Independent Physical Therapists of California Deliver Key Endorsements Regarding the Delivery of PT Services

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Independent Physical Therapists Prefer Value-Driven Payment System, APTA Referral for Profit Policy, and Direct Access to Physical Therapists in California

Many insurance companies have cut PT payment by 20-40%, often below the cost of doing business.

In a statement released today, Dr. Paul Gaspar, physical therapist, announced the initial education goals and advocacy positions of the Independent Physical Therapists of California (iPT of CA). The organization, formed in September 2012, was designed to advocate for practicing physical therapists and deliver education regarding the effectiveness of physical therapy treatment. Today's statement focused on three issues: 1) Payment for Services, 2) Referral for Profit Policy, and 3) Direct Access to Physical Therapy Services. Collectively, these positions can be seen as the 'Triple-Aim' of iPT's education and advocacy goals.

The first leg of iPT's outreach is payment policy. According to Dr. Gaspar, "Payment for physical therapy services has plummeted even though there is plenty of evidence suggesting physical therapy is often more cost-effective than invasive treatments for typical orthopaedic problems." Dr. Chuck Felder, Finance Director of iPT and payment policy expert added, "Physical Therapists have been put between a rock and a hard place in California. Many insurance companies, some of which are recording huge profits, are ignoring the value that physical therapists deliver and have cut PT payment 20-40%, often below the cost of doing business." Dr. Gaspar indicated that many PT clinics have been forced to either lay off physical therapists or see more patients per hour than is clinically appropriate, both which decrease quality of care. For these reasons, the iPT of CA has endorsed the Physical Therapy Business Alliance's (PTBA) Value Driven Payment System, which curtails excessive regulation and considers the relative value that physical therapists bring to the health care system.

The second leg of the iPT's outreach will consist of education regarding referral for profit in health care. Dr. Gaspar points out that medical costs are about 18% of GDP and are rising at an alarming rate. He added, "Every study conducted on referral for profit, whether focused on on imaging, lab services, specialty hospitals, urology, or physical therapy has shown that costs rise sharply and quality of care decreases when physicians self-refer. There is no excuse for self-referral because we cannot afford it and studies show it does not improve coordination of care." iPT of California endorses the American Physical Therapy Association and Private Practice Section for their position on Physician-Owned Physical Therapy Clinics (POPTS), applauds the South Carolina Chapter and Licensing Board for expediting law enforcement eliminating POPTS, and encourages the California Physical Therapy Association to continue disseminating health care literature and education which soundly rejects referral for profit.

Lastly, iPT will widely inform Californians and physical therapy clinicians regarding evidence which encourages early and direct patient access to physical therapy. Dr. Jeff Fairley, PT and Practice Policy Director for iPT said, "It is disappointing that a progressive state, like California, has the most burdensome regulations preventing patients from receiving the physical therapy treatment they need. Dr. Gaspar cited evidence that physical therapists have more training in musculoskeletal screening and diagnosis than most physicians. He also reminded his colleagues that physical therapist direct access legislation would have almost certainly passed in 2012 if Speaker John Perez had not referred bill SB 924 to the Rules Committee where it died without a hearing. Because of their strong position on direct access and unwavering stance on 'diagnosis' by physical therapists, the iPT of CA commends the Arizona Chapter of the American Physical Therapy Association.

In closing, Dr. Gaspar mentioned that iPT's positions satisfy the tenets of the Affordable Care Act, are supported by most health care researchers and economists, and were supported by a recent article in the New England Journal of Medicine. Physical Therapists employed in legal practice settings whom are interested in joining iPT can find out more about the organization by visiting their website at

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Dr. Paul Gaspar, DPT
Independent Physical Therapists of California
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