There’s more in motion in your physical therapy job than (ideally) your patients. Fast-moving clinical and professional developments routinely impact your practice, and it can be challenging to keep up with it all.
At Eisenhower Medical Center, we understand the vital link between the quality of care we provide our patients and the ongoing professional development of the practitioners on our team. We recognize how lifelong learning contributes to not only your growth in your physical therapy career, but also to improved care standards, better organizational performance, and better service delivery.
That’s why we’re enthusiastic about providing educational opportunities for PTs who work in our Inpatient Rehabilitation Center and our many outpatient clinics. It’s also why we’re committed to helping you stay on top of the latest physical therapy news.
Here, we summarize a few hot topics for you. Consider them a jumping-off-point for further exploration.
Muddled Medicare Message
Apparently, the federal government has missed the mark on educating PTs about a Medicare change.
It used to be that senior citizens could be denied insurance coverage for outpatient physical therapy if their conditions didn’t improve. A settlement in a class-action lawsuit issued four years ago, however, dispensed with a “get-better-or-you’re-out” provision in Medicare rules. The settlement ended a therapy plateau for Medicare coverage for seniors with physical disabilities; chronic conditions, such as stroke, Alzheimer’s disease and Parkinson’s disease; or rehab needs following a fall or medical procedure.
Or did it?
According to new reporting from NPR, Medicare patients continue to be routinely blocked from coverage for PT services once progress on their conditions levels off. Seniors have been denied coverage for therapy regardless of the settlement, standing orders from their physicians, and ample research supporting the benefits of longer-term therapy.
The problem, patient advocates say, is the failure of a Centers for Medicaid & Medicare Services’ (CMS) educational campaign to raise awareness of the 2013 change among PTs and other practitioners, bill processors, and claims reviewers. Some PTs, for example, continue to use a billing code still on the books that requires Medicare patients to demonstrate improvement for coverage eligibility.
Parties to the settlement — CMS and the Center for Medicare Advocacy and Vermont Legal Aid (on behalf of several Medicare beneficiaries) — haven’t managed to reach a compromise on how education about the end of the so-called improvement standard should be delivered to providers. A federal judge will sort it out, reportedly within the coming months.
Speaking of Codes…
In case this important news from the feds hasn’t made it your way, CPT codes for PT evaluation and reevaluation have changed.
Effective January 2017, the familiar dual codes for evaluation and reevaluation have been replaced with three new evaluation codes and one new reevaluation code. The updated codes are defined in the final CMS physician fee schedule for 2017.
Here’s a quick rundown of the changes:
- Evaluation code 97001 has been replaced by three codes, each representing a level of patient presentation. The new codes include 97161 (low-complexity), 97162 (moderate-complexity), and 97163 (high-complexity).
- Reevaluation code 97002 has been replaced by code 97164.
The changes demonstrate progress in a long battle waged by the American Physical Therapy Association and others to reform the CMS payment system to more accurately and fairly reflect PTs’ expertise and patient care responsibilities. On the reimbursement front, big hills remain to be climbed, however. While CMS upgraded the payment value of the new reevaluation code, it declined to take similar action with the revised evaluation codes.
The agency did accept APTA’s recommendation that sufficient time be allowed to educate PTs about their use of the new codes. As a result, the Medicare benefits policy will remain unchanged in 2017, giving PTs a brief reprieve from medical reviewers’ penalties.
For details on the new CPT codes, download a helpful Quick Guide and webinar handouts from APTA.
How A-bot That?
The future of physical therapy looks robotic. In a good way.
No, bots aren’t poised to take your job; but innovations in robotic technology appear to be making significant strides — with equally significant implications for future PT practice.
Swiss researchers, for example, are developing robotic exoskeletons that imitate human muscle. An example of “soft” robotics, the wearable technology, fashioned into belts strapped around the waist, intends to help people move and has been preliminarily tested on victims of stroke.
Japanese scientists are taking artificial muscles a step further with ATLAS, a freakily Terminator-like bundle of multifilament tech that mimics a moving human skeleton (see it in action here). The technology shows promise for next-generation prosthetics.
On a friendlier scale, researchers at Georgia Institute of Technology have introduced a pint-sized PT helper bot to children with cerebral palsy. Darwin-OP, looking a bit reminiscent of a Kit-Cat clock minus the tail, uses big-but-somehow-sociable eyes and 3-D motion technology to monitor a child’s therapy movements in the home and assess whether they’re performed correctly. Darwin offers words of encouragement (“Fantastic!”) and physical cues in a let’s-play manner that promotes participation in routine therapy. See Darwin bust some moves in this tech review.
PTs can look forward to more bot breakthroughs. New analysis predicts rehab robots will top $1 billion in U.S. market value by 2020.
Chilling Realities of Hot Yoga
Judging by the rising popularity of hot yoga, cautions about the practice are getting a lukewarm response.
Hot yoga, also called Bikram yoga, involves a series of 26 vigorous poses performed in a studio or other setting that’s heated to between 80 degrees and 105 degrees Fahrenheit with 40% humidity. Based in part on the concept that heat helps warm muscles and promote flexibility, hot yoga has been generally viewed as a welcome adjunct to physical therapy. Yet research is sparse when it comes to evaluation of the risks and benefits of the practice, and the few studies that have been published point to possible problems.
One such study, released in August, found a majority (63%) of hot yoga participants surveyed enjoyed increased flexibility. Forty-three percent of respondents reported higher fitness levels as a result hot yoga participation, and 42% claimed increased stamina.
On the other hand, more than half of the study’s participants, all of whom had some form of pre-existing health condition, reported experiencing adverse effects during hot yoga, including dizziness, nausea, and other signs of dehydration.
While the study’s lead author, Casey Mace, PhD, assistant professor of public health at Central Washington University, pronounced hot yoga beneficial to most people, she warned it might involve risks not typically associated with other yoga practices.
“People may assume the warnings and benefits and possible risks are the same for all types of yoga, and that’s simply not true,” Mace told The New York Times in December. “There may be misconception that these feelings [of dizziness, lightheadedness, nausea, or dehydration] are normal, but they’re not.”
Skeptics point to fluid loss, heat exhaustion, and heat stroke, in addition to muscle and joint injury brought on by participants’ overexertion, as significant cautions to hot yoga exercise, particularly for people with pre-existing cardiac and other health conditions. Anecdotally, as reported in the Times, a healthy woman in Chicago suffered sudden cardiac arrest during hot yoga.
Mace encourages additional research into the potential risks of hot yoga. In the meantime, patients with pre-existing conditions are advised to consult with medical professionals before they crank up the heat on their yoga-based exercise.
Work for a healthcare leader in the Palm Springs area that’s committed to your career growth. Top-ranked Eisenhower Medical Center is currently seeking PT professionals. Search open positions and apply.
Originally posted on 8/3/2017