With the amount of regulatory change happening lately, rehab therapists can be somewhat pessimistic when it comes to our professional outlook, and I’ll put my hand up as being guilty of that from time to time. But we’re entering that time of year when we all take a moment to pause, take stock of our lives, and reflect upon what we’re thankful for. Personally, I have a lot to be grateful for, like our amazing Members, who have stuck with us through the bumps and bruises that have come with our fast growth, particularly during this past year. I’m also thankful for the incredible WebPTers that help those Members achieve greatness in practice day in and day out.
Through it all, we firmly believe that we’re all in this together as true business partners and that every clinician, front office staff member, administrator, clinic owner, and biller who uses our products is a stakeholder in our company’s evolution and future growth. That’s why we consider you Members of the WebPT community and not just customers. So, to have the continued support of so many in our industry is both humbling and gratifying.
With that in mind, here are some trends and developments that we can all be grateful for as a profession, both in 2022 and beyond.
1. Patients are more aware of physical therapists as first-line providers.
Rehab therapists have long lamented the lack of awareness among the general public about both direct access laws and the overall benefits of physical therapy. Now, it seems that the years therapists have spent educating and marketing rehab therapy services to patients are starting to pay dividends, as more patients are recognizing PTs as a first option for care.
According to one recent study sponsored by the APTA, PTs were patients’ providers of choice after physicians, with 33% of past PT patients and 29% of non-PT patients rating them ahead of orthopedists, chiropractors, and massage therapists. This same survey demonstrated that patients have a greater understanding of what PTs can do for them from a proactive health and wellness standpoint; a growing number of respondents cited injury prevention, recovery from surgery, pain reduction, and improving range of motion as primary reasons for seeing a PT, as opposed to just injury recovery.
Even more encouraging is the fact that PTs are increasingly seen as being as knowledgeable as primary care physicians when it comes to injuries, if not more so; among respondents who have been to a PT, 39% rated their PT as more knowledgeable at diagnosing and treating injuries, 38% said PTs were better equipped to help them prevent future injuries, and 37% felt PTs were better suited to help improve their physical activity and mobility—all increases from previous survey responses.
And while we can and should appreciate that patient awareness about physical therapy is moving in the right direction, there’s still plenty of room to increase that 33% figure—and make a more sizable dent in our industry’s persistent 90% problem. To that end, we must continue to improve our efforts to market rehab therapy services directly to patients so that more people can benefit from the care that PTs, OTs, and SLPs provide.
But, this is just a piece of the greater puzzle. Much of our profession’s future rests on its relationship with payers—more specifically, our ability to turn them into advocates for our cause. A lot of this resides in our success of demonstrating positive patient outcomes, as well as how much payers and patients can save on healthcare costs if rehab therapy was placed at the forefront of the musculoskeletal care journey. And while some of these efforts rest squarely on our shoulders, others require a legislative act—which still requires our profession’s full attention and support. This brings me to my next point.
2. Positive legislation is in the works for rehab therapists.
It can be difficult to put too much faith in legislation to improve the fortunes of rehab therapists, given that lawmaking bodies are about the only thing to move as slowly as CMS. Sometimes, however, the wait can pay off, as there are a number of proposed laws currently working their way through Congress that would improve rehab therapy for providers and patients alike.
- H.R. 8800: The Supporting Medicare Providers Act (H.R. 8800) would extend the 3% increase to the conversion factor that Congress passed last year and would negate the additional 1.42% decrease to the conversion factor slated for next year—which would maintain the conversion factor at its current rate for 2023, depending upon the finalized Fee Schedule.
- H.R. 5536: The SMART Act (H.R. 5536) would delay for one year the 15% reduction in Medicare payments for services provided by PTAs and OTAs, and would also standardize supervision requirements for outpatient PT services from direct to general—a huge development in our fight for access to care, particularly in rural or underserved areas where many patients rely upon PTAs or OTAs for their treatments.
- H.R. 2168/S. 3193: The Expanded Telehealth Access Act (H.R. 2168/S. 3193) would permanently add PTs, OTs, and SLPs to the list of providers able to offer telehealth services under Medicare. Considering that 37% of all adults and 43% of adults 65 and overused telehealth in 2021 per a recent survey, and nearly 58% of rehab therapists offer or plan to offer telehealth to patients according to our State of Rehab Therapy report, it’s a safe bet that there’s plenty of telehealth converts among rehab therapy patients and providers alike—which is why it’s absolutely vital that rehab therapists push for the same telehealth access that other providers already have.
- H.R. 3759/S.2676: The Physical Therapist Workforce and Patient Access Act (H.R. 3759/S.2676) would make PTs eligible for the National Health Service Corps Loan Repayment Program, which helps healthcare providers pay back student loans in exchange for working in underserved areas.
- H.R. 3173/S. 3018: The Improving Seniors' Timely Access to Care Act (H.R. 3173/S. 3018) would require Medicare Advantage to establish an electronic prior authorization that can make real-time decisions, which would reduce the administrative burden on providers and help improve the efficiency and timeliness of care.
While it’s fantastic to see so many bills that would help rehab therapy, we also can’t take it for granted that they’ll get passed into law. That’s why we need to push these bills over the finish line with continued advocacy efforts. There’s already been an impressive volume of letters sent in support of these bills to date, but we can’t let up. Both the APTQI and the APTA have easy-to-use tools for making your voice heard in this fight, and you can also reach out to your representative or senator directly.
3. Medicare Part B premiums will decrease next year.
Finally, a Medicare cut we can get behind! CMS announced that the standard monthly premium for Part B will decrease by $5.20 to $164.90 for 2023. And the deductible is falling as well—a $7 decrease to $226. This unexpected windfall is the result of CMS passing on the savings from lower-than-expected costs, both on a new drug for treating Alzheimer’s as well as other Part B items and services.
Granted, the decrease isn’t exactly large enough to warrant a parade, but it’s certainly preferable to an increase for those Medicare patients on a tight budget, particularly as healthcare costs and inflation continue to rise. And we can certainly hope that the (slightly) decreased costs will not only allow existing patients to continue receiving needed treatment from PTs, OTs, and SLPs, but that new patients will be able to take advantage of rehab therapy services. But we have to make sure that patients are aware of those services—which is where direct access marketing to patients is once again vital for therapists.
4. Rehab therapists are ready to thrive in a digital MSK environment.
We’ve seen a rapid rise in digital musculoskeletal (MSK) companies over the past few years. Spending on MSK conditions has doubled to $20 billion over the past decade, and as such, millions of dollars worth of investment have poured into digital MSK companies, as people herald digital MSK treatment as the future of digital therapeutics. So, it’s another bit of good fortune that rehab therapy stands to benefit greatly from this trend—assuming that therapists are prepared to embrace it.
At a time when payers are focused on both cutting costs and increasing revenue, digital PT is well-positioned to fit within this new paradigm.
- Digital PT helps improve access to care. People dealing with MSK conditions can face significant barriers when it comes to getting treatment in person—which is why telehealth and remote therapeutic monitoring (RTM) can be important tools in reaching patients where they are to provide quality care at a distance. As noted in this study, digital PT provided via a digital app can offer patients expeditious care and reduce the need for pain medication and unnecessary operations.
- Digital PT reduces costs. Digital tools represent a significant cost saving for patients, as they can replace more expensive office visits with telehealth visits for regular check-ins and can prevent patients from having to turn to urgent or emergency care. According to one study, a virtual visit with a provider for non-urgent medical care was $93 less than an in-person visit, and a virtual visit with a specialist was $120 less. And it can increase the number of patients a provider sees on a given day while also providing some evidence of reduced costs for the healthcare system.
- Digital PT improves outcomes. With easier and more frequent access to caregivers, a greater ability to monitor progress and adjust plans of care throughout treatment, and improved adherence to medication and treatment plans, telehealth and RTM help patients become more engaged with their care, which in turn drives better outcomes and produces more rehab therapy believers. And with quicker interventions, digital PT can also help reduce reliance on pain medications as well as future injections or even operations, as noted in this study.
Rehab therapists not already using a digital health platform with their patients are missing out on the opportunity to better connect with patients and to reach patients that would otherwise be inaccessible. And while I’m happy to see the increased adoption of digital PT over the past few years, there’s always room to grow the number of converts—particularly when we’re talking about something that improves patient care and drives down healthcare costs.
There’s no shortage of changes that come at you in rehab therapy. We’ve had our share at WebPT over the past year or so, with new leadership, new acquisitions, new products, and the growing pains that have come as we continue to build a better company providing stellar software products and services for our Members. But as the old adage says, “If you aren’t changing, you are dying.” We will continue to evolve and grow, but we also commit to staying true to the industry, keeping our Members’ needs at the forefront, and remaining steadfastly committed to helping rehab therapists achieve greatness in practice.