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Adherence To Physical Therapy Program For Low Back Pain Can Reduce Overall Medicare Spend

Lower back pain patients who adhere to a standard physical therapy regimen with multiple visits cost less in overall Medicare expenditures than do patients with fewer outpatient therapy sessions, according to a new study from The Alliance for Physical Therapy Quality and Innovation (APTQI).

The independent analysis, conducted by health care research firm The Moran Company (TMC), assessed 38,260 Medicare patients.
• All of the patients had a lower back pain diagnosis and an outpatient physical therapy visit in the year following that diagnosis.
• Approx. 22% of those patients had a single therapy visit. Remaining patients averaged 9.1 therapy visits over the course of eight weeks.
• Patients with multiple visits incurred 14-32% lower average total Medicare spending in the year following their diagnosis than patients with one therapy visit in the same timeframe.
• 94% of the patients who had more than one therapy visit spent an average of $625 for outpatient therapy services. That fee is lower than the typical cost of an MRI or other diagnostics that don’t resolve the condition.

“These latest findings suggest that the intensity of physical therapy in terms of the number of visits, is inversely related to total Medicare spending. This study is one more indicator that sticking with a physical therapy program can help patients ease the pain in their lower backs as well as their wallets. Those in charge of insurance design should be looking at ways to remove barriers to physical therapy and improve attendance, not the other way around.”
—Erik Williams, Executive Director of APTQI


Executive Brief:

Full Study: