I am writing in response to your article entitled, "Monitoring physical therapy treatment can curb workers comp costs" posted on August 11 by Sheena Harrison.
There were several points made in the article that I believe require clarification for your readers.
Regarding "physical therapy costs can account for up to 50% of compensation costs in the first 90-120 days of a claim," evidence suggests that if a patient is referred early enough to a physical therapist, he or she can return to work sooner and incur fewer costs. A 2012 study published in Spine showed that early treatment by a physical therapist for low back pain, as compared to delayed treatment, was associated with reduced risk of subsequent health care utilization and lower overall health care costs.
Regarding "there's a lot of physicians who just write a prescription for physical therapy that says ‘evaluate and treat' and will ‘leave it open and let the therapist dictate the treatment duration,'" this is exactly what physicians should be doing.
Physical therapists are healthcare professionals, whose education and expertise allows them to evaluate patients and formulate treatment plans based on the results of that evaluation. In most states, physical therapists may evaluate and commence treatment without a physician referral.
Physical therapist practice also dictates that a plan of care be developed in coordination with the patient, caregiver, and other health care professionals. Thus, once a plan of care is established, the physical therapist will communicate with others involved in the case regarding the proposed treatment, and discuss any concerns about the plan of care.
Finally, regarding "physical therapists sometimes try to make up for the low cost of services they provide by billing for several treatments during each patient visit." The payment system is currently designed to require physical therapists to report the services they deliver. It is appropriate for physical therapists to report multiple units of service, and report different services during the course of any patient visit. The American Physical Therapy Association has recently begun developing an alternative payment system for outpatient therapy services. This new system proposes to pay providers based upon the needs of the patient and not on the amount of services provided.
As health care professionals who restore and improve movement, physical therapist treatment can result in significant cost savings for employers, insurers, and patients, when prescribed appropriately.
Margot Miller, PT
Member, American Physical Therapy Association and
Vice President, Provider Solutions, Workwell Systems Inc.