The much-anticipated changes to the way the Centers for Medicare and Medicaid Services (CMS) conducts its manual medical reviews (MMRs) are under way, with the first round of requests for additional documentation (ADRs) now being sent to providers (here’s a sample ADR).
Here’s what you need to know:
1. The new system targets behaviors.
The old MMR system was automatically triggered when a provider exceeded the $3,700 mark. The new one does not require MMRs for all claims exceeding the threshold, and instead takes a targeted approach, looking at providers who have provided a high amount of hours or minutes of therapy to patients in a single day.
Changes to reporting requirements for inpatient rehabilitation facilities (IRFs) are coming this fall, and the Centers for Medicare and Medicaid Services (CMS) is helping providers prepare.
Now available for free download from CMS: presentation slides from a recent 2-day workshop that explored the ways that reporting on everything from functional abilities to falls will change under rules that implement portions of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. That law, passed in 2014 and supported by APTA, seeks to standardize data collected across postacute health care settings. The new reporting requirements begin October 1, 2016.
Originally presented as a “train-the-trainer” event in mid-May, the meeting’s agenda and all slides can be found by scrolling down the CMS IRF Quality Reporting Training webpage to the Downloads section. The compressed files, all pdf versions of PowerPoint slides, are labelled “IRF Training” 1, 2, and 3. Recordings of the training sessions will be posted to the CMS YouTube site in several weeks.
A first-of-its-kind gathering to explore physical therapy health services research with some of the profession’s top researchers is nearly at capacity, but you still have a chance to tune in remotely.
The Center on Health Services Training and Research (CoHSTAR) is offering a 2-day Summer Institute on Health Services Research June 28-29 at Boston University. Specifically targeted toward training physical therapists in health policy and health services, the institute is CoHSTAR’s first national conference since its inception in 2015.
Events during the institute will include presentations on integrated health care systems, pragmatic trials, health care industry collaboration, hospital and academic collaboration, as well as discussions of ongoing CoHSTAR research projects.
As if the prevalence of arthritis in more than 1 and 5 Americans isn’t challenging enough, now comes information that breaks down statistics at the county level to find that prevalence is very uneven across the US, with rates as low as 15.8% in some counties and more than 33% in others.
The new statistics are part of the US Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report set for release on May 20. That report describes the results of a detailed study of the 2014 Behavioral Risk Factor Surveillance System (BRFSS), a survey of 464,444 noninstitutionalized adults across the 50 states, the District of Columbia, and US territories.
Researchers analyzed the prevalence rates for respondents who answered “yes” to the question “have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?” and found that the overall prevalence rate for US adults is 22.7%.
Ties between moderate-to-vigorous physical activity and cancer prevention may be much stronger than previously thought: according to a new large-scale study, physically active individuals drop their risk of developing 13 different types of cancer by as much as 20%, including risk reduction for 3 of the 4 most-commonly diagnosed cancers worldwide. Additionally, that preventive tie isn’t significantly lessened by a higher Body Mass Index (BMI) or smoking.
The study, published in the May 16 issue of JAMA Internal Medicine, used pooled data from 8 studies in the United States and 4 in Europe to look at the relationship between physical activity (PA) and development of 26 types of cancer among 1.44 million participants who had no cancer at baseline. Individuals tracked in the studies ranged in age from 18 to 98 (average age, 59), with 57% female. A total of 186,932 cancers were included.
The editorial board of The New York Times (NYT) says that Congress has “snapped to attention” and produced a “flurry of legislation” aimed at battling the opioid abuse epidemic, but warns that the efforts need to be backed up by appropriate funding for prevention and treatment—including the use of physical therapy as an alternative approach to addressing pain.
“The House last week passed 18 bills related to opioids, and the Senate approved a comprehensive bill in March,” the NYT states in a May 16 editorial. “The question now is whether Congress will appropriate enough money to address the scale of the problem.”
In addition to pressing for more federal funding for treatment programs, the editorial also calls for greater attention to prevention strategies related to pain treatment, specifically mentioning physical therapy as a nondrug treatment that should be easier for consumers to access and pay for through insurance.
As researchers continue to put together the pieces of the genetic puzzle, physical therapists (PT) can use this knowledge to better assess, treat, and refer patients according to their unique family histories, according to an article in the April issue of Physical Therapy (PTJ), APTA’s science journal.
The “Perspectives” article points out how the instance and progression of chronic disease, including osteoarthritis (OA) and cardiovascular disease (CVD), are affected not only by a patient’s lifestyle and environment, but by their genetics.
Authors explain how, over the past decade, genome-wide association studies have provided insight into the potential for personalized medicine, in which providers can use genetic markers to identify risk factors for certain health conditions. The eventual goal is to offer individualized therapies or preventive strategies.
Authors of a new study say that public health efforts to reduce smoking, alcohol use, obesity, physical inactivity, and irregular sleep may also pay off in reducing the prevalence of low back pain (LBP).
In an article e-published ahead of print in Spine, researchers shared findings from what they believe is the first study to document the association between behavior-related factors and LBP in US adults. Authors gathered data from a series of cross-sectional surveys pulled from the National Health Interview Survey (NHIS), a population that featured adults between the ages of 18 and 85, with a population size totaling 122,337.
When authors cross-referenced individuals with LBP with various behaviors, they found some telling connections. Among them:
It’s not so much like getting a new tool as getting a fully-stocked 5-drawer, 2-cabinet toolchest: that’s the impact of a new offering at PTNow that gives physical therapists (PTs) and physical therapist assistants (PTAs) quick access to point-of-care resources.
The Rehabilitation Reference Center (RRC), now available for free to members, is an easy-to-use system that connects PTs and PTAs with information on diseases and conditions, drug information, patient education materials, exercise images, and practice resources. Designed as a resource that could be used quickly during a PT’s workday, the RRC is updated daily and even contains breaking health care news from HealthDay News.
“The RRC rounds out the offerings at PTNow by giving members quick access to extensive information,” said Anne Reicherter, PT, DPT, PhD, OCS, CHES, APTA senior practice specialist. “It’s a tool that can provide a lot of information very quickly—for example, just before a PT meets with a patient who has a condition that the PT wants to learn more about.”
The Foundation for Physical Therapy (Foundation) now is accepting applications for the 2016 Florence P. Kendall Doctoral Scholarships and the 2016 Research Grants.
The Kendall Post-Professional Doctoral Scholarships assist physical therapists and physical therapist assistants with outstanding potential who are in their first year of post professional doctoral degree studies. The $5,000 awards are given to meet tuition expenses or academic fees associated with a doctoral program. Application deadline is Wednesday, August 3, at noon EDT.
Grant opportunities include:
Magistro Family Foundation Research Grant: $80,000 for a research project investigating physical therapist interventions. A letter of intent is required; applicants will be invited to submit full applications based on content. Letter of intent is due June 1, 2016 at noon, EDT; full application is due Wednesday, August 3, at noon.