Trends in Therapy Services: Deconditioning, Telehealth, and Reimbursement
The world has changed over the last six months, and therapy services is no exception. Rehab providers across the country have had to adapt to the strong market forces affecting their business. In our case, we temporarily shut down our outpatient clinics, saw a significant reduction in the admissions to our skilled nursing facilities, and had to rethink how we were going to deliver therapy services in the healthcare settings we served. At one point, things were changing every day. Now they are just changing every week! In the last six months, we have seen some consistent trends emerge from this pandemic and we have identified three in which we are watching closely.
One of the buzzwords among rehab providers recently has been “deconditioning”. The stay-at-home orders, in many cases, have reduced physical activity and increased social isolation. Muir Gray and William Bird in their article titled, “COVID-19 Will Be Followed by a Deconditioning Pandemic” state that, “the months of isolation at home as a result of the Covid pandemic will have an immense deconditioning effect, affecting millions of people.” Upon re-opening at our locations, we have seen this problem up close and personal. Most patients have regretfully taken a few steps backwards in their rehab journey and therefore have required some intensive therapy in order to regain their previous levels of function and strength. Vice-chair for research and associate professor of occupational therapy at Pitt’s School of Health and Rehabilitation Sciences, Natalie Leland, shares some of these same concerns. In an article titled, “Experts Evaluate Need for More Rehabilitation Services After Pandemic” Leland talks about the multi-disciplinary rehabilitation approach that is required in order to restore patients to their prior level of function. She states, “Each discipline tackles these domains from a different perspective, which ensures a comprehensive approach to their health and functional abilities to ensure they can return to their prior living environment and engage in the meaningful activities they did before”. Let’s see what we can do to tackle this together and help people get back to doing the things that they enjoy doing.
Over the last few months, we have been providing telehealth therapy services to many of our patients. The pandemic has forced us to develop a more innovative treatment plan for our patients that combines both in-clinic with telehealth visits. Telehealth services are like having a new color to paint with. It gives us more flexibility in delivering care without sacrificing the outcomes we want to achieve and allows us to provide more care that is centered around the patient’s needs and preferences. Telehealth can benefit the patient in so many ways including . . .
- Continued Progress: Telehealth allows you to maintain your therapy goals that were established during your initial evaluation under the watchful eye of a licensed OT, PT or SLP (speech).
- Convenience: Making gains from the comforts of your own home.
- Context: Therapy can now be provided in the environment in which you perform most of your functional activities.
Our Response to COVID-19
While we have seen access to therapy services increase through broader adoption of telehealth for therapy visits, CMS continues to be looking for ways in which they can balance their budget for 2021. At the beginning of August, the Medicare Physician Fee Schedule was released for 2021 and in it, CMS proposed to cut the reimbursement for physical, occupational and speech therapy services between 7-9%. The cuts would go into effect on January 1st, 2021. This comes at a very difficult time for therapy services. As a result of this pandemic, patients are in greater need of our services than ever before. Therapy organizations have responded and are trying to persuade lawmakers to consider other ways in which they can reduce spending without such a significant cut to our reimbursement. The American Physical Therapy Association stated that “Our members serve a critical role in the health and vitality of this nation, frequently carrying out the therapy plans of care for older adults who require physical, cognitive, and psychosocial functional stability to remain safe and independent within their communities.” Please join us in this fight and contact your congress member to let them know the impact that this will have on the patients we serve.
We can’t predict whether these trends – patient deconditioning, telehealth adoption, and reimbursement reductions – will last for the long term. However, what we do know is that in the short term they will continue to have an impact on therapy providers across the country and efforts to help patients achieve their highest quality of life.
If you’re interested in learning more about our approach to these trends, please contact us today.