Adherence to Physical Therapy Program for Low Back Pain Can Reduce Overall Medicare Spend

Study: Adherence to a Physical Therapy Program for Low Back Pain Can Reduce Overall Medicare Spend

A study by the Alliance for Physical Therapy Quality and Innovation (APTQI) shows that people suffering from lower back pain who adhere to a standard physical therapy regimen with multiple visits cost less in overall Medicare expenditures than do patients with fewer outpatient therapy sessions.

“These latest findings suggest that the intensity of physical therapy in terms of the number of visits, is inversely related to the total Medicare spending,” said Erik Williams, Executive Director of APTQI. “This study is one more indicator that sticking with a physical therapy program can help patients ease the pain in their lower backs as well as their wallets. Those in charge of insurance design should be looking at ways to remove barriers to physical therapy and improve attendance, not the other way around.”

The independent analysis, conducted by health care research firm The Moran Company (TMC), assessed 38,260 Medicare patients. All patients had a lower back pain diagnosis and an outpatient physical therapy visit in the year following their diagnosis.

Approximately 22 percent of those patients had a single therapy visit. The remaining patients averaged 9.1 therapy visits over the course of eight weeks. Patients with multiple visits incurred 14-32 percent lower average total Medicare spending in the year following their diagnosis than patients with one therapy visit in the same timeframe.

The study also found that 94 percent of the patients who had more than one therapy visit spent an average of $625 for outpatient therapy services. That fee is lower than the typical cost of an MRI or other diagnostics that don’t resolve the condition.

Total Medical Spend Based On Physical Therapy Visits

Visits

1

2-4

5-8

9-12

13+

Cost

$14,954

$12,912

$10,361

$10,221

$12,013

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