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Physical therapy services comprise a significant amount of Medicare expenditures in postacute care settings—inpatient rehabilitation facilities, long-term care hospitals, skilled nursing facilities (SNFs), and home health agencies (HHAs) under Medicare Part A. Physical therapists (PTs) practicing in postacute care are integral to improving the quality of care provided to patients while reducing overall costs. This is particularly true under new value-based payment initiatives such as bundled payment models, accountable care organizations, and patient-centered medical homes.

Payment Squeeze

The Medicare payment system is shifting away from the fee-for-service payment structure, in which providers are rewarded solely for the volume of services provided, and toward a structure that holds providers accountable for patient outcomes and costs. This move to value-based care is intended to advance the goals of health care's "triple aim"—improving the patient experience of care (including quality and satisfaction), bettering the health of populations, and reducing the per-capita cost of health care.

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  1. Medicare Postacute Care Reform. American Physical Therapy Association. http://www.apta.org/Payment/Medicare/PACReform/. Accessed October 17, 2017.
  2. A history of home health cuts. Partnership for Quality Home Healthcare. http://homecarenh.org/wp-content/uploads/2017/09/HistoryOfHHCuts_OnePager_FINAL-FINAL.pdf. Accessed October 18, 2017.

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