is pleased with the decision of the federal court to approve the final
settlement in the class action 'Improvement Standard' lawsuit (Jimmo vs Kathleen Sebelius), which
upheld the right of patients to continue to receive reasonable and necessary
care to maintain their medical conditions and prevent or slow decline,"
President Paul A. Rockar Jr, PT, DPT, MS, in a statement issued today. "We look
forward to working with the Centers for Medicare and Medicaid Services (CMS)
and its contractors to ensure the appropriate and equitable application of
patient care as outlined in the settlement. We believe this final settlement
reinforces the fundamental right established in the Medicare statute that
affords patients the right to receive the services necessary to treat their
diagnoses or illnesses."
final settlement directs CMS to revise its Medicare Benefits Policy Manual to
set a maintenance coverage standard and launch a national educational campaign
to explain the clarified benefit to its contractors, providers, and
beneficiaries. "APTA is eager to serve as an active partner as the agency
begins this work. Over the next several months, we will provide clinical and
professional expertise to CMS to define appropriate treatment in accordance
with our professional standards," Rockar says.
CMS works to publicize changes and new resources, APTA will actively educate
members on how to give appropriate care as defined by this final settlement.
The candidate webpage now is
available. Learn about your candidates for the 2013 elections to national
office by browsing the candidates' biographical information and reading their
written statements. Contact Angela Boyd
with any questions.
The Indian Health Service (IHS) is
accepting applications for its Loan Repayment Program (LRP). This program
offers health care professionals, including physical therapists, the
opportunity to pay off qualified student loans to meet the staffing needs of
Indian health programs. There is an estimated $20 million available for
awards during Fiscal Year 2013. The LRP awards up to $20,000 per year in
exchange for a minimum 2-year service obligation, plus 20% of federal income
tax on the award (see payments and examples).
Applications are accepted and
evaluated monthly until funds are exhausted. February 15 is the first award
cycle deadline. August 16 is the last award cycle deadline. Visit the LRP website for more
and to apply.
The February issue of Health Affairs
explores the burgeoning field of activating and engaging patients in their
health and health care. Studies show that more informed and empowered patients
have better health outcomes, and there is some evidence that they also have
lower health care costs.
One study featured this month
found that patients with the lowest level of "activation"—that is,
those most lacking in the skills and confidence to be actively engaged in their
health care—had average costs that were 8 %-21% higher compared with patients
with the highest level of activation.
Another article reports on how offering online health care for patients with
simple conditions saved money for a prominent Minnesota health plan. Launched
in 2010, "virtuwell" provides 24-hour online access, diagnosis, and
treatment (including prescriptions) by nurse practitioners for about 40 simple
conditions, such as sinus infections, urinary tract infections, and pink eye.
Private and public sector leaders also weigh in with their perspectives on
strategies to lower health care costs, improve quality, engage patients, and
enhance outcomes research.
to popular demand, the deadline for the Innovation Summit: Collaborative Care Models has been extended to March 6. Don't miss out on the opportunity to
participate in this groundbreaking virtual event that will bring together
physical therapists, physicians, large health systems, and policy makers to
discuss the current and future role of physical therapy in integrated models of
out the programming,
the speakers and panelists who will provide you with the information needed to
get involved in accountable care organizations, patient-centered medical homes,
bundled payment models, and private payer and employer-sponsored initiatives.
in attending a viewing party in your area? APTA will soon list viewing parties
and their locations at www.apta.org/InnovationSummit/ViewingParties/.
newly created Leadership Development Committee (LDC) is seeking members to
serve in this capacity. If you or someone you know is interested in developing
the organizational structure for an APTA leadership development program, you may wish to add
your name in the pool for consideration. There are 7 committee member openings
for 1- or 2-year terms starting in April. Contact Elizabeth Grotos with questions
about the LDC.
answer the call for these opportunities, members must first complete a
volunteer interest profile found on the Volunteer Interest Pool webpage. Once your profile is created, you may review the
current opportunities and answer the questions specific to each committee. The deadline to respond to this call is
training regimen to adjust the body's motor reflexes may help improve mobility
for some people with incomplete spinal cord injuries, according to a study
supported by the National Institutes of Health.
The study involved 13 people who
were still able to walk after incomplete spinal cord injuries that had occurred
from 8 months to 50 years prior to the study. All had spasticity and an
impaired ability to walk. The goal was to determine if these individuals could
gain mobility by learning to suppress a spinal H-reflex, which is elicited by
electrical stimulation rather than by a tendon stretch.
Participants in the study received
electrical stimulation to the soleus of their weaker leg while standing with
support. The first 2 weeks of the study involved baseline measurements of the
resulting reflex. During the next 10 weeks, 9 participants underwent 3 training
sessions per week, during which they viewed the size of their reflexes on a
monitor and were encouraged to suppress it. A control group of 4 participants
received the stimulation but no feedback about their reflexes. Before and after
these sessions, the researchers measured the participants' walking speed over a
distance of 10 meters and monitored their gait symmetry with electronic shoe
Six of the 9 participants in the
training group were able to suppress their reflexes. Their walking speed
increased 59% on average, and their gait became more symmetrical. These
improvements in speed and symmetry were not seen in 3 participants who were
unable to suppress their reflexes, or in the control group. Many participants
also spontaneously told the researchers they were noticing improvements in
daily living activities. About 85% of these comments came from people who were
able to control their reflexes after several weeks of training.
author Jonathan Wolpaw, MD, said he
views reflex conditioning as a complement to current rehabilitation practices.
The technique could be tailored to focus on specific reflexes that affect
different muscle groups and, in some cases, to increase reflexes instead of
decrease them. In its 2006 study, his group found that enhancing soleus
H-reflex was beneficial for rats that had spinal cord injuries predominantly
characterized by weakness without spasticity.
Thompson, PhD, who also authored the article, said she plans to study how durable the effects of training are, but
such research presents a design challenge. "Once people noticed their
mobility had improved, they started exercising more and getting involved with
other types of therapy. Those activities are likely to have additional benefits
and will be difficult to separate from the long-term effects of our reflex
conditioning protocol," she said.
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