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  • Clinical Practice Guideline Proposals Due Soon

    APTA sections have less than a week left to submit proposals for clinical practice guidelines (CPGs) and clinical practice appraisals (CPAs) for possible financial support from the association. Proposals for the current review cycle are due March 17.

    Proposals for CPG or 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.

    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.

    CMS Looking For 'Practice Transformation' Input

    Physical therapists (PTs) who have insights on transforming clinical practices now can share those insights with the Centers for Medicare and Medicaid Services (CMS). The agency hopes to shape future policy by reviewing what health care providers have done to meet the aims of "better care and better health at lower costs."

    Health care providers who have participated in practice transformation are encouraged to respond to the CMS request for information (RFI) by April 8. CMS states that it may use the information "to test new payment and service delivery models."

    CMS defines practice transformation as "a process that results in observable and measureable changes to practice behavior" around core competencies that include:

    • Engaged leadership and quality improvement
    • Empanelment and improved patient health outcomes
    • Business and financial acumen
    • Continuous and team-based healing relationships that incorporate culture, values, and beliefs
    • Organized, evidence-based care
    • Patient-centered interactions
    • Enhanced access
    • Progression toward population-based care management
    • State-of-the-art, results-linked care
    • Intentional approach of practices to maximize the systematic engagement of patients and families
    • Systematic efforts to reduce unnecessary diagnostic testing and procedures

    Physical Therapy As Effective As Surgery for Rotator Cuff Tears

    A recent study from Finland asserts that when it comes to treatment of nontraumatic rotator cuff tears, physical therapy alone produces results equal to those produced by arthroscopic surgery and open surgical repair. According to the study's authors, follow-ups of 167 shoulders treated show that "conservative treatment should be considered as the primary treatment for this condition."

    The research, published in the January issue of Bone and Joint Journal (abstract only available for free), was built around treatment of 173 patients aged 55 and older (mean age 65) with supraspinatus tendon tears. Patients were assigned to 3 groups: the first group received physical therapy only; the second group received acromioplasty and physical therapy; and the third group was treated with rotator cuff repair, acromioplasty, and physical therapy. Each group contained similar age ranges and equal distribution by sex. After exclusions and drop-outs, 167 shoulders were available for assessment.

    Components of the physical therapy treatment remained the same across groups: patients were given guidance and information on home exercise that focused on glenohumeral motion and active scapular retraction for the first 6 weeks, with increases during the next 6 weeks, followed up by increased strength and resistance training for up to 6 months. Participants were also referred for 10 physical therapy sessions in an outpatient clinic.

    When patients were assessed using the Constant score at 3 months, 6 months, and 1 year, researchers found substantial similarity in rates of improvement. "Contrary to our hypothesis, surgical repair of a supraspinatus tear does not improve the Constant score when compared with acromioplasty only or conservative treatment," the authors write. Additionally, the patients' subjective satisfaction ratings were the same for all 3 approaches.

    The findings even seemed to contradict the placebo effect often associated with surgery. Authors noted that participants were aware of the treatment path assigned to them, yet the surgery group did not report markedly different perceptions of improvement. The results led authors to speculate that the similar Constant scores among groups "may simply be due to the similar physiotherapy [regimens]."

    Humana Seeking to Amend Provider Contract Terms

    If you've received a letter from Humana or Health Value Management notifying you of reductions in payments in connection to sequestration, consider consulting a healthcare attorney: the letter could contain information on amendments to your contract and deadlines for review and objection.

    Humana and Health Value Management, Inc. doing business as ChoiceCare Network (ChoiceCare) recently distributed the letters, which mention sequestration reductions imposed by the Center for Medicare and Medicaid Services (CMS). APTA strongly encourages you to review the letter, including possible changes to your individual network participation and the time period for objections, and carefully analyze your individual contract terms. You may find it helpful to seek legal advice on whether and how to respond.

    Though APTA provides many resources on its private insurance webpage—including a managed care contracting toolkit—the association cannot provide legal advice or guidance to individual members.

    For further information regarding your contract, you may also contact your payer representative.