Image of senior woman receiving physical therapy from therapist on exercise mat
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The use of physical therapy following a fall-related injury significantly reduces the rate of serious new injuries, related opioid use and healthcare costs among falls-prone patients, a new study has found. The results support the case for Medicare coverage of annual falls risk screening, PT industry advocates say.

The study was conducted by consultant The Moran Company for the Alliance for Physical Therapy Quality and Innovation (APTQI). Investigators analyzed data for Medicare fee-for-service patients with musculoskeletal conditions such as osteoporosis, hip and/or pelvic fracture, Parkinson’s disease and mobility impairments. Beneficiaries had not received PT via skilled nursing facilities, home health agencies or other providers for their musculoskeletal conditions in the six months prior to their initial falls-related injury.

ED visits cut by half

The researchers tracked receipt of PT after the initial injury. Results showed that repeat, injury-related emergency department visits and hospitalizations were half as likely to occur in the six months following a fall when the injured patient received PT. 

Patients were also 39% less likely to use opioids during that time period, the researchers reported. Although the effects declined over a longer time period, the risk for subsequent ED visits, hospitalization and opioid use continued to remain lower at 18 months when compared with the risk for patients who received no PT.

Cost savings 

In addition, investigators estimated that total healthcare savings would be substantial, at $61,400 to $91,900 per 100 additional fall-prone beneficiaries based on reduced use of hospital services after PT alone. There was no link found between reduced demand for opioids and meaningful decreases in opioid spending. Study results were controlled for age, gender, race and dual eligibility status.

The findings support the need for greater investment in PT at a time when Medicare has chipped away at coverage for services, Nikesh Patel, PT, DPT, executive director of APTQI told McKnight’s Clinical Daily. Coverage for falls risk screening would be a good starting point, he said.

An ask for Medicare

“Currently, a Medicare beneficiary is not able to receive an annual fall risk screen from a physical therapist at no cost. APTQI believes that the results of this analysis show that allowing such a benefit would prevent falls and reduce overall costs to the system,” he said in an email.

PT after an injury improves patients’ balance and strength, and physical therapists are well positioned to identify and educate patients about hazardous conditions that increase falls risk, Patel added. 

“As therapy practices have been subject to significant rate cuts over the last few years, it’s important to educate policymakers about the value that therapists can provide to seniors in need,” he told McKnight’s.

Falls are the leading cause of injuries and injury death among adults aged 65 years and older in the United States. Falling once doubles the chances of a repeat fall in this age group, according to the Centers for Disease Control and Prevention.

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