While Covid-19 cases are on a decline, the full extent of the pandemic’s long term effects on health remain in question, which means ensuring access to safe, effective therapies that help patients recover from illness and injury and manage any lingering health conditions. Most agree that specialty care services are vital to the healthcare system, so why is Medicare insistent on slashing funds for health specialties—including physical therapy—again and again?
Physical, occupational, and speech therapy providers are once again facing severe cuts amid the ongoing pandemic – in a move made by Medicare when they finalized payment reductions in the Medicare Physician Fee Schedule (MPFS) for 2022.
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Each year, millions of Americans utilize physical therapy to recover from serious injury and illness. Seniors, in particular, benefit greatly from physical therapy. Following hospitalization, for example, therapy services can help patients regain mobility and strength, restore balance and bodily function, and enhance flexibility and range of motion. This is especially effective for helping seniors avoid falls, which cause approximately 2.8 million emergency room visits, 800,000 hospitalizations, and over 27,000 deaths every year. Physical therapy improves seniors’ health outcomes and quality of life, while also ensuring patients recuperate safely at home so that hospital staff and resources remain available for treating Covid-19 and other acute patients in critical need.
Additionally, physical therapy represents a safe, non-pharmaceutical approach to pain management. The over prescription of powerful opioid-based painkillers has fueled a surge in opioid use disorder (OUD) and overdose deaths. Between January 2020 and January 2021, a record 94,000 Americans succumbed to a drug overdose—a rate that is more than 30% higher than the previous 12-month period. According to a recent Department of Health and Human Services (HHS) report, roughly 1-in-4 Medicare Part D beneficiaries received opioids during 2020, and tragically more than 43,000 beneficiaries suffered an opioid overdose. By offering a safe alternative to opioids, physical therapy can help prevent seniors from developing a dangerous addiction and minimize the risk of diverting painkillers from their medicine cabinets into their communities.
Given the proven benefits of physical therapy, it would make sense to ensure seniors’ continued access to specialty care—especially as individuals continue to face lingering Covid-19-related health concerns. Yet, Medicare has taken the opposite approach.
Despite broad opposition from bipartisan lawmakers and stakeholders throughout the healthcare sector, the Centers for Medicare & Medicaid Services (CMS) once again finalized deep, across-the-board payment cuts to physical, occupational and speech therapy. The PFS Final Rule for CY2022 includes plans to impose a 3.75% cut to providers starting on January 1, with cuts eventually adding up to a 9% reduction by 2024. In addition, the rule also finalized a devastating 15% cut for services provided by physical and occupational therapy assistants. These troubling cuts come on top of years of successive payment reductions which are eroding the nation’s foundation for providing therapy services.
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Considering the cumulative impact, the latest cuts by Medicare will seriously burden physical therapy practices, inject uncertainty into an already fragile healthcare system, and create long term challenges to provider sustainability. At the end of the day, it will be patients who suffer the most. If practices are forced to close their doors, it will become increasingly difficult for America’s seniors to access the therapy services they need to recover from injury and illness. As a result, I fear that more seniors will suffer falls or accidents, putting even more stress on our healthcare system.
Late last year, Congress stepped up to alleviate Medicare cuts through bipartisan legislation, a welcome relief to physical therapists like myself. We once again need Congress to intervene in order to protect patients and providers and stop any further cuts to specialty care.
Photo: MikeyLPT, Getty Images
Javier (Javi) Othon is Executive Vice President and Chief Operating Officer at CORA Physical Therapy and has been in the physical therapy industry since 1997. He started as a physical therapist with CORA in 2000, where his position has evolved from serving as a company-wide leader in workers compensation and multi-market operations to his current role overseeing all existing clinic operations. Javi is a graduate of Florida International University with a BHS in Physical Therapy. He also completed the Stanford University School of Business Executive LEAD Program, Business/Organizational Design, and also earned his certification in OSHA outreach training for general industry from the University of South Florida, as well as a Lean Six Sigma Black Belt Certification.
