ADVANCE Perspective: Physical Therapy : APTA and State PT Associations

Cycle Safe!

Elizabeth Puliti — Mon, 27 Jul 2009 20:53:00 GMT

This past Sunday, teams of professional cyclists pedaled their way through the last stage of the 2009 Tour de France and Alberto Contador was declared the winner. The race--approximately 3,500 kilometers over 23 days--attracted record-breaking crowds...(read more)

Re-Election Roundup

Rob Senior — Tue, 07 Jul 2009 13:40:00 GMT

At the recent APTA annual conference in Baltimore, the APTA's Board of Delegates met to select the organization's officers for the coming term. R. Scott Ward, PT, PhD, was re-elected to a second term as the organization's president. Joining him as vice-president...(read more)

Maley Lecture Emphasizes Health Care Reform

Elizabeth Puliti — Mon, 15 Jun 2009 14:12:00 GMT

BALTIMORE--On Friday, June 12, Helene M. Fearon, PT, was honored with the 14 th annual Maley Lecture. Since 1996, this lecture has been an integral part of APTA's annual conference. Fearon, a graduate of Marquette University's physical therapy program...(read more)

Regulations: Are They a Necessary ‘Evil’?

Lisa Lombardo — Fri, 12 Jun 2009 19:40:00 GMT

BALTIMORE--Do we really need all of the regulations Medicare and the physician fee schedule places on the PT profession-or do the regulations just make practicing PT more cumbersome and confusing? Likely a little bit of both, according to the panelists...(read more)

Gingrich Speaks of ‘Challenge for America’

Lisa Lombardo — Thu, 11 Jun 2009 13:48:00 GMT

BALTIMORE--What's the difference 20 years can make? As former Speaker of the House Newt Gingrich pointed out Wednesday night while making the keynote address at PT 2009, one need only look at the Baltimore Inner Harbor. "The area's growth over the past...(read more)

APTA President Challenges PTs and PTAs to ‘See Possibilities’

Lisa Lombardo — Thu, 11 Jun 2009 13:28:00 GMT

BALTIMORE--On Wednesday, June 10, R. Scott Ward, PT, PhD, addressed attendees of PT 2009, welcoming them to the city of Baltimore. "We can look forward to all this historic city has to offer. It is experiencing a true renaissance and APTA is proud to...(read more)

Off to Baltimore!

Lisa Lombardo — Tue, 09 Jun 2009 19:41:00 GMT

The last time I was in Baltimore I was struck by how open and inviting the city was, especially the Inner Harbor area. There was a lot to explore but since I was on a business trip at the time I didn't have a lot of free opportunity to see the town outside...(read more)

Don’t Miss the Debates!

Lisa Lombardo — Fri, 05 Jun 2009 14:07:00 GMT

To quote French writer Joseph Joubert, "It is better to debate a question without settling it than to settle a question without debating it." That is definitely the spirit of the two debates held each year at APTA's annual conference. I have had the opportunity...(read more)

Future of Home Health PT Lies in Recruitment

Lisa Lombardo — Wed, 03 Jun 2009 17:47:00 GMT

While the population of the United States continues to age rapidly, with the baby boomer generation reaching their 60s, 70s and 80s in large mass, the amount of students entering into home health physical therapy seems to be dropping. This population...(read more)

APTA 2009: Here We Come!

Elizabeth Puliti — Tue, 02 Jun 2009 21:05:00 GMT

The ADVANCE for PT editors are getting ready to board the train to Baltimore! From June 10-13, the American Physical Therapy Association's 2009 conference will take place in "Charm City" at the Baltimore Convention Center. We plan to take part in key...(read more)

PTs Making Progress

Rob Senior — Tue, 26 May 2009 20:12:00 GMT

Earlier this week, 200 physical therapists, PTAs and students of physical therapy programs went to Capitol Hill to speak with legislators about the need to improve patient access to physical therapy services. Once in meetings with Senate and House members,...(read more)

Is Medicare Direct Access Finally On Its Way?

Lisa Lombardo — Mon, 11 May 2009 20:48:00 GMT

According to a recent report by the American Physical Therapy Association (APTA), the U.S. Senate has introduced legislation that would increase access to physical therapy services for Medicare beneficiaries by removing the need for a physician's referral...(read more)

Strategies on Combating POPTS

Lisa Lombardo — Wed, 18 Feb 2009 15:09:00 GMT

CSM 2009 Wrap-up: The APTA keeps a watchful eye on the legislative strategies states can use to fight encroachment of physician-owned physical therapy practices (POPTS). But there are other ways to stop what many therapists see as a major cause thwarting the autonomy of the PT profession.

Peter J. McMenamin, PT, MS, OCS, and Brian J. Tovin, PT, DPT, presented "Combating POPTS: Legislative and Non-Legislative Strategies for Every PT" on Wednesday, Feb. 11 at CSM 2009 in Las Vegas.

While the session was well-attended, both speakers expressed concern that it wasn't packed. The profession's ability to combat POPTS through legislative and legal means is directly related to its survival as an autonomous profession, McMenamin said.

"Can PTs have a viable and independent business model as part of Vision 2020?" he asked. "The interest is there-within 8 years we have seen a complete reversal of educational programs in this direction, from 20 percent of programs offering the DPT to 93 percent today. So it is market-driven. Direct access is also making progress, with full direct access in 14 states and provisional DA in 31," he said.

Strategies states are attempting to use to ban POPTS include laws against referral-for-profit (RFP); fee-splitting provisions for owners of practices, and professional corporation law, which is still a theory to deal with POPTS, McMenamin said.

POPTS are banned in South Carolina, Delaware and Missouri. All three states have language in their state practice acts that effectively bans POPTS; in SC, it is illegal for PTs to work for a POPTS. On the other hand, POPTS are deemed legal in Alabama, Tennessee and Rhode Island. McMenamin said in some of these cases, POPTS earned the right to exist in a state's practice act by essentially bartering direct access-physicians in the state backed direct access language in the PT practice act in exchange for the right to own PT practices if they chose.

"Many physicians assume that in states where they are allowed to own a POPTS, it will at some point become illegal, but they are willing to continue owning until that risk becomes reality," he said.

State chapters should never attempt to "go it alone" when developing a plan to eliminate RFPs.

"It has to be a chapter-wide effort, and you have to have your full board committed to it," McMenamin stressed. "Everyone involved must fully understand their practice act implications, and have a war chest to fight with." Other important steps include:

Establishing a POPTS task force;
Developing an educational mission for the chapter to inform about POPTS;
Developing a legal team with a lawyer to work for the chapter;
Creating a lobbying team for the chapter;
Conducting a SWOT analysis on PT autonomy to determine where support against POPTS lies;
Scrutinizing the language in the state practice act on fee-splitting prohibitions, direct access and licensure rules;
Building a base of state private practice PTs who can campaign on fighting POPTS.

The important thing to remember is that the profession still controls its own success, said Dr. Tovin. "Eliminating POPTS would have more of an effect on the profession's control than direct access does," he said.

Driving the Consumer Marketplace for PT

Lisa Lombardo — Wed, 11 Feb 2009 23:33:00 GMT

LAS VEGAS-- As part of the session "Emerging Issues in Medicare, Medicaid and Private Insurance presented Tuesday at CSM 2009, Carmen Elliott, MS, outlined trends in private insurance reimbursement and what PT can do to help itself not lose out in an ever-narrowing window of payment opportunities.

"Consumers are beginning to assume a huge share of the risk for their own health care and providers know it," Elliott said. "They are becoming savvy shoppers for insurance, and they are looking for competitively priced services and quality outcomes."

Conversely, employers are shifting more risks to their employees. More than 60 percent of workers are still covered by health benefits offered by the firm they work for, she said.

Payers are now more likely to raise premiums and reduce medical claims costs where they can. Payers also are emphasizing more consumer-driven products such as high deductible health plans and health savings accounts, she said.

National industry trends show employer-sponsored health insurance is decreasing and that underinsured and uninsured groups are growing.

The result? "The power of consumerism is driving the health care market, especially in this economy," Elliott said. Since they are being asked to pay more out of pocket for their health insurance, consumers will comparison-shop for those who offer the best outcomes for the lowest cost.

There is an impact on physical therapy that the profession must recognize, she said. Opportunities for PT in this economic climate include educating patients on lifestyle changes, contracting directly with employer groups, decreasing reliability with third-party payers if possible, tracking market trend data and payer activity, and stepping up advertising and good marketing.

"Health care is a business whether we like it or not," Elliott said.

Assessing PT Market Demand

Elizabeth Puliti — Wed, 11 Feb 2009 23:30:00 GMT

LAS VEGAS-- In PT - Who Needs It? Exposing & Forecasting Market Demand for Physical Therapy Services, Lynn Steffes, PT, and Bridget Morehouse, MPT, MBA, spoke with PTs on how to accurately assess the market.

"We are facing tremendous economic uncertainty. Fear of the unknown is the greatest fear businesses and the greater population faces," said Steffes.

In this new economy, uninsured people will become insured through government plans. PTs need to think about what that means to their business, she added.

"Suddenly, the way we practice clinically is affected by the economy. What can we do to be proactive?" Steffes asked the audience.

Responses consisted of: having sales on services, extending practice hours, advertising businesses and bundling services. Some practices that are really struggling are getting by through contracting their services to another area, such as outpatient services.

Steffes advised PTs to look at market demographics and ask themselves what these demographics say. "Census data is available to you and you should be looking at it."

Morehouse stated that private practices have an advantage in this current economy. There's change in the market and private practices are agile, she noted.

It's a good idea to collect competitor information and market trends. One way PTs can do this is through identifying all "alternatives" to physical therapy. "PTs tend to look at competitors as only other PT practices," said Steffes, "but people who are paying out of pocket might use massage therapy because they understand what massage therapy is, it's it has a perception of being less expensive and they can control how many times they go."

Literature shows that the quicker patients have access to physical therapy, the quicker they get better. Therefore, "we have to stop clinging to the past and start thinking of proactive solutions," to get patients in the door, Steffes said.