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PHYSICAL THERAPY.BENEFITS. Better Access • Improved Outcomes • Reduced Cost. What’s the Problem? Health care costs are rising at an alarming rate in the U.S.
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What’s the Problem?
High co-pays often results in the patient being unable to afford to receive necessary health care services such as physical therapy.
Studies show a high rate of poor health care literacy rate which correlates to poorer health status and higher health care costs.
Where’s the Evidence?
“One in three patients has ‘basic ‘ or ‘below-basic’ health literacy” (O’Reilly, 2012).
Studies have indicated a positive correlation between poor health literacy and increased health care costs and poorer health status (Boodman, 2011).
Where’s the evidence?
Given the rising costs of health care, “it is only fair and logical to ensure that consumers have the information they need about quality and cost to make informed decisions…to seek care” (Health Care Incentives Improvement Institute, 2013).
How does it relate to PT?
Physical therapy is a medical profession that focuses on promoting and restoring the best possible movement and functional mobility.
Physical therapists are the practitioners of choice for the “prevention of impairments, functional limitations, and disabilities related to movement, function, and health” (APTA, 2012).
Physical therapy co-pays are typically that of a ‘specialist’ which is a 2nd tier co-pay.
Physical therapy reimbursement rates are not comparable to other ‘specialist’ reimbursement rates.
Physical therapy co-pays are often more than 50% of the total cost of the physical therapy services.
Higher co-pays correspond to patients reducing or avoiding the physical therapy that they need to regain functional mobility again.
This lack of access to physical therapy services leads to poorer health, increased disability, and increased long-term health care costs.
Health insurance companies must become more accountable and transparent.
Co-payments for physical therapy should be proportional to the total cost of service.
Legislation has been passed in 4 other states (Missouri, Kentucky, South Dakota, Arkansas limiting the co-payment amount. Similar legislation is still pending in Pennsylvania and New York (Appleby, 2012).
Where Do We Start?
Who’s with us?
Virginia Physical Therapy Association (VPTA)
American Physical Therapy Association (APTA)
Virginia Health Information (VHI)
Catalyst for Payment Reform (CPR)
National Business Coalition on Health
Department of Health and Human Services (DHHS)
Virginia Department of Health (VDH)
Virginia Department of Medical Assistance Services
How do we get there from here?
How do we get there from here?
Coalition on Health
Potential Senate Supporters
Potential Delegate Supporters
Who do we contact?
Contact your district Delegate and Senator to encourage support.
Contact other potential supporters within the Virginia House of Delegates or Senate.
American Physical Therapy Association. (July 2013). Fair Physical Therapy Co-Pays. Retrieved from: http://www.apta.org/StateIssues/FairCopays/
American Physical Therapy Association. (2013). New Missouri Law Limits Patient Co-Pays for Physical Therapy. Retrieved from: http://www.apta.org/Media/Releases/Legislative/2013/7/9/American Physical Therapy Association. (2013). New Legislation Means Reduced Out-of-Pocket Expenses for Patients in Arkansas. Retrieved from: http://www.apta.org/Media/Releases/Legislative/2013/3/21/American Physical Therapy Association. (July 2013). State Laws Governing Fair Co-Pays. In Fair Physical Therapy Co-Pays. Retrieved from: http://www.apta.org/StateIssues/FairCopays/American Physical Therapy Association. (July 2013). Sample Opposition Talking Points: What to Expect from Opponents PT to Co-Pay Legislation. In Fair Physical Therapy Co-Pays. Retrieved from: http://www.apta.org/StateIssues/FairCopays/
American Physical Therapy Association. (2012). South Dakota Law Limits Physical Therapy Co-Pays. Retrieved from: http://www.apta.org/Media/Releases/Legislative/2012/2/27/
Appleby, J. (2012). States Consider Limiting Costs for Physical, Speech, and Occupational Therapy. Kaiser Health News. Retrieved from: http://www.kaiserhealthnews.org/Stories/2012/April/23/patient-physical-therapy-payments.aspxBoodman, S.G. (2011). Helping Patients Understand Their Medical Treatment. Kaiser Health News. Retrieved from: http://www.kaiserhealthnews.org/stories/2011/march/01/health-literacy-understanding-medical-treatment.aspx?referrer=search
Health Care Incentives Improvement Institute. (2013). Most States Fail to Make the Grade in Health Care Transparency for Consumers. Retrieved from: http://www.hci3.org/content/most-states-fail-make-grade-health-care-price-transparency-consumers
Kaiser Health News. (2004) 90M U.S. Adults Have ‘Limited Health Literacy’ IOM Says. Retrieved from: http://www.kaiserhealthnews.org/daily-reports/2004/april/09/dr00023143.aspx?referrer=search
O’Reilly, K.B. (2012). The ABC’s of Health Literacy. Posted on amednews.com. Retrieved from: http://www.amednews.com/article/20120319/profession/303199949/4/
Virginia General Assembly. (2013). Code of Virginia. Retrieved from: http://lis.virginia.gov/000/src.htm
Virginia General Assembly. (2013). Virginia Administrative Code. Retrieved from: http://lis.virginia.gov/cgi-bin/legp604.exe?000+men+SRRVirginia General Assembly. (2013). Virginia House of Delegates. Retrieved from: http://dela.house.virginia.gov/dela/MemBios.nsf/MWebsiteCO?OpenViewVirginia General Assembly. (2013). Senate of Virginia. Retrieved from: http://apps.lis.virginia.gov/sfb1/Senate/TelephoneList.aspxVirginia General Assembly. (2013). Who's My Legislator? Retrieved from: http://conview.state.va.us/whosmy.nsf/VGAMain?openform
for your support.