Posts tagged health care costs
Pre Operative Expenses Linked To Post Operative Expenses After Hip Surgery
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Arthroscopic hip surgery is one of the fastest growing orthopedic surgical procedures today. This procedure is commonly utilized to treat hip impingement and hip labral tears. The rapid growth of surgery for this condition is thought to result from both an increase in surgeons trained in hip arthroscopic surgery, as well as, the increased utilization of MRI scans. Experts have expressed concern over these increases in surgical rates due to the large numbers of pain free athletes and patients who show impingement and labral tears on MRI, but remain asymptomatic. One of the key indications for surgery remains failure of conservative treatments including high level, evidence based Physical Therapy. Patients who are unable to return to a desired level of activity or play may opt for the surgery after completion of this Physical Therapy program. A recent study reports on the pre and post operative costs associated with this procedure.

Clewley and colleagues performed a retrospective analysis of pre and post operative costs in 1850 patients who elected for hip arthroscopic surgery over a 12 year period (JOSPT. 2018). Authors found significant differences in costs and health care use between high and low health care utilization groups. In addition, authors found patients who utilized greater amounts of care before the procedure were more likely to use greater amounts of healthcare after the procedure. As expected, the higher utilization group spent significantly greater amounts of money for their associated care compared to their lower utilization peers. Future research is needed to determine the psychosocial and behavioral traits associated with higher health care expenditures.

Physical Therapy First Reduces Opioid use, ER visits, and Healthcare Costs in patients with low back pain
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The evidence and momentum continue to build for seeing a Physical Therapist first for patients with low back pain.  Physical Therapists have continually been shown to be clinically and cost effective providers for low back pain conditions.  This approach, direct access to Physical Therapy, has been utilized by large hospital systems and Fortune 500 companies to both accelerate a patient's recovery and reduce health costs.  Studies report up to $1500 in cost savings when using this approach secondary to decreased utilization of health care services include office visits, medications, imaging, and surgery.

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A recent study followed patients with a recent onset of low back pain over a one year period (Frogner et al. Health Services Research. 2018).  Participants healthcare utilization was calculated based on whether they saw a Physical Therapist first, a Physical Therapy later, or were not prescribed Physical Therapy.  Consistent with the existing literature, patients who were seen by a Physical Therapist first had a 90% lower probability of being prescribed an opioid, as well as, lower rates of emergency department and imaging services.  The lower utilization of healthcare services were reflected in the significant cost savings found in the PT first group.

Contact the experts at MEND to learn how to resolve your low back pain symptoms

Choosing Physical Therapy First For Low Back Pain Saves $1500 Per Episode Of Care
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In previous blog posts, we have described the clinical and financial benefits of seeing a Physical Therapist first for treatment of neck or low back pain.  Patients who choose Physical Therapy first experience accelerated recoveries with decreased pain and recurrence rates compared to other providers.  In addition to the clinical benefits, this patient group is also less likely to undergo unnecessary, expensive, and risky interventions such as imaging, injections, and opioid medications.  Taken together patients seen by Physical Therapists first spend significantly less for the same or better recovery compared to other providers.

A recent article in the Journal of Orthopedic and Sports Physical Therapy followed 600 patients with either neck or low back pain to determine the cost and clinical effectiveness of seeing a Physical Therapist or Primary Care Physician for their care  (Denninger et al. 2017).  Authors reported patients see by direct access or patient self referral to Physical Therapy services spend on average $1543 less than those seen by a primary care physician.  Importantly, both groups demonstrated similar improvements in pain and disability.  This study highlights, the cost savings patients can experience if they choose Physical Therapy first for both their neck and low back pain.

Patients Who Seek Care from Physical Therapists Are Less Likely To Use Opiates
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Some of the highest quality Physical Therapy research details the effectiveness of our profession treating patients with neck pain.  Patients can expect an accelerated recovery with less short and long term pain if they see a Physical Therapist for their neck symptoms.  In addition, Physical Therapy interventions including manual therapy and exercise are about 1/3 the cost of seeing a primary care physician first for neck pain.  Recent research is also highlighting other important benefits of seeing a Physical Therapist first for neck pain.

Researchers from Duke University analyzed 1700 patients with neck pain to determine which interventions and providers they utilized during their course of care (Horn et al. Proceedings: Innovations, Quality, and Outcomes).  The authors reported patients chose to see either their Physical Therapist, primary care physician, specialist, or chiropractor as the first provider in their care.  Patients seen by a Physical Therapist first were less likely to receive opioid medication in the first year after the onset of their symptoms.  In addition, these patients were less likely to use more expensive, risky, and invasive procedures for their neck pain including injections compared to patients seen by physicians.

This study highlights the importance of patient self referral to Physical Therapy for neck pain symptoms. 

Cost Effectiveness of Low Back Pain Interventions
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Low back pain is the second most common reason patients seek care from their primary care physician.  In addition, it is one of the most common reasons people seek care at our Boulder Physical Therapy practice.  Due to its' high incidence in the population, low back pain has become a significant financial burden on our health care system costing tens of billions of dollars each year.  The cost of low back pain treatments is higher than the amount we spend on cancer each year.  Due to this cost, we need to provide patients with both clinically and cost effective treatments.

Physical Therapy remains an effective treatment of choice for many patients with low back pain.  Interventions supported by the medical research literature include patient education, spinal manipulation, and exercise interventions.  A recent article also highlights the cost effectiveness of these Physical Therapy interventions.  Andronis and colleagues reviewed the cost effectiveness of common conservative (excluding medication) treatments for low back pain (Appl Health Econ Health Policy. 2017).  The authors concluded education, exercise, and spinal manipulation remain cost effective treatments for patients with low back pain.  To learn more about how Physical Therapy can help you alleviate your low back pain contact your local Physical Therapist.

Individualized Physical Therapy Saves Money Compared to Usual Care for Low Back Pain
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As healthcare costs continue to rise, all stakeholders (patients, providers, and payers) are looking for ways to reduce costs associated with common conditions.  In our field, we commonly see patients given generic, one size fits all exercise programs for common conditions including low back pain.  Our previous post highlights the limitations of this approach including providing incorrect, inadequate, and sometimes harmful exercises to patients without a proper Physical Therapy examination first.  In addition, patients provided these incomplete, generic exercise programs will often spend additional healthcare resources in the coming months looking for relief of their symptoms.  

A recent research article in the journal Spine compared the effectiveness of individualized Physical Therapy services to guideline based advice for patients with low back pain. (Hahne et al. 2016).  300 patients were randomized to one of the two groups then were followed for 1 year to determine the effectiveness and cost of each treatment group.  Patients treated with Physical Therapy reported higher levels of health benefits at a lower cost than the guidelines group.  Specifically, patients missed fewer work days at a savings of close to $2,000 per worker.  This study adds to the existing data on the importance of individualized Physical Therapy for patients with low back pain