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Physical and Occupational Therapy Are on the Medicare Chopping Block

— Cuts could be devastating to patient care if Congress doesn't take action

Last Updated December 13, 2022
MedpageToday
A photo of a senior woman using a practice staircase in a physical therapy clinic.

Americans expect the best care from their doctors. Decades of experience, thoughtful interdisciplinary planning, and evidence-based research mean providers are treating them based on widely accepted standards of care.

For example, someone who has experienced a heart attack would never be discharged from a hospital without being prescribed medications to mitigate future cardiac events. A patient with acute pulmonary issues would receive medications and resources for oxygen therapy, if appropriate. Stroke patients receive the acute hospital-based care they need to save their lives, as well as a constellation of other types of care and services to decrease complications and enhance recovery -- pharmacological, dietary, and rehabilitative.

are among the critical standards of care that would be included for all of these patients. These services help form the bedrock of ensuring good outcomes, decreasing secondary injury and complications, and reducing rehospitalizations.

In addition to serving as an important part of post-acute care, physical and occupational therapy provided by licensed therapists can help improve balance and mobility, improve cardiovascular function, reduce pain, and decrease falls. In fact, healthcare associated with falls costs the healthcare system tens of billions of dollars each year -- and exercise interventions by physical therapists have helped to of falls by 31%.

Eliminating or reducing access to physical and occupational therapy due to Medicare cuts would be devastating to patients' health outcomes. Not only would it undermine the standards of care for many conditions, it would also complicate the lives and tenuous health situations of the millions of Americans who depend upon it.

Seniors nationwide, therefore, are about the 4.5% cut to their therapy providers in 2023 under the Medicare Physician Fee Schedule. If this cut is implemented, the physical and occupational therapy community will experience cuts totaling by 2024. The continued practice of annual Medicare cuts threatens the sustainability of the country's physical and occupational providers, especially in rural and underserved areas where they are needed most.

Our nation's Medicare beneficiaries understand how integral physical and occupational therapy are to standards of care -- and they value it deeply. According to a , 9 out of 10 Americans over the age of 65 have favorable views of physical therapists, and the majority see considerable value in the services they provide. Nearly the same number (88%) expressed concerns that proposed Medicare payment cuts may eliminate alternatives for therapy outside of nursing homes and eliminate seniors' ability to age in place. More than three in four respondents (76%) say it is important for them to be able to access their physical therapist when they cannot come into the office for an in-person appointment.

Care professionals across the healthcare continuum -- from skilled therapists to physicians to nurse practitioners and physician assistants -- recognize the negative impact these cuts would have on their patients, and support efforts in Congress to address these cuts in the year ahead.

Bipartisan lawmakers in Congress have introduced legislation to block these harmful cuts from taking effect in 2023, an essential step toward ensuring all Americans can access quality physical therapy and other specialty services. The Supporting Medicare Providers Act of 2022 () would block Medicare's Physician Fee Schedule cuts by providing an additional 4.42% to the conversion factor for 2023.

It's inconceivable to think we can continue to provide thorough care without one of the most essential elements -- therapy. We that Congress will act -- and quickly before the end of the year -- so that our critically important healthcare standards for patients suffering from a multitude of diseases, injuries, and conditions are not irrevocably undermined.

Nikesh Patel, PT, is executive director of the Alliance for Physical Therapy Quality and Innovation.