Skip to main content
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Digital Health
    • Transformation
    • ESG
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Blogs
    • AI
    • Deals
    • Layoff Tracker
    • HIMSS 2023
  • Opinion
    • Breaking Bias
    • Commentaries
    • Letters
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - AI and Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Sponsored Video Series - One on One
    • Sponsored Video Series - Checking In with Dan Peres
  • Data & Insights
    • Data & Insights Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • Newsletters
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
June 03, 2014 12:00 AM

Physical therapy services up 30%, but self-referrals not to blame

Andis Robeznieks
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print

    Physical therapy services provided to Medicare beneficiaries increased by almost 30% between 2004 and 2010, but unlike other healthcare service-utilization increases, self-referring physicians were not the cause for the jump, according to a new U.S. Government Accountability Office report.

    About 4.3 million Medicare beneficiaries received outpatient physical therapy treatments worth $4.1 billion in 2011. And, according to the GAO, the number of physical therapy services provided per 1,000 Medicare fee-for-service beneficiaries increased from 1,223 in 2004 to 1,595 in 2010. While the number of services generated by self-referring family physicians, internists and orthopedic surgeons stayed flat at 320, the number of non-self-referred services grew by 41% from 903 in 2004 to 1,275 in 2010.

    This is in stark contrast to the findings of three other GAO reports on self-referral for diagnostic imaging, anatomic pathology services and intensity-modulated radiation therapy, or IMRT, for prostate cancer. In those sectors, utilization increased among physicians who referred patients to a facility that they or a family member had a financial interest in.

    The GAO examined 2004-10 Medicare Part B claims for family physicians, internists and orthopedic physicians—the specialties that account for almost 75% of all physical therapy referrals. It identified the number of physical therapy services referred per provider, the number of beneficiaries referred, and the number of physical therapy services received per beneficiary.

    The GAO found that self-referring physicians in all three specialties generally referred more patients for physical therapy, but their patients, on average, received fewer services than doctors who didn't do self-referring.

    Expenditures for self-referred services increased 10% during the study period from $389 million to $428 million. The cost of non-self-referred services increased about 57% from $1.2 billion to $1.9 billion.

    “One potential reason for this difference is that non-self-referred PT services can be performed by providers who can directly influence the amount, duration and frequency of PT services through the written plan of care required by Medicare,” the GAO concluded. “In contrast, non-self-referred services we examined for our prior work tend to be performed by providers who have more limited ability to generate additional services or referrals.”

    Radiologists, for example, do not have the discretion to order more or more-intense services, the GAO noted.

    The report also cited comments made by the associations whose specialties were examined in the report. The American Academy of Family Physicians considers physical therapy a more cost-effective and less invasive way to treat patients than surgery or prescribing opioids to manage pain, the report noted.

    Nine states changed their laws on self-referring during the study period and that may have affected its findings, the American Academy of Orthopaedic Surgeons said. The AAOS also noted that they are on the low end of self-referral among the “switchers,” physicians who changed from non-self-referral to self-referral status during the period studied. The GAO noted that, between 2008 and 2010, orthopedic surgeon switchers increased referrals by about 4% while the rate was 18% and 20% for internists and family medicine switchers.

    The GAO also noted that the American Physical Therapy Association “expressed concern” about the findings because the study did not take into account patient condition, physical impairments or co-morbidities, which it said have a major correlation to the amount, duration and frequency of treatment.

    Follow Andis Robeznieks on Twitter: @MHARobeznieks

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Rob Allen Intermountain 23
    Intermountain's Graphite Health may be AI 'grounding point,' CEO says
    Nursing home wheelchair
    4,000 Michigan nursing home beds at risk in proposed staffing mandate
    Most Popular
    1
    CMS tries luring providers to revamped Medicare ACOs
    2
    Oregon joins other states in setting ratios for nurse staffing
    3
    Blue Shield CA taps Amazon, Mark Cuban, CVS for new PBM model
    4
    A health innovation hub grows in Lake Nona Medical City
    5
    Hospital-at-home providers push for Medicaid coverage
    Sponsored Content
    Modern Healthcare A.M. Newsletter: Sign up to receive a comprehensive weekday morning newsletter designed for busy healthcare executives who need the latest and most important healthcare news and analysis.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Help Center
    • Advertise with Us
    • Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Digital Health
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • ESG
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Blogs
      • AI
      • Deals
      • Layoff Tracker
      • HIMSS 2023
    • Opinion
      • Breaking Bias
      • Commentaries
      • Letters
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - AI and Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Sponsored Video Series - One on One
      • Sponsored Video Series - Checking In with Dan Peres
    • Data & Insights
      • Data & Insights Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • Newsletters
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Jobs
      • People on the Move
      • Reprints & Licensing