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  • New APTA Policy Priorities Push for a More Wellness-Oriented, Value-Based, and Accessible Health Care System

    APTA's newest advocacy roadmap puts the current state of health care in the United States in stark terms—and commits the association to working for change.

    Describing the United States as being "at a crossroads," the association's 2019-2020 Public Policy Priorities document characterizes the country's health care system as one that favors treating illness over investing in prevention and wellness. It's an approach that APTA believes leaves too many Americans underserved, including people with disabilities, chronic conditions, and opioid addiction.

    The association's response? "This must change."

    The need for systemic change throughout the health care system is the common thread running throughout APTA's new resource, a high-level exploration of the areas that will be the focus of the association's advocacy efforts for the next 2 years. Much like the association's recently adopted strategic plan, the priorities point to an association that will fuel change at the societal level.

    The guide lays out 4 broad areas of emphasis for 2019 and 2020: population health; patient choice and access; value-based care and practice; and research and innovation. Within each area, the association lists multiple advocacy opportunities. Some, such as working for increased funding for the Individuals with Disabilities Education Act, are targeted at specific existing programs. Many others, however, such as a continued press for increased direct access to physical therapists (PTs) and decreased administrative burden, are more open-ended.

    The mix of general and specific was purposeful, according to Katy Neas, APTA's executive vice president of public affairs.

    "Over the course of 2018, the APTA Public Policy and Advocacy Committee [PPAC] developed policy recommendations that enhance the role of the profession as integral to an effective and efficient health care system that ensures better health outcomes for our patients," Neas said. "This guide advances the APTA Board of Directors' approval of the PPAC recommendations in ways that clearly reflect our commitment to true change in the health care system, and position APTA to partner with other stakeholders in innovative ways."

    Part of the reason the priorities take a more expansive approach is that an earlier advocacy goal—ending a hard stop on therapy services under Medicare part B, known as the "therapy cap"—was achieved in early 2018. With the nearly 2-decade battle over, the association found itself with an opportunity to survey an even wider advocacy landscape.

    Next: turning that plan into action, something that's already happening in many advocacy areas, according to Justin Elliott, APTA's vice president of government affairs.

    "Advocacy never stops for APTA and its members," Elliott said. "The new policy agenda includes many APTA existing priorities, such as our work to finalize the coverage of physical therapist assistants in the Department of Defense TRICARE program, but also creates opportunities to act as new legislation and policy possibilities arise."

    The new advocacy opportunities available to the profession will be a major focus of the upcoming APTA Federal Advocacy Forum in Washington, DC, a 3-day conference that provides the latest on regulatory and legislative issues affecting the profession, and ends with a chance for attendees to apply what they've learned by making in-person visits to Senate and House offices. The event is set for March 31 – April 1; registrations are open until March 18.

    APTA, ACSM Partnership Agreement Formalizes Long-Time Collaboration

    A longstanding collaborative relationship is now official: APTA and the American College of Sports Medicine (ACSM) have entered into a formal partnership that the organizations believe will strengthen their work toward improving health through movement.

    ACSM is now a participant in the APTA Partnerships Program, an initiative aimed at enhancing relationships between the association and other organizations that share common goals. ACSM joins Special Olympics, Move Together, the American Academy of Orthopaedic Manual Physical Therapists, the Federation of State Boards of Physical Therapy, and the US Department of Veterans Affairs in the program.

    ACSM and APTA aren't strangers to each other. The organizations have worked together before, and they hope to build on their relationship to bolster advocacy efforts as well as expand participation in each group's events and initiatives.

    "I am so pleased we were able to formalize our already productive and positive relationship with ACSM," said APTA CEO Justin Moore, PT, DPT, in an APTA news release. "Both organizations are founded in helping individuals live their best lives, and this partnership will help better achieve our goals."

    ACSM EVP and CEO Jim Whitehead also sees promise in the new partnership.

    "The American Physical Therapy Association is a recognized leader in promoting recovery, health, and wellness," said Whitehead. "Our 2 organization have a shared vision to improve lives through exercise and healthy lifestyles, so this partnership will open the door to tremendous opportunities that wouldn't be possible otherwise. We can't wait to get moving."

    ACSM's members number more than 50,000 and include physicians, scientists, researchers, educators, exercise professionals, and others in the field of sports medicine and exercise science. The mission of the college is to advance and integrate scientific research to provide educational and practical applications of exercise science and sports medicine.

    New Medicare Home Health Payment System Explained in Upcoming Q-and-A Sessions

    Private practice physical therapists (PTs) aren't the only ones facing major changes in the way Medicare provides reimbursement: PTs and other providers in the home health setting will face an entirely new payment methodology beginning next year. APTA can help you get up to speed.

    Coming in early March: 2 live Q-and-A sessions with APTA experts on the coming payment system, known as the Patient-Driven Groupings Model (PDGM). Presenters for the hour-long sessions—offered on March 5, 2:00 pm-3:00 pm ET, and March 6, 7:00 pm-8:00 pm ET—will answer questions from registered participants who've reviewed a prerecorded webinar that will be available February 20. The recorded webinar and live sessions are free to APTA members.

    Interested? Start by registering now for 1 of the Q-and-A sessions, then check back in on the Home Health Patient-Driven Groupings Model Webinars page on or after February 20 to download and review the recorded webinar. Have your questions ready for the hosts, including APTA Director of Regulatory Affairs Kara Gainer, JD; Bud Langham, PT, MBA; Carol Zehnacker, PT, DPT; and Ellen Strunk, PT, MS, a board-certified geriatric clinical specialist.

    [Editor's note: Even more information on both the new home health and skilled nursing facility payment models is available on a specially created APTA webpage that includes resources from APTA and the US Centers for Medicare and Medicaid Services.]

    New APTA Strategic Plan: Leading the Profession and Association Into the Next Century

    Take a look at the new APTA strategic plan covering the next 3 years, and almost immediately something becomes abundantly clear: the association has no intention of kicking back and cruising into its centennial in 2021. Dig deeper, and you're likely to find that the goals to be reached between now and the beginning of APTA's next century are as ambitious as anything the association has ever attempted.

    The plan, now available on the APTA website, is the result of an 18-month-long Board of Directors effort that included input from nearly 4,000 stakeholders to identify where APTA needs to go to realize its vision of transforming society by optimizing movement to improve the human experience. The end result: a roadmap built around 4 outward-facing goals, with measurable objectives that don't shy away from some ambitious targets.

    In an APTA Media Center interview conducted during APTA's 2019 Combined Sections Meeting, President Sharon Dunn, PT, PhD, characterized the plan as a new phase in the association's evolution.

    Dunn said that APTA's previous 5-year strategic plan served as a "pivot" away from work that supported the earlier "Vision 2020" statement and toward the association's current vision, adopted in 2013. During 2017 and 2018, and especially after listening to stakeholders and evaluating the association's opportunities, it became clear to the Board that the pivot was complete.

    "We were ready to make some bold moves toward actually transforming society," Dunn said.

    The 4 main goals in the new plan are centered on increasing member value and engagement, fostering the long-term sustainability of the physical therapy profession, elevating the quality of care provided by physical therapists (PTs) and physical therapist assistants (PTAs), and maximizing stakeholder awareness of the value of physical therapy.

    Each goal contains 2—and in 1 case, 3—objectives that lay out specific activities that APTA will pursue. The goal aimed at stakeholder awareness of the value of physical therapy, for example, sets APTA on course to advocate for payment policies that increase patient access to physical therapy, to leverage the #ChoosePT campaign and MoveForwardPT.com as public information platforms, and to "embody the APTA mission and vision through an integrated brand strategy." The sustainability goal directs the association to "champion student and early-career issues including debt burden and career-earning potential," and to "make APTA an inclusive organization that reflects the diversity of the society the profession serves."

    The plan isn't designed to be all-inclusive. Many ongoing activities central to APTA—including federal and state advocacy—will continue to be integral parts of the association's operations. Rather than covering every area in which the association will be working, Dunn said, the new plan "looks at what is absolutely necessary to take us into our next century."

    According to Dunn, one of those elements—the long-term sustainability of the physical therapy profession—is a goal that reflects a pervasive sentiment among the stakeholders providing input on the strategic plan's development and, in the case of student debt and early-career earning potential, "one of the things that keep's [APTA] leadership up at night."

    Dunn explained that APTA's efforts in this area must include not only providing program faculty with resources and tools to help keep a lid on education costs but also a wider effort to make the profession itself as diverse and inclusive as possible—something Dunn believes is key to the profession's long-term sustainability.

    "We need to make the path [to becoming a PT or PTA] easy, make it affordable, and engage and mentor along the way," she said.

    All of the goals and objectives in the plan are equally ambitious and equally capable of having a strong impact on the profession and society, according to Dunn. Here's what she had to say about other elements of the plan:

    • On translating the latest research into tools and resources for practice: "There's a lag time to translating evidence into practice. The environment doesn't allow for that lag time anymore."
    • On supporting the growth of the APTA Physical Therapy Outcomes Registry: "Payers have our data, and we need to have our data and use it to advocate for the benefits of physical therapy."
    • On advocating for PTs on the primary care team: "Putting a physical therapist on the front end of anything—pain, chronic disease—rather than the back end, [results in] a lot of quality and cost savings."
    • On expanding the #ChoosePT campaign beyond the opioid epidemic: "[#ChoosePT] will evolve into other opportunities for the physical therapy profession to meet societal need."

    What's next? With the goals and objectives in place, APTA leadership is now developing metrics to not only measure progress but to help keep the association on course as it attempts to achieve results that, as Dunn said, "meet the needs of not only our society but our members as we treat our patients."

     

    2019 Federal Advocacy Forum Coming March 31; Registration Open Through March 18

    When it comes to federal advocacy for the physical therapy profession, the watchword is "new"—new priorities after the end of the hard cap on therapy services under Medicare last year, new challenges that have surfaced in the wake of rulemaking and other changes, and a new Congress that needs to be well-acquainted with the profession's message of patient-centered, transformative care. APTA's 2019 Federal Advocacy Forum, set for March 31-April 2, promises to help attendees navigate all those new twists and more.

    Registration is now open for the annual event, which brings together physical therapists (PTs), physical therapist assistants (PTAs) and students together in Washington, DC, for a 3-day conference that provides the latest on regulatory and legislative issues affecting the profession, and ends with an opportunity for attendees to apply what they've learned by making in-person visits to Senate and House offices. Registration deadline is March 18.

    Other activities at the Forum include an evening reception, awards presentations, and breakout sessions on state and federal advocacy, regulatory affairs, and student action.

    "While 2018 was a year of real accomplishment, much more needs to be done with the new Congress that started this month," said Michael Matlack, APTA director of congressional affairs. "There are now almost 100 new members of Congress who need to learn about the essential role that physical therapy plays in the nation’s health care system—and in the lives of their constituents."

    [Editor's note: Want to get a feel for what the Federal Advocacy Forum is all about? Check out the video recap of the 2018 Forum on the Federal Advocacy Forum webpage.]

    From Move Forward Radio: Retreat Helps Veterans With Amputation—and Their Families

    Adjusting to life after an amputation can affect a veteran’s entire family, not just the individual. That reality wasn't lost on the Travis Mills Foundation, which offers a retreat program that aims to help veterans and their families bond with one another and participate in traditional activities that are adapted to teach new skills and strategies to ensure participation for everyone.

    Now available from APTA's Move Forward Radio: a conversation with APTA member Kelly Roseberry, PT, DPT. Roseberry is program director of the Travis Mills Foundation, which was founded by a veteran who had a quadruple amputation. Roseberry describes what this unique program means to veterans, families, and to her personally. "To be able to see a service member do something they never thought they would do again, or to see how happy their family is to watch them get to do that and to share in those moments together is…priceless," Roseberry says.

    Since 2017, selected veterans who have been injured in active duty or as a result of their service have come to Maine in the summer, along with their families, for an all-expenses-paid vacation. They participate in activities such as swimming, biking, kayaking, and a ropes course.

    “We take a great deal of pride in being able to serve the whole family," Roseberry tells Move Forward Radio. "We recognize that rehab is a lifetime process, and when someone is injured or goes through some sort of trauma, not only is the service member injured, but the injury affects the entire family. They may not think they can get on the floor with their kids or take them for a bike ride. We want to be able to not only encourage them but give them the tools to reach outside their comfort zone and do things with their family, because at the end of the day their family is their support system.”

    Move Forward Radio is hosted at MoveForwardPT.com, APTA's official consumer information website, and can be streamed online or downloaded as a podcast via iTunes, Google Play, or Spotify.

    Other recent Move Forward Radio episodes include:

    Maintaining an Active Lifestyle and Avoiding Pain
    Surfing legend and fitness and nutrition expert Laird Hamilton applied lessons he learned through his surfing injuries to his preparation for—and recovery from—hip replacement surgery. In the podcast, he describes how he avoided pain medicine of any kind during the process, and how he surprised his health care team with one of the fastest recoveries they had ever seen.

    A Primer on Sciatica and Physical Therapy
    As many as 40% of people will experience sciatica in their lifetime. APTA member Mark Bishop, PT, DPT, PhD, breaks down sciatica’s symptoms and causes for consumers, and explains how physical therapy can help relieve pain.

    Navigating the Health Care System With Chronic Pain
    APTA member Jen Bambrough, SPT, was in car accident at age 19 but seemed to sustain no initial apparent injuries. Over time, though, a physical toll revealed itself as chronic pain, limiting her activities and compromising her quality of life. Because the root of her pain couldn’t be readily detected, however, she faced skepticism in the medical community and experienced misdiagnoses. Bambrough, now a third-year DPT student, discusses how she became a strong self-advocate and how physical therapy is an important piece of the pain management puzzle.

    A PT With Breast Cancer Turns to Her Peers to Make Life-Saving Decisions
    When APTA member Gwen Simons, PT, felt what she thought might be a lump in her left breast in 2010, it set in motion a series of decisions and scans that led to surgery. Simons shares her story of unexpected mammogram results, a strategically timed lecture, consultations with colleagues in the physical therapy profession, and a decision by Simons that may have saved her life.

    Cancer-Related Falls
    Cancer survivors have a higher prevalence of falls than do people who haven’t been treated for the disease. Even worse, various significant health consequences of falls may be more likely and extensive in cancer survivors. APTA member Elizabeth Hile, PT, PhD, discusses the reasons for increased falls susceptibility in cancer survivors, red flags to heed, and how physical therapy and certain types of community resources can help.

    Using Physical Therapy to Treat Pain in Addiction Treatment Centers
    America is in the grips of an opioid addiction crisis. APTA members Ahmed Rashwan, PT, DPT, and Eric Chaconas, PT, PhD, discuss the treatment for addiction to opioid pain medication. They are working with addiction treatment centers to help medically stabilized patients learn more about their pain and show them how they can use physical therapy to participate in managing it, making relapse less likely.

    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. Ideas for future episodes and other feedback can be emailed to consumer@apta.org.

    APTA Outcomes Registry Earns Key QCDR Designation for Use With MIPS

    APTA's Physical Therapy Outcomes Registry (Registry) has been approved again by the US Centers for Medicare and Medicaid Services (CMS) as a qualified clinical data registry (QCDR). The designation for 2019 means that physical therapists (PTs) who participate in the Merit-based Incentive Payment System (MIPS) can submit their measures data directly from the Registry—including new measures supported by APTA that now position the Registry as the leading physical therapy registry in terms of the number of QCDR measures offered.

    The approval comes as many PTs are facing a new reporting and payment world, the result of a CMS decision to include physical therapy in its Quality Payment Program (QPP) beginning in 2019. That program, with MIPS as its centerpiece, puts a heavy emphasis on outcomes reporting and ties that reporting to potential payment adjustments.

    That's where the number of measures offered through the Registry comes into play. Basically, more measures mean more data points to report, and more data points mean more opportunities for PTs to meet CMS requirements—and possibly receive payment increases in the future. The Physical Therapy Outcomes Registry now offers more QCDR-related measures than any other physical therapy-only option.

    According to Heather Smith, PT, MPH, APTA's director of quality, while the Registry's role in helping PTs comply with MIPS is important, it's far from the only benefit of the resource.

    "With the Physical Therapy Outcomes Registry, APTA is looking forward, beyond MIPS data submission," Smith stated in an APTA news release. "Because the Registry gives users continual feedback on performance throughout the year, physical therapists can better understand their treatment patterns, interventions, and outcomes for specific patient populations, and apply that information to improve their practice. Ultimately, this will benefit the profession as a whole."

    Headed to the APTA Combined Sections Meeting this month? Check out the Registry booth at the APTA Pavilion. For a detailed look at MIPS and QPP, be sure to attend " Emerging Issues in Medicare: Quality Programs and Alternative Payment Models," on Friday, January 25 at 11:00 am. CMS representatives will be on hand to discuss the programs.

    2019 MPPR Calculator Now Available

    It's back: APTA's members-only multiple procedure payment reduction (MPPR) calculator for 2019 is now live.

    This year's calculator incorporates both the MPPR 50% reduction as well as the overall 2% cut to Medicare payments implemented through sequestration. The calculator, delivered by way of an Excel spreadsheet, calculates Medicare physician fee schedule payment for procedures provided to a beneficiary on a given day.

    Added features this year include options for selecting your Medicare participation status—participating, nonparticipating but accepting assignment, or nonparticipating and not accepting assignment—as well as the ability to compare the 2019 payment rate with the rate in 2018. The calculator also includes a Merit-based Incentive Payment System (MIPS) adjustment feature, which isn't applicable to physical therapists this year but will become a useful tool beginning in the 2021 payment year.

    What's New at PTNow? More Guidelines and Systematic Reviews Enrich an Already-Robust Resource

    The range of conditions that physical therapists (PTs) and physical therapist assistants (PTAs) face every day can be expansive, and staying on top of the latest effective treatment approaches can seem like an impossible task. PTNow is helping to change all that by bringing members the evidence they need in just a few clicks.

    Best of all, the association's flagship site for evidence-based practice resources continues to expand in ways that help PTs and PTAs easily find an even wider array of information. If you haven't visited the site lately, check it out soon. Here's a quick take on the latest additions.

    Recently added clinical practice guidelines

    New Cochrane Systematic Reviews
    Cochrane reviews provide some of the most reliable information on evidence-based health care—thoroughly researched, carefully evaluated, and presented in a way that makes it easy to understand the effects of interventions on rehabilitation, treatment, and prevention.

    PTNow has added access to an additional 65 Cochrane reviews—too many to list here—that address areas including wound care, musculoskeletal conditions, pediatrics, neurology, prevention, geriatrics, women's health, cardiovascular and pulmonary issues, oncology, acute care, and more. Visit the Cochrane review section of PTNow to browse or search for specific articles.

    New Resource Page Helps PT, PTA Students Explore Options for Financial Aid, Loan Forgiveness, Post-Degree Loan Repayment, and More

    Students in physical therapist (PT) and physical therapist assistant (PTA) education programs have a lot on their plates. They must keep up with classes, of course, but on top of that, they have to figure out exactly how they're going to pay for those classes. And, oh yeah, they probably should be thinking about how they'll approach student loan repayments they may face once they’ve earned their degree. At the same time, they need to keep up with related actions from the profession and their association.

    It's not easy. But APTA is helping to make life for PT and PTA students a bit less overwhelming.

    Recently, the association unveiled a completely revamped Education and Financial Resources for Students webpage—a 1-stop source for information on everything from association and component-sponsored awards to federal student loan forgiveness opportunities. Also included: links to evidence-based practice resources, APTA policies, and the association's Financial Solutions Center—which focuses specifically on financial education and student loan refinancing.

    Have suggestions for resources to add to the page? Contact the APTA Student Assembly with your ideas.