With the significant rise in health care costs and the opioid epidemic, wouldn’t it be nice if there was a better treatment option for individuals who suffer from low back pain? Well, the good news is there is! An article in the latest issue of the magazine PT in Motion highlighted a study, recently published in Health Services Research, that tracked insurance information for 150,000 patients for 1 year after their physical therapy (PT) initial evaluation for low back pain. The 150,000 patients were divided into three groups: PT first, PT after visit with a health care provider, no PT. Qualifying patients did not have a history of low back pain, surgery, or other conditions that may cause low back pain. The researchers wanted to identify differences in the kind of health care used.
“The conclusion: patients with LBP who received care from a PT first experienced lower out-of-pocket, pharmacy, and outpatient costs after 1 year and reduced their likelihood of receiving an opioid prescription by 87% compared with patients who never visited a PT.”
Well that sounds like a pretty good solution to the problems of rising health care costs and the opioid epidemic doesn’t it? At the end of the article, the researchers are quoted,
‘Some patients who may benefit from seeing a PT early, however, do not have access, sometimes because of regulatory and health insurance restrictions and, often, patient awareness,’ authors write. ‘Given the findings of this study, states should consider reviewing their laws that restrict direct access to physical therapy services and insurers should assess their policies.’
For years, the field of physical therapy has been fighting for “Direct Access” for physical therapy services. “Direct Access” means that patients can go straight to a physical therapist for services without first receiving a prescription from a physician. Most states have some form of Direct Access, with a few exceptions. In CA, patients have restricted Direct Access because CA Law states that a patient can be seen for 12 visits or 45 calendar days (whichever comes first) without prior referral from a physician. Once those limits have been met, patients are required to go to the physician for an examination and receive a signed plan of care approving the physical therapist’s plan of care for continued treatment. That’s not so bad, right? Well, in addition to the restrictions set by the state, some insurance companies REQUIRE a physician referral for reimbursement. So, in CA you kind-of-sort-of have direct access, if your insurance company allows for it.
See, this is part of the problem. Physical therapy has been proven time and time again as a safe and effective treatment for not just low back pain, but all musculoskeletal pain complaints, but state laws and insurance providers are denying patients access to treatments. For this reason, Game Changer Physical Therapy is out-of-network meaning, we don’t have contracts with insurance providers because WE WORK FOR YOU, NOT INSURANCE COMPANIES. This is part of how we are “CHANGING THE REHAB GAME ONE PATIENT AT A TIME”. If you are experiencing pain that is keeping you from doing activities you enjoy, then give us a call. We will help you restore function to improve your performance and quality of life.
Reference: News Now Staff. (2018, May 24). Study: Seeing a PT First for LBP Lowers Overall Costs, Reduces Chances of Later Opioid Prescription. PT in Motion. Retrieved May 30, 2018, from https://www.apta.org/PTinMotion/News/2018/05/24/PTFirstForLBP/?_zs=nT4eX1&_zl=UiFr4
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