Louisville, KY (PRWEB) June 19, 2014
Physical Therapy Business Alliance (PTBA)’s President, Jeff Hathaway, and Board of Directors have reviewed the General Accountability Office (GAO) study and it’s conclusions concerning practice patterns of physicians with ownership in physical therapy services, and have in turn called for an increase in legislative action on restricting self-referral schemes.
The GAO study found sharp spikes in increased referrals when physicians shifted from a model in which they have no incentive to refer, to a model where they have monetary incentives from which they can benefit. Additionally, 100% of previous, scientifically valid studies that have examined physician referral-for-profit have clearly demonstrated over-utilization of services, substandard care, or both.
“The question then becomes, with every scientifically credible study showing referral-for-profit leading to over-utilization, why would the GAO not come to a similar conclusion,” said Hathaway. “Their key responsibilities include providing oversight of tax payer money.”
The PTBA’s response presents a two-fold answer: flawed methodology compounded by erroneous assumptions, and a blurring of the actual results in order to provide more broad-brush stroke conclusions regarding the physical therapy profession. To rectify these shortcomings, the PTBA urges critical analysis of the methodology that the GAO used and further clarification of the purpose of the study.
PTBA asserts that the methods by which the GAO determined the provider referral status were faulty with respect to understanding and identifying the myriad of financial relationships that currently enable physician self-referral as well as the inherent problem that multispecialty groups like Mayo and Cleveland Clinic present. The study should have simply compared the homogenous groups of patient services that exist in outpatient PT clinics where patients referred by self-referring and non-self-referring physicians and where PT's have a provider number.
Additionally, it has been shown repeatedly in past literature that many physicians owning PTs are eager to "cherry pick" patients with private, well-paying insurance or those with problems that are easier to manage in higher volume settings. These are critical variables that must be accounted for in any study.
Secondly, several studies showing the cost-effectiveness of physical therapy and direct access to physical therapists, as compared to invasive medical interventions, drugs, and surgeries suggest that healthcare expenditures should shift MORE toward physical therapists' services - NOT less. Physical therapists are also being increasingly called upon for preventive services to help curtail hospital re-admissions. PTBA applauds policies built into the Affordable Care Act encouraging these referrals because it is much cheaper to spend a small amount of money to reduce the glaring risks and proven preventable costs of secondary medical problems and hospital re-admissions.
“In conclusion, PTBA believes that the findings of current research warrant immediate action by legislators - NOT more expensive, flawed studies,” said Hathaway. “The PTBA believes the evidence is, and will continue to overwhelmingly show, that when healthcare providers engage in self-referral the value-based premise of the Affordable Care Act becomes severely compromised. We must act on the consistent self-referral findings to ensure that physical therapists can deliver the value research is consistently showing.”
For more information on the PTBA’s response, please visit http://www.ptballiance.org. To contact Jeff Hathaway, please email jeffh(at)proactiveptclinics(dot)com.
About Physical Therapy Business Alliance:
Physical Therapy Business Alliance provides focused, agile, and unencumbered response to legislative and payment challenges to improve business conditions for independent physical therapy practices and erase the fear, uncertainty, and doubt surrounding declining payment, POPTS, and practice management. Physical Therapy Business Alliance’s Board is made up of proven leaders from around the country who provide local resources and a national voice to achieve results. For more information on the Physical Therapy Business Alliance, please visit http://www.ptballiance.org.
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