Direct Access to Physical Therapy Now a Reality in California

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A new law went into effect January 1, 2014 allowing the people of California to go directly to a physical therapist, eliminating unnecessary appointments and delays in accessing care, according to San Francisco Sport and Spine Physical Therapy.

Californians seeking alternatives to prescription medication and surgery are now able to choose physical therapy for the prevention and treatment of conditions, like back pain, that affect their movement and function. As of January 1, Californians can go directly to a physical therapist to seek treatment, eliminating unnecessary appointments and delays in accessing care.

According to California's Office of Statewide Health Planning and Development (OSHPD), approximately 7.4 million Californians are in a Primary Care Health Professional Shortage Area. Improved access to providers who are expert in musculoskeletal issues should lessen the burden on primary care providers.

California should also realize cost savings. An analysis of Blue Cross-Blue Shield claims showed that the total paid claims for physician referral episodes to physical therapy was 123% or 2.2 times higher than the paid claims for direct access episodes. Physician referral episodes were 65% longer and resulted in 60% more office visits than direct access episodes. The total paid claims averaged $2,236 for “physician referral” episodes as compared to $1,004 for Direct Access episodes. (Mitchell J, de Lissovoy G. A comparison of resource use and cost in direct access versus physician referral episodes of physical therapy. Phys Ther. 1997; 77:10-18.)

Already a reality for people on Medicare, direct access to physical therapy is no longer hindered by state law. A 2005 revision to the Medicare Benefit Policy Manual (Publication 100-02) describes the Medicare beneficiary being able to go directly to a physical therapist without a referral or visit to a physician.

The evidence supporting the benefits of allowing people to directly access a physical therapist has been mounting over the years. A Virginia Mason Medical Center study examined the “Old versus New approach” in managing low back pain. The study showed lower total health care costs to back pain treatment with standardizing a path with direct access to a physical therapist, and the physical therapy appointment happening first. The study found lower wait times for appointments, less MRI utilization (dropping from 15.4% to 10%), and only 6% of people lost time from work.

"We have a great network of physicians and enjoy working with them. Improving access to health care providers empowers people to control their own care", says Sturdy McKee, CEO of San Francisco Sport and Spine Physical Therapy. "The new law will reduce delays in accessing care, and should lead to better outcomes for patients. Simply, it removes obstacles to care and makes the whole process more people friendly."

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Jerry Durham
since: 02/2009
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San Francisco Sport and Spine Physical Therapy
since: 06/2010
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San Francisco Sport & Spine Physical Therapy

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