Better way to determine proper post-acute therapy duration and intensity discovered, researchers say

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Academic researchers say they have devised a more accurate way to determine “optimal” levels of therapy for post-acute patients. The method also can better judge therapy intensity, investigators from the Washington University School of Medicine said.

Tiny devices called accelerometers attached to patients' lower extremities are the key, researchers said. Their original goal was to compare experimental high-intensity therapy to standard-of-care therapy.

The new method “provides an objective, reliable, and valid index of physical activity during PT and OT treatment sessions that has utility as a real-world alternative to the measurement of treatment intensity,” Helen H. Host and fellow researchers noted in the most recent issue of the journal Physical & Occupational Therapy in Geriatrics. Twenty-six older patients with a variety of diagnoses were studied.

Regulators and lawmakers have increasingly scrutinized long-term care therapy providers after certain billing practices were brought into question. A variety of regulations and reimbursement policy changes have resulted in recent years.

For example, skilled nursing facility therapy billings in the Ultra-High RUG category increased steadily and accounted for more than 50% of SNFs' Medicare Part A billed days of service last year, CMS recently reported. In 2011, the proportion of residents classified in the Ultra High group was 44.8%, but that number jumped to 48.6% in 2012. The agency said it will continue to monitor therapy billing patterns and hinted that more policy changes could occur.

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