As the COVID-19 pandemic rages on, Idaho has not yet become the hot spot that many feared, however the impact of the deadly disease will resonate with our state’s economy and healthcare system long after this unprecedented crisis begins to abate.
Since the Idaho Department of Health and Welfare issued a statewide stay-at-home order, many businesses including healthcare practitioners have had to find new ways to serve vulnerable populations who find themselves unable to leave their homes. Physical therapy practices like mine are no exception. While I worry about the financial stress lower patient volume and burdensome Medicare regulations have on my bottom line, I am terrified that my most vulnerable patients—senior citizens and Idahoans with underlying health conditions—will forgo the care they need to maintain their health and wellbeing.
As hospitalization and death rates make clear, patients who are elderly, suffer from chronic health conditions, or a combination of the two are bearing the brunt of the COVID-19 national emergency. Unfortunately, the social distancing guidelines that are undoubtably necessary to keep these individuals safe also create long-term health setbacks as thousands of patients have their continuity of care interrupted. Fearing the risks of exposure to the deadly disease, many Medicare beneficiaries have cancelled important healthcare appointments, putting them in jeopardy of suffering serious injury, limited mobility, severe pain, or death. Even as we continue to expand our telehealth offerings, we have seen nearly half of our patients cancel their physical therapy sessions, while new patient screening (most often recommended by a patients’ primary care doctor or surgeon) has come to a virtual standstill.
This is dangerous for seniors. Because physical therapists provide highly specialized care to help patients deal with debilitating pain, regain mobility, prevent falls, and recover from serious illness and injury, any delay in care can be dangerous. Continuity of care is vitally important because any disruption or delay in treatment can make permanent the loss of mobility, independence, and pain-free living. It’s no exaggeration to say that many seniors who put off physical therapy during the COVID-19 crisis will completely miss the opportunity to regain full functionality.
To understand why, consider just one of the many dangers physical therapists help seniors avoid: falling.
Every single year, falling causes 2.8 million injuries, 800,000 hospitalizations, and 27,000 senior deaths in the United States. On top of these severe health ramifications, falls also generate billions in preventable Medicare costs at a time when we can ill afford it.
So, given the current national health crisis and its implications for both physical therapists and their patients, the least one might expect is supportive policy from federal officials in Washington D.C. Unfortunately, much of the current policy on the books does the opposite.
Current Medicare policy included in the Physician Fee Schedule (PFS) final rule for Calendar Year 2020 imposes substantial across-the-board cuts to various medical specialties, including physical therapists, starting in 2021. Following a decade of other significant reimbursement reductions, any new cuts will make it harder for specialty practices, including physical therapy, to meet the growing burdens placed on us. As a physical therapist and small business owner, I’ve been proud to help heal ailing patients in the heart of the Magic Valley, Boise and Eastern Idaho communities, but it’s becoming harder to stay afloat. With rising costs and sinking payments, it’s hard to imagine how the future will be sustainable for physical therapists across the state and the country.
In order to better ensure patient access to care, I’m calling on Idaho’s lawmakers in Washington to support efforts to provide much-needed relief by striking budget neutrality provisions from the existing evaluation and management (E/M) payment codes, thereby preventing cuts to specialty providers.
Providing immediate relief to specialty providers like physical and occupational therapists is not only the right thing to do for patient care, it will also have an amplifying impact on our healthcare system and economy. Protecting access to care and stabilizing healthcare specialty practices across the nation is a win-win for everyone.
Bryan Wright is Founder and CEO of Wright Physical Therapy.
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