The following transcript was created using artificial intelligence and may contain typos, omissions, or other errors.

Taj: Welcome to this APTA Podcast. Your APTA membership helps to advance the physical therapy profession by supporting our research and development efforts, including the association’s work to improve the long-term sustainability of the profession. The development of APTA’s landmark report, “The Economic Value of Physical Therapy in the United States,” would not have been possible without the support of our 100,000+ members. APTA is using this report to inform policymakers, payers, employers, and consumers about the significant role and economic value that physical therapy brings to the health care system. The podcast you’re about to hear is part of a series that explores the report’s general impact as well as describes the findings on individual conditions and treatments.

Troy: Once again, welcome to this APTA podcast on the economic value of physical therapy in the United States. A landmark report from the association that shows physical therapies potential to deliver true economic value to patients, the US healthcare system and society as a whole. I'm Troy Elliott and in this podcast, the first in a series we're producing on the report, we're going to look at some of the hows and whys of this new resource, as well as the reports findings. And we're going to do it from a fairly big picture perspective, though we might zoom in from time to time. Now all that zooming in and out might seem like a tall order, but luckily I'm joined by just the right people to help us. Kate Minick and Greg Bennett two members of the APTA Volunteer Work Group that helped to shape the report. And Alicia Hosmer, APTA senior director of brand strategy and communications, who happens to know a thing or two about the story behind this report and the ways APTA will leverage this resource and how will help Members in the public do the same. So welcome to all three of you. And Alicia, I'm gonna just start right in with you. I'm wondering if you could walk us through what I guess is like the biggest of the big pictures. What exactly is this report and what do APTA members need to know about it?

Alicia: Yes, thank you so much Troy, for having us on. I'm delighted to be here. So first, our Members should know that the development of the economic value of physical therapy in the United States was driven by APTA strategic plan goals. Those were developed by APTA Board of Directors and our embedded in our 2022 to 2025 strategic plan. And this report really funnels into two of the four overarching goals. So the first goal is to drive demand for and access to physical therapy as a proven pathway to improve the human experience. The economic findings in this report are being used nationwide in a multi year campaign to increase demand for physical therapist services. The second strategic plan goal that directly correlates to the development of this report is improving the long term sustainability of the profession and that, of course includes increasing payment of physical therapist services. So we recognize the environment that PT and PTA's are in as well as our overall health care system and we need to reinforce the value to influence change. And this report is going to help us change the conversation to advance payment priorities while driving demand from consumers and influencing payers and insurers, policymakers and employers. So. Member or Members should really know this is just the beginning of what will be a years long campaign to policymakers, payers, insurers, employers and consumers. We will be communicating the significant role and economic value of physical therapy brings to patients and the healthcare system in the United States. So ultimately the end goal is to be able to expand access to care and coverage for physical therapist treatment and to ensure PTs and PTAs are receiving fair pay for their services.

Troy: Well, you know it let's you know, I'm backing up even more because on the face of it, it sounds like a fantastically great idea to somehow determine the economic value of physical therapy somehow.

Alicia: Yeah.

Troy: But you know, it also seems like that would be a really, really hard thing to get at. So I mean like where do you start? And Kate, what do you think? I mean, how did nous and the work group figure out what those economic values were? And first of all, before I even ask you that question, tell us a little bit about the structure and now scroop and that relationship too.

Kate: Sure. So the APTA contracted with the NOUS group, who has done a similar report with the Australian Physiotherapy Association, and for this project we combined a detailed literature review consultations with subject matter experts across a wide range of physical therapy space and health, economic methods and modeling in order to outline the economic benefits of physical therapy treatments. So the first stage of the project focused on identifying interventions most suit, and then we built the evidence base for economic modeling, which involved extensive literature review and the model that we followed identified 4 aspects of the value of physical therapy treatment which are direct benefits, avoided cost, indirect benefits and costs. And when the economic value attached to the quality of life improvements or our direct benefits exceeded the net cost of treatment, then it was determined that the treatment delivers a net benefit.

Troy: And that's I think that's such an important component because of so many studies have focused on those that narrow range of costs, if you will, associated right at the right with treatment right then and there, right. And this really takes into account, umm, a much broader picture that's more based on long term outcomes, is that right?

Kate: That is right. Uh, the net benefit of treatments that we included generally was calculated for a for a per episode of care over the course of a whole year.

Troy: Now, Greg, I noticed that the report has focuses on 8 conditions. So why those eight conditions and what are they?

Greg: Well, it's an interesting question. It's not like we chose the 8 pathological groups to study, and so as Kate alluded to in the beginning, we started out with the premise of there are a lot of things that physical therapists are involved with and a lot of pathologies and anatomy that we. Uh, I have created interventions for this was the first effort to create sort of a macroeconomic picture and so we had more than 30 and some of the groundwork was laid by the Australian groups that Kate mentioned earlier, but we had more than 30 different areas that that we thought that we need to dig into the literature and do a deeper dive and start winnowing, if you will, the different parameters that Kate mentioned. And so these eight were not the chosen 8, but rather the ones that we had the best data to support. The conclusions that were met, so big picture is we'd like to take this eight, this group of eight and expand them to a a much broader body of evidence for the profession.

Troy: And that's going to depend on the, UM, sort of accumulation of literature around those conditions, right?

Greg: Right. And so, you know, our hope is that some behaviors will change to the original question is how, how do Members use and why do they need to know about this resource? This is a game changer. We hope we, we hope this alters the vernacular, the discussion that people have around the use of physical therapy resources in treatment. And so we want them to talk about the net cost of care and where does it improve? A huge problem is physical therapy. In every other aspect of medicine is is looked at often as an expense, and we want to change that. And this data goes is is just a huge step in that direction.

Troy: Yeah. Well, let's get to that date a little bit, Kate. UM, we've got these eight conditions. Can you can you go through some of them or all of them and and tell us what the findings were?

Kate: Really. So broadly, before we dig in, the main finding is that physical therapy provides a value to Americans across a variety of conditions and at all stages of life. And as Greg mentioned, we looked at a various conditions. We narrowed it down to those that had the most robust evidence for this type of macroeconomic analysis, and these ranged from, you know, a net benefit for falls prevention to stress urinary incontinence, to carpal tunnel. And it's important to keep in mind that even though we're going to discuss these in the same conversation and see them together on similar infographics, they're not really meant to be compared to one another. So I just want to put that caveat there up front. Rather, it just shows that that PT is beneficial and cost effective across to a wide range. And so we looked at a number of things. I mentioned a few. We have osteoarthritis of the knee and hip acute low back pain, claudication cancer rehabilitation, lateral epicondylitis as well and those were purposeful to cover a wide range. So that we weren't hyper focused in one specific area of physical therapy, but many areas where physical therapy is plausible and safe treatment compared to alternatives.

Troy: Yeah. And as it so happened, I know it wasn't. Uh, I I know it was based on the evidence and and.
And what emerged was it so happened. We're talking about some of the most prevalent conditions that that patients that consumers that Americans face, right? I mean, we're talking about knee OA, we're talking about carpal tunnel. We're talking about tennis elbow UI, all that stuff, so it's even more relevant, I would think to the consumer because it's stuff that hits home for a lot of people.

Kate: Absolutely. And as we move into more value based system it it has huge implications for healthcare systems as well.

Troy: Yeah.

Kate: Go ahead, Greg.

Greg: Or Troy system. Important to note that again, that we didn't choose these eight, they emerged and so we've already received some comments on why didn't we look into Pediatrics or cervical spine and we certainly did, but we do need more studies and more literature and more clinical examples that that meet the criteria. Basically, you know, we've all heard of the three R's. It's reading, writing, and arithmetic, but our 3R's were relevance, robustness and recency, and studies that which is in the in the article. So we're hoping that leading researchers, leading clinicians, and even just grassroot level clinicians will start gathering data and contributing to the body of knowledge so that we can include other pathologies. As this moves forward.

Troy: So I have to ask this question because I always ask it of whenever I get to talk to uh people involved with research, and that is for both of you. Were you surprised by anything that you found through this research, Greg? You, you start and then Kate.

Greg: Umm I was not. I was surprised, perhaps by some of the quantitative results like carpal tunnel had astounding savings for the patient. So to me this whole effort is a validation and an affirmation of what we have spent our careers doing. Now in providing treatment. And so I'm very pleased to see monetary a justification and quality justification for what we've been doing and new worked well. So that part was backed up then also by the international data. The Australian example will be in one, so it's not just us saying we're good, but we are and that didn't come out the way I really wanted it to. But I I saying what we're doing matters and contributes. It's a much broader picture than that.

Troy: What about you, Kate?

Kate: I would agree with Greg that that the results didn't over, you know, really surprise me on was surprised, I'd say by some of the conditions that we ultimately weren't able to include in the report things that we really dug into that we, it's been a lot of time on the literature with that we that didn't meet the threshold didn't meet the level and I speak I think that speaks to the robustness of this report as a whole is that there was a really high bar to be included in it.

Troy: Well, now, Alicia, I'm gonna go back to you because of this report. Debut this is the last week. We're we're in the last week, couple days of September and this report made its debut just this week.
Members have may have seen all the social media we've done on it and received emails about it and even seen it. It's made it into some of the press. So you might have seen it, but that's just the beginning, right? I mean, what else are we doing to spread the news?

Alicia: Yes, exactly. So I our kickoff did include letting our Members know first. So our Members had first access to the report via an email from our President, Roger Herr. And then our public relations team activated our plan to connect with media outlets. So that's the result of what you're seeing now of many news organizations picking up the findings and starting to report out on them. And and that will continue. The report release was intentionally timed to happen right before national Physical Therapy Month, so October every year we celebrate physical therapy and we use our resources that we've budgeted and our staff talents to get the word out about physical therapy on through a nationwide campaign. So this year is just even more spectacular. The messaging from the report is woven throughout our digital advertising campaign that's driving consumers to ChoosePT.com, APTA's consumer website and it features our find a PT search engine. So all Members have get to have a profile in our Find a PT database so we're using the messaging from value of PT throughout the choose PT brand. All of our outreach to drive consumers to choose PT and ultimately to find a PT to treat them for these types of conditions, we're doing a satellite, a nationwide satellite media tour. We have an ad running in Times Square for the month of October and that's just really the tip of the iceberg. We've developed numerous member tools which can be found at value of pt.com and that is the website we've developed to to contain all of our resources, including the report and some marketing and public relation resources that are Members can utilize to help us get the word out.

Troy: Yeah.

Alicia: Includes. Yeah, go ahead, Troy.

Troy: And I was gonna say, and I should add these podcasts to for our Members. Uh, the next two are worth listening to.

Alicia: Mm-hmm.

Troy: I'm gonna say because one will deal with leveraging this in terms of its use for policymakers and payers and and getting the word out and the others going to talk about how this can be leveraged in terms of communications with consumers. So I would also stay tuned for those upcoming podcasts too.

Alicia: Yeah. So the those will be great resources and the consumer outreach is really first this first phase of dissemination. Umm, there is a second phase that will start in 2024 where we start to train our Members on how to use the research and resources to advocate at all levels the federal level, the state level with private payers. How do you have those conversations with private payers? So we're investing a lot of time and resources to make sure our Members have the tools they need so that they can activate this research in their conversations and and actually start to change the landscape of the way we're engaging with consumers and and what and what physical therapists and physical therapists assistants are getting paid for those services. So phase three, after the training is going out and having those conversations hearing back from our Members, seeing what's working and then phase phase four is the long game that is measuring our impact and this is this is this is gonna take years and we're in it for the long haul and we're really optimistic about the impact this research is gonna have on the profession.

Troy: And Greg and and Kate, too of what are your thoughts on the the groups, I mean clearly this is a a great resource and benefit for our Members and for the profession as a whole. But what other groups do you see as this being particularly impactful for?

Greg: I made a quick list so and it all starts with P it's it's the payers, it's the politicians. It's a patience. It's the providers, it's our peers, it's physicians and it's our partners in the industry and I feel allow me to elaborate just for a minute. I think I covered virtual everybody on Earth, but regardless of that, the payer impact remains to be seen, but should be instrumental in broader change throughout the industry. A lot of early changes, like with Tricare, they have embraced innovative projects within the profession to create more access where we have proven value and cost savings and quality. And we hope that this influences pairs on a much bigger scale. Medicare is a good example. They view us as a cost center, not as a quality center. So if therapy utilization goes up, that's a negative because we have a requirement in sequestration and budget neutrality that if if utilization goes up, then payment has to go down and we're facing that again this year. So the timing of this report with those kinds of payers is critical, but we have to change their thought process that won't occur this year. Congress will do what Congress does in order to achieve their their. Their goal of budget neutrality. So that's the politicians P being involved in seeing this data and saying we have to think about this a different way. Our patients, we want them to see this and say, boy, maybe there is an alternative to surgery or maybe there's an alternative to radiation examinations, that kind of thing. Our peers need to know about this burnout and fatigue within our profession and all of medicine. Is it an all time high and this should be a shot in the arm for therapists to to look at this data and say WOW, I I didn't realize the impact that I could have and not only that, I need to tell my colleagues and I need to tell other peers within the revocation profession that hey, maybe we can contribute to your patients welfare whether it's athletic training or occupational therapy or others. We want physicians to know about this and some physicians may feel threatened because, Gee, you know what if therapy works and not on my surgical volume goes down. And and that's cynical. Why?
I know, but we all have budgets to live with and and lifestyles and everything else. So I I know that was a bit long winded, but we really think this impacts a lot of folks in a very positive way and we want to maximize that.

Troy: If do you think Kate?

Kate: I'm trying to figure out how to make it start with a P, but I would also just add employers. So for example, in the treatment of low back pain we found, you know, we find that that enable skilled employees to return to their work more quickly, which improves productivity. And so as we promote physical therapy in the treatment of low back pain, it's going to have a net benefit on the employers as well.

Greg: 2nd.

Troy: Yep, so true and and I would imagine that to get to show employers how this report makes the case for the fact that physical therapy will keep your employee working for you. You know that's that's kind of what it's all about rather than out missing days and things like that, I wanna ask one final question and I'm gonna toss it to you, Alicia, about the two of you. Should feel free to chime in to and I want to circle back to our Members and talk just a little bit about that. And Alicia, you kind of covered this, but let's let's let's just make sure we've got it all sewn up. What do you have to say to a member who wonders why it's important to share this report? And then once you convince them of that, how do they help do it?

Alicia: Yeah. So it really shouldn't take much to convince any of our members to share this data and and the findings in this report, it's a reason I believe that we have over 100,000 members because people believe in the power of association and the power of Better Together and our unified voice is tremendous. So we can promote from APTA, you know, the National Association of of for the Profession.
But when our Members tell this story and our Members are the boots on the ground saying how they are making a difference in the lives of their patients, and we're saving the health care system money, that's gonna influence change. So we just we compound our impact when we do it together in our Federated model gives us those channels that we need through our state chapters through our specialty sections. So I just, I feel really good about the about member engagement around this. We've already seen tremendous engagement around downloads of the report in views of the website. Umm, so we're off to a good start. And so, you know, our Members can use this in tandem with strong clinical evidence to show both the impact and the economic value of physical therapy. They can use it like we were discussing before. Educate patients and their families about the economic value of physical therapy for a variety of conditions. And they can advocate for coverage and payment for their services. You know it can be used to improve interdisciplinary collaboration and and increase referrals and all of these resources we've developed and we're going to continue to add to these resources are on ValueofPT.com. So I encourage all of our Members go to the website. Go to valueofpt.com. Read through the findings.  We have each condition broken out very high level and then you can dig into the methodology if you'd like to go into the report and then check out our campaign resources, go to the campaign resources section. We have a we have social media posts that you can share their plug and play. We've written the post copy and the graphics are designed for you. We have some templates in place for media, local media outreach and then that last plug and I'll just say it again, go to your find a PT profile. It's a member benefit. Update it put your specialty. Make sure your location is in there. Put your, put your setting and when consumers go to ChoosePT.com and they're learning about treatment for carpal tunnel. They're learning about treatment, treatment for low back pain and they click on find a PT. Your name, your face. Your specialty is gonna show up in our database, and so consumers can get to you faster. So that's my that's my plug for the day is to maximize your member benefit with us because that's huge. It's huge.

Troy: Well, I want to thank Kate, Greg and Alicia for helping give us a little context. A lot of context and background on the value of physical therapy report listeners you can count on hearing, as Alicia said, a lot more about this report. Uh along just about every APTA communications channel, so please stay informed and that we make that so easy. So you just simply follow us on social media: Facebook, X. Instagram, LinkedIn, and of course, by way of our APTA weekly emails, which round up everything, they arrive in your inbox every Wednesday. We share news about the report. We're going to be showing more news about the report and a whole bunch of other important information all throughout affecting the profession and all, all different ways. And it's, of course all freedom members. And don't forget to be on the lookout for those future podcasts in this series. We'll be exploring the ways this report could change the conversation with policymakers and payers, as well as how the findings can resonate with consumers. Thanks for listening.

Taj: APTA’s landmark report, “The Economic Value of Physical Therapy in the United States,” would not have been possible without the support of our members. If you’re not an APTA member, visit APTA.org to learn more about the value of membership. You can also read the report and find resources to promote the value of physical therapy at ValueofPT.com. Make sure you’re also following APTA on Facebook, the platform X (formerly known as Twitter), and Instagram to join us in informing consumers, policymakers, payers, and employers about the significant role and economic value that physical therapist services bring to the health care system.