FOTO Data from Early Stages of COVID Helped Convince Payers to Cover Telehealth

Initial results from last summer and latest data in Physical Therapy Journal making case for ongoing role 

Last year, physical therapists (PTs) experienced a 34% reduction in Medicare Part B payments¹ as a result of decreases in utilization of their services during the pandemic. The use of telehealth – and the corresponding increase in payments for vital services provided – has become essential to ensuring the viability of many PT practices struggling through the pandemic.

Recognizing that data was needed to make the case for telehealth, Focus on Therapeutic Outcomes, (FOTO), a Net Health company, last year launched a landmark research project on the topic.

Preliminary results from the pilot phase of the study, shared with the public in September 2020, suggested that, on average, rehabilitation patients receiving therapy via telehealth methods (videoconference, phone, and email) experienced as much functional improvement, utilized fewer therapy visits, and were just as satisfied as those getting in-person care.

Data Helped Payers Change Reimbursement Policies

This was just the kind of data needed to encourage payers to change long-held reimbursement policies.  Bob Hall, president of Sabre Advocacy and a consultant and advocate for the Private Practice Section of the American Physical Therapy Association (APTA), used the FOTO data to help build the case for acceptance of PT care delivered via telehealth with the five largest private insurers – Aetna, Anthem, Cigna, Humana, and United Healthcare – as well as with regional and state-based payers.

“This was some of the best data we had for our advocacy with private payers and the federal government,” Hall maintains. “At least two companies, Cigna and Humana, updated their telehealth policies within the last year and have made them permanent.

And those include physical therapy. Under the telehealth umbrella is telerehabilitation, or simply telerehab.

The FOTO data has absolutely helped us prove that physical therapy can be delivered effectively via telehealth or telemedicine services and that rehab therapists should have that capability.”

With the changing policies of payers, it’s time to look at what’s next.

Hybrid Models of Care on Horizon

This new paradigm doesn’t mean an end to traditional PT; in-person visits are necessary for effective PT care and will remain hallmarks of the profession.  What we’ll likely see as we all strive to adapt to a new marketplace is a hybrid model that recognizes the importance of hands-on care while incorporating telehealth where it can provide the most value.  

For example, the APTA, Hall and other clinicians believe that two areas of immediate need will be the ongoing opioid crisis, which many fear worsened during the pandemic, and low back pain due to employees working from home. PT has shown it can play an important role in addressing both.

We believe that data is key to ensuring an ongoing understanding of the vital role PT plays in healthcare today and the future.  FOTO will continue to use its resources to analyze critical industry data. Specifically, FOTO’s Patient Outcomes database has proven its value for ongoing studies on telehealth for routine rehabilitation outpatient practice, all while controlling for a comprehensive set of patient characteristics.

To provide further important insights on the value of telehealth during COVID, FOTO recently published a peer-reviewed paper on the topic, Telerehabilitation During the COVID-19 Pandemic in Outpatient Rehabilitation Settings: A Descriptive Study.

Need tips and advice on expanding telehealth in your practice? For more information on FOTO’s research work, schedule a demo with a dedicated solution specialist.

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¹American Medical Association, Policy Research Perspectives, “Changes in Medicare Physician Spending During the COVID-19 Pandemic,” 2021