ADVOCACY

MEDICARE PHYSICIAN FEE SCHEDULE ADVOCACY

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In regards to the Medicare physician fee schedule advocacy efforts of the APTA, we are totally in support of those activities, however, the health disparity consideration shown in a recent Kaiser report in 2021 revealed that black beneficiaries actually had higher healthcare cost related issues in comparison to white beneficiaries. So, as CMS considers reducing payments to not just physical therapists but other Healthcare Providers, ultimately that will cause a trickle down to Black beneficiaries disproportionately impacting their care. Additionally, when we talk about cost-related problems, we’re talking about trouble getting care due to costs that result in delaying care and also problems paying medical bills - all of which just layers on top of a disproportionate presentation of high cost commorbidities in the black community as well.

TELEHEALTH UTILIZATION AND REIMBURSEMENT ADVOCACY

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Another consideration within that Medicare physician fee schedule advocacy efforts is changes to Telehealth utilization and reimbursement. The health disparities consideration there has been shown in regards to survey research (there's an article that was published in 2021, the last author was Denise Anthony) that show that in their survey project that black respondents reported that they were more likely to use Telehealth during the covid-19 pandemic. There are also other studies that are showing that Telehealth is going to address our consideration and our concern related to rehab deserts within many of these underserved or not served communities.

MEDICARE PAYMENT DIFFERENTIAL SERVICES PROVIDED BY PTAs

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In regards to the medicare payment differential for services provided by PTAs, this is actually an issue that will substantially impact African American, black communities, and really rural communities as well because it is often PTAs that are providing a large percentage of the care in those areas. There are some that argue that by doing this we're going to push PT's into those areas, but that is not true based on what we see from existing practice data. Therefore, there is the potential that we are removing their primary care providers in these underserved areas.

EDUCATION AND WORKFORCE ADVOCACY

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​The Education and Workforce advocacy efforts that are going on with the Physical Therapist Workforce and Patient Access Act and the Allied Health Workforce Diversity Act - these are two acts that will potentially significantly impact racial and ethnic students within the physical therapy profession. The Thurgood Marshall College Fund published a report (it's actually up on their website, they use College pulse data) that talked about the fact that nearly 3 in 10 college students are solely responsible for paying all of their higher education costs. They reported that the number was even higher for Native American, Black, Hispanic, and Latino college students. So, when we're looking at these advocacy efforts that could potentially allow us to participate in the National Health Services Corps Loan Repayment Plan and also provide scholarships and stipends for recruitment. This is definitely a workforce diversification issue and it definitely is a black and brown issue. It would be nice to put that information even more clearly and concisely out in the APTA’s website and also in their main messaging. 

THE HEALTH INFORMATION TECHNOLOGY ADVOCACY​

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The Health Information Technology Advocacy work the APTA is currently pursuing there is no doubt that there is a health disparity component. Normally, rural persons of lower-income, persons from racial and ethnic minority groups - we find their care is often fragmented. We find that their care is also influenced by implicit bias. So, as we start to build, utilize, and engineer the use of Health Information Technology into the delivery of care, we will see the following changes. Number one, that is going to allow healthcare practitioners to be able to see the complete picture, which is going to be needed to provide high-quality, individualized care. Number two, it is going to allow us to minimize the influence of implicit bias in that care. If you put in all of the metrics that may have been done during that care episode, the system can tell you what is best practice and what would be considered high quality care., If you choose to do something differently than the system, it will make you give a reason for that which will hold us accountable to high quality care. By engineering some of that into the delivery of physical therapy, hopefully it will decrease implicit bias, which the literature suggests plays a strong influence on healthcare outcomes.