Key Highlights from the APTA State Payment Advocacy Forum

Posted By: Kari Nies Smith Practice & Advocacy,

Kari Smith (Payment Chair) and Kim Parker-Guerrero (Director of Practice) represented the Academy of Pelvic Health Physical Therapy at the APTA State Payment Advocacy Forum on August 16, 2022, at the APTA Centennial Center in Alexandria, VA.  The attendees shared experiences and perspectives in their advocacy work at the state and federal levels. Topics such as Multiple Procedure Payment Reduction and telehealth were discussed, with speakers from different states sharing their wins and challenges. These presentations made it clear that we all have similar payment issues relating to the administrative burden, utilization management, and stagnant fee schedules. In addition, a common thread was the increased challenges of providing equal access to our services for all populations, especially the most vulnerable patients with Medicaid insurance.  

Robust discussion between physical therapists (PTs), policymakers, and insurance companies was facilitated to examine the reimbursement process.  In addition, states shared strategies for permanent telehealth coverage, and participants were encouraged to use data and infographics to demonstrate the value of physical therapy.  

Virginia state Senator Adam Ebbin, the keynote luncheon speaker, shared his thoughts on strategies to build relationships with legislators, which included attending town hall meetings, sending emails in advance for notification about a specific topic to be discussed, and supporting policies/legislation the legislators may have sponsored.  He also recommended developing a brief one-page report with talking points/bullets highlighting a bill or specific opinion to be discussed.

Because many Academy of Pelvic Health Physical Therapy members transitioned to providing some version of telehealth during the pandemic, the most impactful discussion highlighted the need for all physical therapists to have the ability to offer digital healthcare services.  Prioritizing permanent telehealth coverage across all payers, broadening the participation in the PT Compact for telehealth coverage expansion, and developing systems to provide digital healthcare will be key to furthering our profession.  We must evolve with technology to bring value by providing earlier access to care, expanding our reach to rural populations, and maximizing services to areas without a pelvic health physical therapist.  

Digital healthcare also presents unique opportunities for patients, families/caregivers, and providers.  It allows PTs to observe how patients engage in their personal environment, with the assistance of wearable monitoring devices and other equipment.  It also supports stronger patient-provider alliances, facilitating a method of simple and efficient communication to ensure adherence to any instructions and suggestions provided during episodes of care.

However, physical therapists should be aware of companies that are well equipped in each state to serve these patients in a digital format, including those advertising physical therapy digital services without having a PT involved.  We must remain diligent to protect our specialized services and skill set that cannot be replicated by means of a computer program.

Payment advocacy at the federal, state, and local level must be multifaceted to best meet the needs of PTs/PTAs and the patients we serve every day.