Open Letter
OPEN LETTER TO PATIENTS FROM VINCE HANNEKEN, PT
Hello, With this issueweareputtingsomeattention on the world of insurance. Insurance is a key factor in how each of you can access the important benefit of physical therapy. Depending on your age each of you have some attention on the future and how you will be able to sustain your physical ability through time. There are many opinions and treatment philosophies on aging and health. Diet, exercise, stressmanagement, and medications along with the helping disciplines (PT, massage, physicians, and chiropractic) are all variables people use to some degree to sustain their ability to be active and feel good. Central to getting help is how will your insurance cover the cost of the help you choose? To access the benefits of your plan, it is important to understand the language of insurance. To help in this regard, our insurance verification person, Lori, has put together a short article on insurance terminology, how billing, collections work, and medical necessity. Your knowledge in this area can be helpful to not feel overwhelmed with this often foreign but important part of your benefits. Inour practice, about 40%of our patients are over 65 and access their health coverage through the various Medicare plans. I am writing today to discuss in brief Medicare’s current plan to cut reimbursement for physical and occupational therapy by 9% for the upcoming year. This will represent a 9% reduction in our fee schedule which determines how we get paid for one of your treatments. I think we are all pretty aware of how much waste there is in our federal government’s programs. A great example is, “By far the largest example of wasteful spending is the $48 billion in improper payments in the Medicare system. These payments include an international scheme to defraud the federal government out of $1.2 billion by chargingMedicare orthopedic
braces doctors prescribed “either without any patient interaction or with only a brief telephonic conversation with patients they had never met or seen.” (1). That example is sad since those are fraudulent schemes, but there are actual approved expenditures for outlandish programs like nearly $500k for studying the mating calls of the Panamanian frog. So howmuch federal money is spent with no return to our society? Those are tax dollars that should benefit those who pay taxes. Last I knew, no frog has ever paid any U.S. taxes or people living in Panama. As far as effectiveness and benefit per dollar spent, physical therapy provides
which patients attend PT appointments can also impact cost. Patients diagnosed with lower back painwho visited a physical therapist between 9-to-12 times reduced Medicare Part A/B spending by 32% compared with beneficiaries who only attended a single appointment.”(2) So, it is frustrating to see how these cuts could unfairly affect how we are going to be able to deliver quality care to each of our Medicare patients especially in light of how money is so wastefully spent in our federal government. In effect there is not a lack of money if we can study frogs in Panama, its more about distribution and valuing what we do.
and we got paid. So, don’t doubt the power of your voice. Life often works like a pendulum; we try to help you feel and function better and now the pendulum reverses and we need you to help us. Listed below is the contact data for our legislators, and even the President. Let’s let them know how important PT is for everyone and that it is one of the few federal programs that actually saves them money in the long run unless you feel better knowing more about the mating calls of frogs in central America. Thank you for your time and attention. To wellness, Vince Hanneken, PT Owner Bill Huizenga https://huizenga.house.gov/contact/ Gary Peters https://www.peters.senate.gov/ contact/email-gary Debbie Stabenow https://www.stabenow.senate.gov/ contact Donald Trump https://www.whitehouse.gov/contact/ 1. https://www.ourpursuit.com/senator-pauls- latest-oversight-report-finds-50-billion-in-wasteful- spending/ 2. Physical therapy episodes for low back pain: Medicare spending and intensity of physical therapy services. The Alliance for Physical Therapy Quality and Innovation. aptqi.com/ wp-content/uploads/2019/03/APTQI-Complete- Study-Physical-Therapy-Episodes-Lumbago- October-2017.pdf. Published October 2017.
“Last I knew, no frog has ever paid any U.S. taxes or people living in Panama.”
one of the best rate of savings for the federal government of any of their programs because it makes people more able and self-sufficient as they get older thus reducing the need for expensive assisted living facilities and surgeries. As an example of this savings here is a study summary of cost to benefits, “According to a study conducted by the Moran Company, use of PT as a first intervention for lower back pain resulted in 19% lower costs to the Medicare program when compared with injections as a first intervention, and 75% lower costs when compared with surgery as a first intervention. Beneficiarieswho received PT early (within first 15 days of their diagnosis) had lower average treatment costs than those who began PT later.5 In fact, those beneficiaries who received therapy within the first 15 days (compared to 45-90 days post diagnosis) had downstreamcosts that were 27% lower on average. Further, the evidence suggests that the frequency in
Here is where you come in and where we have been communicating to our legislators. Getting more key people to value what we do is the pivot point to change. There is not a valid reason why they are cutting our reimbursement. Don’t forget, you are the one who paid into Medicare for decades, it is your money paid in check after paycheck that has been funding it (although they havewritten IOUs against it to fund frog studies and the like). I am putting the names and contact information for our legislators for you to contact and will try to make it easy for you. If you access our digital newsletter on line you can just copy and paste these addresses and then communicate your opinion. Your voice is listened to the most by them. I remember once we were having trouble getting paid by a federal military program and so we wrote letters starting at the top with the President all the way down to the department and our legislators. Wow, I was amazed how I got a response
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