Committee Chair Letter

image_print
Janet Shelley, PT, DPT
By Janet Shelley, PT, DPT

This month’s Impact theme is secrets. Physical therapy has often been referred to as one of healthcare’s best kept secrets.

The “secret” being the ability of physical therapy to decrease the total healthcare cost to treat musculoskeletal conditions. Accessing physical therapy first and physical therapy early has repeatedly shown a reduction in the healthcare spend, as well as eliminates costly physician visits, urgent care services, imaging costs, pain medications, decreases surgeries and reduces lost workdays. As chairperson of the APTA Private Practice Payment Policy Committee, I am privileged to lead a talented group of therapists that are creating a plethora of resources for members to share our secret with patients, payers, and employers.

First, patients. Our patients make their way to physical therapy through traditional referral pathways, and increasingly through direct access and community networking. Unfortunately, the path to complete treatment is littered with utilization reviewers who make it difficult to access a patient’s full insurance benefit for therapy. APTA Private Practice Payment Policy Committee members developed an informative webinar “Fighting for Your Patients: Best Practices to Reverse Insurance Coverage and Payment Denials” (bit.ly/3zYjQ7c) and a suite of complementary tools to ensure your patients continue to receive the secret sauce of physical therapy treatment.

Next, payers. APTA Private Practice commissioned an actuarial firm to study episode of care costs for treatment of low back pain and the impact of physical therapy on these costs. It’s no longer a secret that physical therapy first and physical therapy early has changed the narrative on the value of our services. The section staff regularly meets with payers for this discussion, but our committee produced a customizable PowerPoint presentation that members can also present these secret savings to payers in their individual markets. Level 1B presentation is designed to be presented to a payer; includes low back care and opioid statistics highlighted in the Milliman data (bit.ly/3SjfPkG).

Lastly, employers. As the physical therapy secret has gotten out, employers across the country are contacting APTA Private Practice to ask how they can be matched with physical therapists to help them control costs. Our committee has seized the opportunity to collaborate and develop an educational model for direct-to-employer contracting. Direct-to-employer marketing is the private practitioner’s newest and most exciting plan of action to eliminate third-party administrative burdens and improve reimbursement, all while improving patient satisfaction and early access to physical therapy. Three modules are planned, with the first to start this fall:

  • Effectively Connecting and Meeting with Employers to Pursue Direct Services
  • Understanding the Business of Direct to Employer Contracting
  • Addressing Legal and Regulatory Concerns

Our Payment Policy Committee welcomes members to participate on our working task forces. Please reach out to me at jshelley@therapypartnersolutions.com if you would like to join your colleagues as we search for ways to reduce administrative burden, create new revenue streams, increase access, and promote the value of physical therapy to consumers, payers, and employers.

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

Are you a PPS Member?
Please sign in to access site.
THANK YOU
Enter Site!