Early this month, the American Physical Therapy Association (APTA) and American Occupational Therapy Association (AOTA) released Dobson DaVanzo TOPS study findings in a joint statement. The study calls on payers to model their reimbursement based on these results, instead of disincentivizing appropriate therapy use. Get the highlights via the summary infographic or continue reading for more detail.

PT/OT provides functional benefit to most patients:

  • Significant rehabilitative value seen across 1.4 million Medicare cases.
  • Direct and positive impacts seen with patients in post-acute care (PAC) settings, including improving the functional ability of patients and reducing readmissions to acute care hospitals.
  • Patients who receive OT and PT during their initial post-acute episode are more likely to have better outcomes and better quality of life
  • Therapy increased meaningful participation in everyday living

PT/OT provides direct and positive value in post-acute care:

  • There are positive ramifications for PT/OT reimbursement under the current fee-for-service and any future unified payment system.
    • Improving the functional ability of patients
    • Reducing readmissions to acute care hospitals
  • There is positive value in PT/OT provided in PAC settings – rehabilitating and preventing decline of core function in daily living activities.
  • Increased therapy intensity is positively correlated with increases in measured functional status in patients following discharge from initial hospitalization.
  • Thirty-day readmission rates to acute-care hospitals following a PAC episode decreased after therapy and appear to have varying threshold effects within each setting.

The takeaway is obvious. Therapy improves the quality of patient care and outcomes. The hope is that payers like Medicare will take this into consideration when it comes to reimbursement models. 

For help managing contracted therapy costs, contact us about our Managed Care MASTER software for PAC contract and case management, or join our 4/27 webinar with Mix Solutions – Goodbye PDPM, Hello Levels!

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