The United States Government Accountability Office released a study showing the integration of physical therapy into physician practices did not lead to over-utilization of services, and professional groups like the American Academy of Orthopaedic Surgeons are responding.
Here are five takeaways from the study, using data collected between 2004 and 2010, which include orthopedic surgeons along with family practice and internal medicine:
1. Non-self-referred physical therapy services increased at a faster rate than self-referred physical therapy services. Self-referred physical therapy services were flat over the six-year period per 1,000 Medicare fee-for-service beneficiaries; at the same time, non-self-referred PT services grew by 41 percent.
2. Expenditures associated with non-self-referred physical therapy services was higher than for self-referred services. "Physical therapy outcomes are best when a patient's surgeon and therapist can work closely together," said Frederick M. Azar, MD, AAOS President, in a news release. "This study confirms the responsible use of in-office ancillary services by orthopedic surgeons and the importance of maintaining integration of those services in an orthopedic surgeon's office to allow for the continuation of care and to provide the best treatment option for patients."
3. The average number of physical therapy services referred per provider was mixed, although among orthopedic surgeons, self-referring surgeons on average referred fewer physical therapy services than non-self-referring orthopedic surgeons. However, self-referring providers generally referred more beneficiaries for physical therapy services, but there were fewer physical therapy services per beneficiary compared to non-self-referring providers.
4. Orthopedic surgeons are currently able to refer patients to in-office physical therapy because of the In-Office Ancillary Services exemption, which also allows physicians to provide imaging services in their office. Controversy in recent years about self-referrals has led to some challenges of the exemption, but this study reiterates its importance.
"Limiting IOAS exemption would be counter-productive in terms of quality patient care, as it results in both fragmented care and higher costs to patients. The ability of orthopedic surgeons to diagnose, initiate and oversee a treatment plan quickly and efficiently by offering physical therapy services in their offices is essential to restoring patient mobility and preventing future injury."
5. If access to the IOAS exemption is limited, patients would be forced to seek ancillary care in different settings, which increases the cost and time it takes to undergo these services. It would also potentially decrease patient satisfaction since many patients prefer coordinated care.
More Articles on Orthopedic Surgeons:
Should Spine Surgeons Seek Out Co-Management Agreements?
Trends in Spine Surgeon Pay: What Can the Future Hold?
5 Big Financial Trends for the Global Healthcare Market