of Family Medicine and the University of Washington. Her team reviewed 150,000 insurance claims and discovered that patients with low back pain who saw a Physical Therapist first lowered their chance of using opioids by 89%, advanced imaging by 28%, and ED visits by 15%. That’s a significant saving in healthcare costs. Age Matters • People over age 65 account for 14% of the population, but spend 34% of the healthcare dollars (CMS). • 95.7% of people over age 65 have out-of-pocket healthcare expenses. 16.4% pay >$2,000 (CMS). • 97.2% of people over age 75 have out-of-pocket healthcare expenses. 18.6% pay >$2,000. Location Matters An article reviewed a total of 590,000 insurance subscribers and 136,000 Physical Therapy claims. They found that hospital outpatient Physical Therapy departments charged between 41-64% more than private PT clinics for the same service (2014, National Institute for Health Reform). Healthcare services are almost always more expensive in a hospital setting compared to a private facility (Wall Street Journal, 12/27/2018).
Healthcare in the US is a complicated and intricate business. Like an onion, there are many layers. When you start to peel them back, it makes your eyes water, and you want to cry. I’ve compiled some facts and figures about our healthcare spending habits in the US and want to share some of them with you today (sources are cited for your reference). Medications The US spent $3.5 Trillion on healthcare in 2017 (CMS). Of that, 9.8% or $343 Billion was spent on prescription medication. In October 2018, the FDA approved a new synthetic opiate (Dsuvia) that is ten times stronger than Fentanyl and 500-1,000 times stronger than Morphine! This was done despite objections from Dr. R. Brown, the chair of an FDA Drug Product Advisory Committee. In 2016, 42,249 people died from opioid overdoses, and another 49,068 died in 2017. That is a 14% increase (NIH/ CDC). A study has shown that patients experiencing back, neck, shoulder, or knee pain who saw a Physical Therapist early on were less likely to take any opioids for their pain (JAMA Network Open/APTA). The CDC guidelines for chronic pain suggest that conservative treatment, including Physical Therapy, be considered a first-line treatment option vs opioid medication.
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Bianca Frogner, Ph.D. is an associate professor in the Department
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