Where Things Stand, What APTA’s Doing: Fee Schedule, SNF, and HH Rules From CMS

The Centers for Medicare and Medicaid Services (CMS) spends much of its spring and summer churning out regulatory rules for the coming fiscal and calendar years. That means it’s an equally busy time for APTA, its members, and other stakeholders to stay on top of the proposals, respond to whatever challenges emerge, and advocate for change when needed.

This year’s standout challenge: advocacy efforts around the CMS proposed physician fee schedule (PFS). The rule as proposed includes at least 2 troubling provisions that demanded a strong response—1 around how CMS would go about determining whether therapy services were delivered “in part” by a physical therapist assistant (PTA) or occupational therapy assistant (OTA), and another that proposes an estimated 8% cut to reimbursement for physical therapists (PTs) and several other professions.

APTA has been aggressively fighting these changes through comments, creating a platform to facilitate a flood of individual member letters to CMS, multiprovider organization sign-on letters, meetings with CMS representatives, and the latest: a bipartisan letter signed by 55 members of Congress urging CMS to rethink the cuts.

Full story at APTA

Wrist-worn step trackers accurate in predicting patient health outcomes

Determining how far patients with pulmonary disease can walk in six minutes has long been an effective clinical tool to help physicians determine their exercise capacity, as well as to aid in predicting health outcomes and mortality.

Now, in a new study, researchers at Intermountain Healthcare in Salt Lake City found that steps measured through a step tracker worn on the wrist can be used to estimate exercise capacity and determine the health status of patients, rather than the standardized six-minute walk distance test, which is usually conducted in a clinical setting.

Using the wrist-worn step trackers, researcher found data may be used in clinical care at higher intervals to effectively monitor patient progress and disease management. Researchers say the results are another example in how wearable and monitoring devices like Fitbits and Apple Watches can be used in patient care to improve outcomes.

Full story at Medical Xpress

CMS Releases a Burden Reduction Rule That Affects a Wide Range of Facilities, Settings

The big picture: An omnibus rule that could ease some regulatory burdens
The US Centers for Medicare and Medicaid Services (CMS) has released a final rule aimed at reducing Medicare- and Medicaid-related regulatory burdens in a range of settings, from hospitals to home health care. And for the most part, the rule hits its target.

The final rule includes provisions related to outpatient rehabilitation facilities, home health agencies, ambulatory surgical centers, hospitals, CAHs, psychiatric hospitals, transplant centers, X-rays, community mental health clinics, hospice care, and more. For the most part, the changes either lift or relax requirements, giving facilities more leeway in meeting reporting and other duties. CMS estimates the changes will save providers 4.4 million hours of paperwork time and result in $800 million in savings annually.

Full story at APTA

Imagining Grasping May Help Restore Hand Function in Spastic CP Children, Study Suggests

Children with unilateral spastic cerebral palsy (CP) have a preserved ability to imagine grasping with both hands, according to a new study.

The findings suggest that tapping into that ability during rehabilitation therapy could help recover hand function and upper limb movements in children with CP.

The research, “Explicit Motor Imagery for Grasping Actions in Children With Spastic Unilateral Cerebral Palsy,” appeared in the journal Frontiers in Neurology.

Children with unilateral CP, who have one side of their body affected by the movement disorder, have shown impairments in motor imagery (MI) — imagining a motor action without actually moving.

Full story at Cerebral Palsy News Today

Scientists identify a personality feature that could predict how often you exercise

Individuals who make concrete plans to meet their goals may engage in more physical activity, including visits to the gym, compared to those who don’t plan quite so far ahead, research shows. These research findings, published in Psychological Science, a journal of the Association for Psychological Science, suggest that self-reported levels of a trait called ‘planfulness’ may translate into real world differences in behavior.

Some people seem to be able to more consistently meet their goals than others, but it remains unclear if personality traits that have been found to promote goal achievement in the lab similarly encourage individuals to achieve long-term goals in their day-to-day lives, says lead researcher Rita M. Ludwig of the University of Oregon.

Conscientiousness, a measure of individuals’ orderliness and dependability on the Big Five Inventory of personality, has long been tied with healthy behaviors, notes Ludwig and colleagues Sanjay Srivastava and Elliot T. Berkman, also of the University of Oregon. Narrowing their focus to a single facet of this trait, planfulness, allows researchers to zero in on the psychological processes—such as mental flexibility, and a person’s ability to make short-term sacrifices in pursuit of future success—that contribute directly to achieving long-term goals.

Full story at Medical Xpress

Walking patterns may help differentiate types of dementia

The causes of dementia can damage the brain in different ways. Is it possible that these differences may reveal themselves in the way that people walk? A new study that compared walking patterns in people with two types of dementia explored the question.

“Alzheimer’s and Lewy body disease have unique signatures of gait impairment,” state the authors in a recent Alzheimer’s & Dementia paper about their findings.

The researchers suggest that the unique impairments to gait — or alterations to walking pattern — may reflect the specific damage that each disease inflicts on mental function and the brain.

Full story at Medical News Today

Advancements in pain management are giving new options to patients

Hardly a day goes by without the public being warned about the dangers of opioids. But still, according to the National Institute on Drug Abuse, more than 130 people die every day of opioid overdose and the problem is getting worse. A Houston Methodist pain specialist says new advancements in pain management are giving patients options.

Chokshi says if a doctor only prescribes pain medication for chronic or severe pain, it’s important for patients to ask three questions:

  • Are there any alternatives to pain medications?
  • Can we reduce the dosage of the pain medications by combining them with other treatment options?
  • What is the plan for weaning me off of the medications?

Full story at News Medical

Falls Awareness Week: An Ounce of Prevention Is Worth a Pound of Cure

According to the Centers for Disease Control and Prevention, emergency departments treat 3 million older adults for falls each year. More than 800,000 patients are hospitalized after a fall, approximately 20% of falls result in serious injuries, and falls are the second leading cause of accidental or unintentional injury deaths worldwide. Despite these often preventable statistics, individuals enrolled in Medicare often are not screened for risk of falling at their annual wellness visit.

Currently, during the initial annual wellness visit, a provider is required to assess an individual’s functional ability and level of safety with regard to the ability to successfully perform activities of daily living, falls risk, hearing impairment, and home safety. However, the Centers for Medicare and Medicaid Services (CMS) does not require functional status and safety assessments in follow-up wellness visits, in part due to the fact that the United Stated Preventative Services Task Force (USPTSF) has not proffered a recommendation for such.

Full story at APTA

Most kids can manage pain after surgery without opioids

About one in five kids are prescribed opioids after common pediatric surgeries, but a new study suggests they may do just as well with alternative pain relievers like acetaminophen or ibuprofen.

From 1999 to 2016, opioid-related overdoses rose by 250% among children and teens in the U.S., prompting widespread efforts to curb use of these addictive narcotic painkillers. Even though acute pain after surgery is the most common reason opioids are prescribed for kids, it’s not been clear how well this type of pain relief stacks up against other options, researchers note in JAMA Surgery.

For the current study, researchers asked caregivers of 404 kids under age 18 to log how often children took prescribed painkillers and whether the caregivers felt their pain was well controlled.

Full story at Reuters

Calorie restriction plus exercise can make bones more fragile

Calorie restriction, especially in combination with exercise, can make bones smaller and weaker, according to new research in mice.

In contrast, exercising while on a full calorie diet can benefit bone health, say the researchers.

They describe their investigation and its results in a recent Journal of Bone and Mineral Research paper.

“These findings were somewhat of a surprise for us,” says senior study author Dr. Maya Styner, an associate professor of medicine at the University of North Carolina at Chapel Hill.

Full story at Medical News Today