The 119th Congress and the Trump Administration have before them significant challenges for long-term healthcare reforms. As policymakers discuss new ways to make healthcare more cost-efficient and streamlined, they should prioritize preventative care to keep older Americans healthier and reduce downstream costs.
To help prevent painful injuries and costly hospitalizations, and reduce dependence on dangerous opioids, access to physical and occupational therapy services should be strengthened and sweeping payment model cuts—which only would further destabilize access to care—should be soundly rejected.
First and foremost, lawmakers in Washington should work to reverse the latest -2.8% cut to the Medicare Physician Fee Schedule (MPFS) that went into effect on January 1. Unless addressed soon, this cut will make it exceedingly difficult for older patients to access the preventative care they need to stay healthy and independent.
Even as practice costs continue to soar, Medicare payments to specialty providers, including physical and occupational therapists, have continued to decline. At a time when a growing number of practices are being forced to scale back services to Medicare beneficiaries or consider closure, these cuts only threaten patient access to care.
Congress must fix the most recent Medicare fee schedule cut to create stability for the therapy practices that are helping older Americans avoid dangerous falls, regain strength after an illness or injury, and improve their quality of life. The upcoming budget negotiations in March will provide legislators with the perfect opportunity to support practices and patients by passing long-term relief.
Another key policy to help protect older Americans is the bipartisan Stopping Addiction and Falls for the Elderly (SAFE) Act. Falls are the leading cause (PDF) of injury-related deaths for Americans aged 65 and older—costing the healthcare system roughly $80 billion (PDF) annually—but thankfully, physical and occupational therapy can reduce seniors’ risk of falling to prevent harm, expensive health care spending, and poor quality of life.
If passed, the SAFE Act would increase access to no-cost falls risk assessments and falls prevention services by physical and occupational therapists as part of Medicare beneficiaries’ Annual Wellness benefit. This legislation would help keep older Americans on their feet and prevent injuries that can lead to opioid abuse, all while reducing overall healthcare spending and saving taxpayer money (PDF).
Reintroducing and passing the SAFE Act should be an early priority for Congress, particularly given its popularity among seniors. According to a Morning Consult survey (PDF), 87% of older registered voters support the SAFE Act to prevent falls, and three out of four older voters say they would be “more supportive of the Medicare program” if it included the services outlined by the SAFE Act.
Further, as President Trump’s healthcare leadership team takes shape, Medicare should work to ensure the efficient implementation of key policies finalized last year. That includes Medicare’s expansion of general supervision for physical and occupational therapy assistants (PTAs and OTAs) for services delivered in private practices. By expanding general supervision and empowering PTAs and OTAs to perform vital services for older Americans, this provision will enable practices to extend their hours of operation and treat more patients—which is especially important in rural or underserved areas.
CMS must also swiftly implement a new process for plan-of-care approvals to reduce administrative burden. By allowing for a signed physician’s referral to demonstrate certification of a therapist’s plan of care, Medicare has eliminated the need for therapists to procure duplicative signatures which will save valuable time and money. This provision must be faithfully implemented to reduce paperwork burdens and ensure timelier access to care nationwide. Moving forward, CMS should work to properly and efficiently implement new provisions that will require updating Medicare Administrative Contractor (MAC) policies to ensure physical and occupational therapists are reimbursed fairly under these new rule changes.
The Trump administration must not delay in implementing these regulatory efficiencies.
We can secure a safer, stronger future for older Americans by supporting, passing, and implementing cost-efficient policies that improve access to preventative physical and occupational therapy services. Our community stands ready to work with the new leaders in Washington to advance policies that improve our healthcare system without jeopardizing patient care.
Nikesh Patel is executive director of the Alliance for Physical Therapy Quality and Innovation, as well as national director of clinical services and regulatory affairs for U.S. Physical Therapy.