Physical therapy is in a very precarious position. Here in Colorado, our profession is fighting tooth and nail just to make insurance companies pay a fair price for the benefits their customers receive. Under many of these insurance carriers, physical therapy is paid per diem; meaning each visit from each patient is reimbursed the same. exact. amount. Essentially, our billing codes mean little as far as being paid, but still play a very important role in unlikely malpractice suits.
Right now, patients might pay upwards of $60, $70, $100 as a co-pay! If you look at the reimbursement rates from insurance, they may only give the physical therapist $50. This means the patient is essentially paying for their entire plan of care on their own. How is this still happening for a tried and true conservative medical profession?
We see the issues with manipulations, dry needling, direct access, and fair reimbursement for physical therapists all over the country. For such a widespread and effective form of care, physical therapy is sure facing a ton of obstacles. While we are aggressive in confronting these issues on a state-level, I believe the current landscape of U.S. healthcare demands a strong national movement. By beginning an aggressive campaign nationally through the APTA, we can positively impact the idea of healthcare to favor physical therapy.
In many ways, the APTA has provided a lot of singular value for the individual physical therapist. However, as the national body for such a large healthcare presence, I think the APTA can do much with their powerful position. This is why I believe our governing body has not done enough to advance the profession in the eyes of Americans. How can we get fair co-pays for our patients if insurance companies still believe physical therapy is largely unnecessary?
This was the main argument I heard from the opposition to our bill in Colorado asking for a fair share of payment between insurance and their consumers. Representatives of major insurance carrier, as well as those testifying for the Denver Chamber of Commerce, argued that this bill would encourage patients to go to physical therapists when they should be going to a “real doctor” for proper care? Yes, many patients need care that physical therapists cannot provide, nor should we. But the idea that insurance companies still view physical therapy as a service rather than a profession speaks volumes. By thinking of physical therapy as a service, that implies that we have less professional education and development, and that many others can simply “do physical therapy.” It really is discouraging to me that this is still the belief of many large healthcare entities.
What I propose is a strong dialogue between physical therapists nationwide and their appropriate state chapters of the APTA. These state chapters need to collaborate in a way that shows the federal APTA that we all need help with our image. Not that patients have a bad image of what we do, rather they have no image of physical therapy. We can certainly change that! When our patients see what we do as a necessary and vital aspect of healthcare, and an effective way to reduce their healthcare costs, then we can make large changes for our profession. Until then, why should we expect changes from people who don’t even know who we are?
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