and the ability to enter activities backlogged to the beginning of the 2014 Log 'N Blog event. Learn more and register at the Log 'N Blog website. This year's event will run through July 31.

    From CSM: Leadership Necessary to Make APTA Vision a Reality

    Everyone has the potential to lead—and the responsibility to do so, John Lowman, PT, PhD, CCS, told attendees at the Recognition Ceremony for Clinical Specialists of the American Board of Physical Specialties (ABPTS) at CSM 2014 on February 3.

    Lowman cited traits and responsibilities of leaders, then described the findings of leadership expert Jim Collins, author of Good to Great. Collins found that while the best leaders all had the necessary management skills, they also had a combination of personal humility and professional will.

    Although some people may seem to be born with heroic leadership abilities, Lowman insisted that leadership can be learned, even later in life, and can be developed through making wise choices.

    He said that heroic leadership will be necessary for APTA’s vision to become reality, “Leadership is not a lab coat you can take off at the end of the day,” he said.

    More details on Lowman's remarks can be found in the daily CSM report available online.

    New Podcast Focuses on Jimmo v Sebelius Updates

    APTA members now have access to a podcast that will help them understand changes made to Medicare policy as a result of the January 2013 Jimmo v Sebelius settlement agreement on maintenance care.

    Though the agreement reinforced the US Centers for Medicare and Medicaid's (CMS) policy on maintenance care, updates and changes to the Medicare Benefit Policy Manual were still required. Last month, CMS issued summary of updates (.pdf) made to the manual, and APTA is now producing member resources that help to explain just what those updates mean.

    The podcast now available is the first in a planned series on the topic and focuses on the impact of changes to inpatient rehabilitation facilities, home health settings, skilled nursing facilities, and outpatient therapy. The next podcast will help listeners understand how to appropriately document skilled maintenance therapy to minimize the risk of denials. Transcripts of the podcasts are also available to members for download at the APTA website.

    The podcast joins several other resources on APTA's Medicare coverage webpage about the settlement and its potential impacts. The presentation is also available on iTunes.

    Resistance Training May Increase Testosterone in Older Men

    Authors of a small-scale study are asserting that resistance training may increase testosterone levels in older men. Researchers believe that increased levels of the hormone may help guard against osteoporosis and increase resistance to injury from falls.

    The study (abstract only available for free) is published online in the FASEB Journal from the Federation of American Societies for Experimental Biology and documents a research project that involved 6 young men and 13 older men. Levels of testosterone were measured before and after a 12-week resistance training program focused on knee extension and flexion. Biopsies were taken from the vastus lateralis.

    Researchers found that "muscular sex steroid hormone levels and sex steroidgenesis-related enzyme expressions were significantly lower in older subjects than younger ones at baseline, but 12 weeks of resistance training significantly restored hormone levels." Additionally, authors reported significant restoration of steroidogenesis-related enzymes through the training program.

    An article with details on the research is available at Medscape Medical News (readers must sign up for a free account).

    Prickett Appointed to International PT Awards Committee

    APTA member Nancy Prickett, PT, MA, MPT, GCS, NCS, has been selected to join the World Confederation for Physical Therapy's (WCPT) awards committee. The committee will be overseeing the awards process for the 2015 WCPT Congress in Singapore.

    Prickett was nominated by the International Association of Physical Therapists Working with Older People, and will represent the North American Caribbean Region (NACR), of which APTA is a member.

    WCPT is accepting proposals for presenters interested in teaching a pre- or post-conference course at the 2015 Congress. Submission information is available at the WCPT website. Deadline for submissions is February 14.

    ACOs 'Off to a Strong Start,' According to CMS

    Early news on savings achieved by Accountable Care Organizations (ACOs) is out, and it's mostly good: According to a study just released by the US Centers for Medicare and Medicaid Services (CMS), almost half of the ACOs started in 2012 were already reporting significantly lower-than-projected expenditures in their first year.

    Of the 114 ACOs that began operations in 2012, 54 reported exceeding program benchmarks, and 29 of the 54 "generated shared savings totaling more than $126 million," according to a press release issued by CMS. These ACOs were also cited as helping to create $128 million in net savings for the Medicare Trust Funds.

    Among 23 ACOs that adopted the Pioneer model—a model designed for providers experienced in coordinating care for patients across care settings—9 had "significantly lower spending growth" while exceeding quality reporting requirements. CMS found that the Pioneer ACOs generated combined savings of $147 in their first year.

    Physical therapists (PTs) in private practice, home health agencies, skilled nursing facilities, and rehabilitation hospitals are among the providers able to participate in multiple ACOs. APTA members can learn more about the PT's role in an ACO by visiting APTA's webpage, FAQ: Accountable Care Organizations (ACOs): Medicare Shared Savings Program and Pioneer Models.

    APTA Selects J. Michael Bowers as Chief Executive Officer

    Michael Bowers, APTA CEO

    APTA has selected J. Michael Bowers as its new chief executive officer, effective February 28, 2014. The announcement comes after an extensive nationwide search that spanned more than 6 months and attracted roughly 160 potential candidates.

    Bowers comes to APTA with recent experience as the CEO of the American Association for Marriage and Family Therapy (AAMFT). He worked at AAMFT in a variety of leadership positions for more than 25 years, developing expertise in many aspects of association management, including advocacy, governance, volunteer development, financial management, and member relations. While at AAMFT, he led the effort to achieve universal licensure for marriage and family therapists, and also improved the association’s financial position by overseeing the purchase of and full payment for a headquarters building.

    "On behalf of the APTA Board of Directors, I am thrilled that Michael will be joining us as CEO, and I look forward to working with him," said APTA President Paul A. Rockar Jr, PT, DPT, MS. "Throughout his career, Michael has proven himself to be an innovative and visionary leader who cares deeply about members and staff. He also exhibits a passion for the types of quality of life issues that are so important to mission-based organizations like APTA and to the physical therapy profession."

    Bowers will succeed Bonnie Polvinale, CMP, who has been serving as Interim CEO since June 2013.

    "I couldn't be more excited or honored to join the staff of APTA in advancing physical therapy," Bowers said. "I look forward to getting to know as many members as possible. My commitment to members and the organization is to work collaboratively, with all my energy, to achieve outcomes that matter for patients and for the profession."

    During his tenure at AAMFT, Bowers presented testimony in 22 state legislatures, the US House of Representatives, and US Senate, and has appeared on CNN and NBC Nightly News. He was instrumental in AAMFT becoming a part of the Substance Abuse and Mental Health Services Administration Minority Fellowship Program, and having marriage and family therapy recognized as a core mental health profession. He also led AAMFT to its highest student membership in the organization's history.

    Bowers is trained as a marriage and family therapist and has bachelor's and master's degrees from Harding University in Searcy, Arkansas. He has prior experience as a therapist in the justice system and also as a minister. He is also an active member of the American Society of Association Executives.

    Away from work, Bowers enjoys writing and playing acoustic music, scuba diving, creating great wine and food pairings, and cheering for the Washington Nationals. He also has a special appreciation for the benefits physical therapy. His first grandchild was born prematurely in 2012, and after a diagnosis of mild cerebral palsy she has been receiving physical therapy since her earliest days.

    Bowers lives in Alexandria, Virginia, where he and his wife participate in the music community as singer-songwriters.


    An Extensive Nationwide Search

    APTA's search for a new CEO began early in the summer of 2013 by engaging the search firm Isaacson, Miller (IM) and appointing a CEO search work group (CEOSWG). The CEOSWG included APTA Vice President Sharon Dunn, PT, PhD, OCS, and Secretary Laurie Hack, PT, DPT, MBA, PhD, FAPTA, as co-chairs. Also serving on the CEOSWG were Rockar, Treasurer Elmer Platz, PT, Director Roger Herr, PT, MPA, COS-C, and members Steve Anderson, PT, DPT, Susan Appling, PT, DPT, PhD, OCS, Daniel Dale, PT, DPT, David Emerick Sr, PTA, BBA, Colleen Kigin, PT, DPT, MS, MPA, FAPTA, and Craig Moore, PT, MS.

    Isaacson, Miller began its work with the CEOSWG to frame the position description, opportunities, and challenges through focused conversations with stakeholders, meetings with staff, and a staff survey. A scope of work document, which included a profile of the ideal candidate, was presented to the Board of Directors at the August board meeting. This information was distributed broadly to all members and beyond, inviting referrals and interested parties to submit applications, potential candidates, and suggestions. IM used these suggestions and additional networks to solicit potential applicants for the position.

    The CEOSWG met 4 times in fall 2013 to review the candidate pool (roughly 160 persons of interest), provide guidance to IM about potential prospects to pursue (about 30-45), and to determine which candidates to interview. The CEOSWG conducted preliminary interviews (8 candidates) in early December, and 4 finalists were selected to submit to the Board of Directors.

    The Board met in early January this year to interview the finalists and select the CEO.