$12.5 Million PCORI Grant Will Fund Research on Team Approach to Pain Management

A recently announced $21 million grants program includes a $12.5 million award for a project that will investigate the effectiveness of interdisciplinary teams that include a physical therapist (PT) in creating “integrative” pain management options to avoid reliance on opioids.

The grants program, sponsored by the Patient-Centered Outcomes Research Institute (PCORI), will support research related to the management of chronic pain, with a goal of reducing opioid use. The largest award was provided to a University of Minnesota project that will evaluate 2 approaches in the treatment of veterans with chronic pain: one approach that pairs a pharmacist and supervising physician to determine a medication plan and create a telemedicine-based care program, and a second approach that establishes a team including a physician, psychologist, and PT to create a plan “that encourages integrative pain management options, such as exercise, in addition to medication,” according to a PCORI news release.

The second grant award, for $8.5 million, will go to a University of Wisconsin-based research team investigating the effectiveness of mindfulness meditation and cognitive behavioral therapy in the treatment and management of low back pain.

Full story of PCORI grant on pain management at APTA

ACA Anti-Discrimination Rule for Health Care Providers, Payers Takes Effect July 18

In a combination of changes that codify longstanding guidance and expand definitions, the Department of Health and Human Services (HHS) will very soon implement an anti-discrimination rule that could alter the ways some providers and payers manage care.

Beginning July 18, health care providers and payers that accept federal dollars will be subject to a provision of the Affordable Care Act barring discrimination in care and coverage on the basis of race, color, national origin, age, disability, and sex. As with other similar changes at the federal level, the new rules include gender identity discrimination in the definition of sex discrimination—meaning, among other things, that individuals must be allowed to enter the restrooms, hospital wards, or other gender-restricted areas that are consistent with their gender identity.

Full story of ACA anti-discrimination rule for health care providers at APTA

Senate Committee Hearing on Stark Law Touches on Self-Referral Loophole for Physical Therapy, Other Services

Though there are plenty of political distractions out there, some members of the Senate have not forgotten about problems with the so-called “Stark law” intended to counter abuses of physician self-referral. At a hearing of the Senate Finance Committee this week, legislators talked about how certain provisions of the law, including exceptions that allow for self-referral to physical therapy, may not be in the best interests of Medicare’s shift to value-based models.

The hearing was called by chair Orrin Hatch (R-Utah) to look at the entire breadth of the Stark law, which he characterized as “the embodiment of good intentions muddled with complex execution.” That law prohibits physicians from referring Medicare patients for services or facilities in which the physician has a financial interest, but it contains a loophole for referrals for “in-office ancillary services” (IOAS)—physical therapy, anatomic pathology, radiation oncology, and advanced diagnostic imaging. APTA has long advocated for the elimination of this loophole.

Full story of Stark Law and self-referral loophole at APTA

Highlights of New Home Health Agency Claims Program Posted

Now available to members through the APTA website: highlights and resources to help members prepare for big changes to home health agency (HHA) Medicare claims coming to 5 states.

Beginning with Illinois on August 1, 2016, the Centers for Medicare and Medicaid Services (CMS) will require HHAs to submit supporting documentation for services while beneficiaries still are receiving care. CMS will review the pre-claim and make a review decision. The other 4 states—Florida, Texas, Michigan, and Massachusetts—will be phased into the program during the rest of the year and into 2017. The final version of the program was announced in June.

The new APTA highlights (look under “APTA Summaries”) provide the basics on how the system will work, including information on making submissions, the process for resubmission of a claim that is not affirmed by CMS, and penalties for claims submitted without pre-claim review. Links to CMS resources are also included.

Full story of new home health agency claims program at APTA

Proposed CMS Rule Aims to Tackle Medicare Appeals Backlog

In response to pressure to do something about a growing backlog of Medicare appeals, the Centers for Medicare and Medicaid Services (CMS) has proposed a new rule that it hopes will make the system more functional through, among other measures, expanding ways to set precedent and extending some adjudicatory powers to attorneys.

The proposed rule seeks 2 major changes to the Medicare appeals process: the first update would allow the US Department of Health and Human Services’ Department Appeals Board to select certain cases to be “precedential,” meaning that the rulings would be binding on all future decisions. The idea behind the change is to give those considering making an appeal more resources to help them decide if the effort is worth pursuing, and to provide judges with a body of cases to reference when deciding on new appeals.

Full story of CMS rule and the growing backlog of Medicare appeals at APTA

Study: Could Occupation Affect Leisure-Time Physical Activity Rates?

Here’s the good news: employed adults seem to be meeting national health guidelines for leisure time aerobic and muscle-strengthening activities ahead of a 2020 deadline. Here’s the bad news: that’s an across-the-board average. When you look at the numbers in terms of employment setting and demographics, the picture is less uniformly rosy. Authors of the study that revealed the differences believe the findings point to “barriers” to leisure time physical activity that affect some more than others.

A recently released Department of Health and Human Services (HHS) analysistook a look at adults across the US who reported meeting federal guidelines for both aerobic and muscle-strengthening activities, divided both by demographics and occupational settings—managerial, professional, teaching or social service, services, sales, and production and related occupations. The federal guidelines call for 150 minutes per week of moderate physical activity, or 75 minutes per week of vigorous activity, accompanied by muscle-strengthening activities 2 or more days per week. The HHS Healthy People Initiative has established a goal of 20% of all Americans meeting these guidelines by 2020.

Full story of occupations and leisure physical activity at APTA

Raising the Priority of Lifestyle-Related Noncommunicable Diseases in Physical Therapy Curricula

Given their enormous socioeconomic burdens, lifestyle-related noncommunicable diseases (heart disease, cancer, chronic lung disease, hypertension, stroke, type 2 diabetes mellitus, and obesity) have become priorities for the World Health Organization and health service delivery systems. Health care systems have been criticized for relative inattention to the gap between knowledge and practice, as it relates to preventing and managing noncommunicable diseases. Physical therapy is a profession that can contribute effectively to patients’/clients’ lifestyle behavior changes at the upstream end of prevention and management. Efforts by entry-to-practice physical therapist education programs to align curricula with epidemiological trends toward best health care practices are varied. One explanation may be the lack of a frame of reference for reducing the knowledge translation gap. The purpose of this article is to provide a current perspective on epidemiological indicators and societal priorities to inform physical therapy curriculum content. Such content needs to include health examination/evaluation tools and health behavior change interventions that are consistent with contemporary values, directions, and practices of physical therapy.

Full story on lifestyle-related noncommunicable diseases at APTA

The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 Statement

Abstract We developed a reporting guideline to provide authors with guidance about what should be reported when writing a paper for publication in a scientific journal using a particular type of research design: the single-case experimental design. This report describes the methods used to develop the Single-Case Reporting guideline In BEhavioural interventions (SCRIBE) 2016. As a result of 2 online surveys and a 2-day meeting of experts, the SCRIBE 2016 checklist was developed, which is a set of 26 items that authors need to address when writing about single-case research. This article complements the more detailed SCRIBE 2016 Explanation and Elaboration article (Tate et al., 2016) that provides a rationale for each of the items and examples of adequate reporting from the literature. Both these resources will assist authors to prepare reports of single-case research with clarity, completeness, accuracy, and transparency. They will also provide journal reviewers and editors with a practical checklist against which such reports may be critically evaluated. We recommend that the SCRIBE 2016 is used by authors preparing manuscripts describing single-case research for publication, as well as journal reviewers and editors who are evaluating such manuscripts.

Full statement on BEhavioural interventions at APTA

The TIDieR Checklist Will Benefit the Physical Therapy Profession

Evidence-based practice involves physical therapists incorporating high-quality clinical research on treatment efficacy into their clinical decision-making.1 However, if clinical interventions are not adequately reported in the literature, physical therapists face an important barrier to using effective interventions for their patients. Previous studies have reported that incomplete description of interventions is a problem in reports of randomized controlled trials in many health areas.2–4 One of these studies examined 133 trials of nonpharmacological interventions.4 The experimental intervention was inadequately described in over 60% of the trials, and descriptions of the control interventions were even worse.

A recent study5 evaluated the completeness of descriptions of the physical therapist interventions in a sample of 200 randomized controlled trials published in 2013. Overall, the interventions were poorly described. For the intervention groups, about one quarter of the trials did not fulfill at least half of the criteria. Reporting for the control groups was even worse, with around three quarters of trials not fulfilling at least half of the criteria. In other words, for the majority of the physical therapy trials, clinicians and researchers would be unable to replicate the interventions that were tested.

Full story of TIDieR Checklist and PT at APTA

PT in Motion Magazine Recognized for Editorial Excellence

APTA’s PT in Motion magazine has earned 5 awards from 2 prominent publishing competitions in 2016.

Association Media & Publishing’s annual Excel Awards program handed out 3 awards for article writing:

  • Gold level: “Embezzlement? That Could Never Happen in My Practice,” feature article from May 2015; Keith Loria (freelance writer), author; Don Tepper (PT in Motion editor), editor
  • Gold level: “Coming Clean,” column in the Defining Moment series from February 2015; APTA member Adele Levine, PT, DPT, author; Eric Ries (PT in Motion associate editor), editor
  • Silver level: “A Constructive Approach,” column in the Defining Moment series from September 2015, APTA member Michael Konstalid, PT, DPT, author; Eric Ries, editor

For more on the Excel Awards visit APTA