Anthem’s Acquisition of Cigna Continues Insurer Consolidation Trend

Health insurer Anthem’s recent announcement that it will acquire Cigna in a $54.2 billion deal is continuing a consolidation trend that could reduce the number of major insurance companies in the US from 5 to 3. And while the nuts and bolts of the deal are plain enough, when it comes to speculation on what it will mean for consumers and providers, there’s less consensus.

What’s known is this: the multibillion dollar acquisition will make the Anthem-Cigna combination the country’s largest private health insurer in terms of members, with an estimated 53 million people covered. Revenues for the new company are projected at $115 billion annually.

Anthem’s acquisition comes on the heels of a July 3 merger announcement from insurance giants Aetna and Humana, meaning that if federal regulators approve both deals, the country’s 5 major private insurance companies will be reduced to 3, United Healthcare being the third. Pending regulatory approvals, the Anthem-Cigna deal will close in late 2016.

Full story of Anthem acquisition of Cigna at APTA

PCORI Devotes Additional $142 Million to Expansion of Clinical Research Network

The Patient Centered Outcomes Research Institute (PCORI) plans to invest $142.5 million to expand its clinical research network—another facet of a broad initiative that includes major grants supporting physical therapy research.

According to a PCORI news release, the money will be used to establish a second-phase expansion of the National Patient Centered Clinical Research Network(PCORnet), a project that links various health data research networks. The funding will be used in part to expand the number of PCORnet participants from 27 to 34, and will include both clinical data and patient-powered research networks.

The 34 PCORnet partner networks encompass more than 150 conditions, including Alzheimer’s disease and dementia, autism spectrum disorders, heart disease, obesity, Parkinson disease, behavioral health disparities among low-income populations, and health disparities among sexual and gender minorities, all drawn from a wide variety of population groups.

Full story of PCORI adding money to clinical research at APTA

Study: Early Supervised Exercise Reduces Fatigue, Improves Strength for Women After Breast Cancer Diagnosis

A new study from the Netherlands is lending more support to the value of exercise during the early stages of adjuvant treatment for breast cancer. Researchers say that a combination of supervised strength and aerobic training not only reduces fatigue, but helps patients actually increase muscle fitness during the first 18 weeks of treatment.

For the project, 204 breast cancer patients were divided into 2 groups of 102—one receiving usual care and the other participating in physical therapist-supervised resistance and aerobic exercise as soon as possible after diagnosis. By design, all participants received chemotherapy at some point between baseline and by an 18-week assessment.

The exercise program was conducted at the patient’s treating hospital, and consisted of 2 aerobic and 2 resistance exercise sessions per week, with each type of session lasting 25 minutes. Muscle training was targeted at all major muscle groups and designed to reach 1 set of 10 repetitions at 75% of 1-repetition maximum by the end of the 18-week period. Results were published in a recent issue of BMC Medicine.

Full story of early supervised exercise reducing fatigue at APTA

ADA Turns 25—Here’s How You Can Help Celebrate

Happy 25th anniversary to a law based on an idea that lies at the very heart of the physical therapy profession—that individuals should not face barriers of any kind based on disability.

Signed into law on July 26, 1990, the Americans with Disabilities Act (ADA) altered everything from employment policies to building design, and from educational approaches to the ways information is made available to people across the US. Its legacy, including the ways in which it has been expanded and strengthened over the years, is one of transformation—not just toward accommodations in physical, employment, and educational environments, but toward a more inclusive society.

Full story of Americans with Disabilities Act turning 25 at APTA

Medicare Extends 5-Star Ratings to Home Health Agencies

Home health agencies are now part of the Centers for Medicare and Medicaid Services (CMS) 5-star rating system, which incorporates evaluations of patient mobility in its assessment of an agency’s overall effectiveness.

Released through its Home Health Compare website, the star ratings are based on 9 of the 27 quality measures included in that program. The measures included are patient wait for a first visit, thoroughness of explanations of drugs to a patient or caretaker, administration of a flu shot, hospital stays, and improvements in walking, getting in and out of bed, breathing, and movement with less pain.

Of the 9,359 agencies rated (out of 12,261 total agencies), only 239 received 5 stars, while 2,218 received 4 or 4.5 stars. Nearly half of all agencies—46%—landed in the middle of the pack, receiving 3 or 3.5 stars, with 28% receiving lower ratings of 1.5 to 2.5 stars. Of all agencies rated, 6 received a single star.

Full story of 5-star ratings on home health agencies at APTA

Could electromagnetic pulses be used to treat tinnitus?

The study, published in JAMA Otolaryngology-Head & Neck Surgery, assesses the use of repetitive transcranial magnetic stimulation (rTMS), delivered with a coil to the patient’s scalp.

“We do not believe that rTMS should be viewed as a replacement for effective tinnitus management strategies that are available now,” write the authors. “Instead, rTMS could augment existing tinnitus therapies and provide a viable option for patients who do not respond favorably to other treatments.”

Tinnitus is the perception of noise or ringing in the ears without a source. The problem affects around 1 in 5 people and is a symptom of underlying conditions such as age-related hearing loss and ear injuries.

Full story of electromagnetic pulses and tinnitus at Medical News Today

Meta-Analysis Backs Use of Electrical Stimulation on Patients Posttroke

Authors of a review and analysis of studies on neuromuscular electric stimulation (NMES) in the treatment of patients poststroke say they’ve taken a step toward settling some of the debate about the technique’s effectiveness. Bottom line: it’s an option that they recommend to reduce spasticity and increase range of motion.

The study, which appears in the August edition of Stroke, examined 29 randomized clinical trials that were focused on the use of NMES either alone or in combination with other treatment techniques, compared with a control group that did not receive NMES. Application sites were limited to lower or upper extremities, but researchers did not put upper or lower limits on NMES dosage. A total of 940 individuals were included in the combined trials.

Full story of electrical stimulation on patient post-stroke at APTA

Popular ICD-10 Webinar Now Available for Free Download

Did you miss the sold-out APTA webinar on ICD-10 implementation? It’s now available to APTA members as a free recording.

“ICD-10: Final Steps for Successful Implementation,” is a 90-minute presentation that provides a brief history of ICD-10, an overview of how it’s different from ICD-9, and strategies for using the system set to begin on October 1. The webinar includes case studies and audience participation. APTA staff members Gayle Lee, JD, and Matt Elrod, PT, DPT, Med, NCS, lead the session, which was presented on July 9 to a full virtual house.

Full story of popular ICD-10 webinar at APTA

5 Tips on Cultural Competence

Everyone recognizes that cultural competence is a crucial component of the physical therapy profession, and a concept that’s strongly tied to APTA’s transformative vision. But what is it really? And how will you know when you’re living out cultural competency in your practice?

Here are 5 tips on cultural competence, drawn from APTA’s extensive online resources that include videos, online and text-based courses, as well as association plans, policies, and guidelines. Take a few minutes to get reacquainted with these basics, and then explore the details through the APTA website.

Full story of cultural competence at APTA

Study: Concussed College Athletes Almost Twice as Likely to Experience Later Lower Extremity Injuries

A study of Division I college athletes has reinforced the idea that there’s a connection between concussion and later musculoskeletal injury, with an estimate that for as much as a year after the initial head injury, concussed athletes are nearly twice as likely to suffer an acute lower extremity injury than they were prior to the concussion.

Researchers analyzed electronic medical records of 44 concussed and 58 nonconcussed college athletes for a 2-year period that extended 1 year before and after the concussion (the nonconcussed athletes were matched with the concussed athletes over the same time period). Records were retrieved at 365 days, 180 days, and 90 days before and after the concussion, with researchers focusing on reports of acute lower extremity musculoskeletal injury that included sprains, strains, contusions, and fractures, but didn’t include chronic and overuse injuries.

Full story of concussions and lower extremity injuries at APTA