Value of PT: Insurance Companies Encouraging More people to Get Physical Therapy.
TRICARE, one of the nation’s largest insurers wants its members to get physical therapy for back pain. They think that treating back pain with PT is so important that they’re willing to waive the cost to their members. That’s a huge deal. When’s the last time you remember an insurance company covering the entire cost of anything?
Let’s dive into back pain treatments and see why TRICARE likes PT so much.
You probably already know that back pain is a common problem. What you might not know is that the medical system isn’t very good at treating it.
“Non-drug treatments like physical therapy” are the first treatment recommended for back pain.
Unfortunately, many providers don’t follow this, and treatments are often recommended based on opinion rather than research.
This means insurance companies and patients often end up spending a lot of money on outcomes that are less than stellar.
Here’s how it usually goes:
You go see your doctor with back pain.
They might give you medication, recommend rest, some stretches, send you for x-rays or an MRI.
Next will likely be a referral to a specialist like an orthopedic surgeon.
Chances are you won’t be having surgery right away, so the specialist will either refer you to PT or back to your PCP where you’ll end up with a PT referral.
The path will look different for each person, but the end result is usually the same – multiple failed treatments, imaging you probably didn’t need, and a delay of weeks or months to get to a physical therapist.
Multiple large studies have looked at the effects of early physical therapy on low back pain with impressive results.
One of them was done in 2006 in Seattle by Virginia Mason Health Center. They teamed up with Aetna and Starbucks to send workers with back pain to see both a physical therapist and physician for their first treatment. The use of MRI dropped by 1/3, people got better faster, missed less work, and were more satisfied with their care. The cost savings were so great, that Virginia Mason was losing money on treating back pain and Aetna ended up paying them more for PT treatments because Aetna was saving so much money.
Intel ran a similar program with their employees, getting people with back pain to a PT within 48 hours. Previously it took about 19 days for people to get to a PT. With the earlier access, patients completed their care in 21 days, compared with 52 days previously, and costs dropped between 10 and 30%. Intel also found more satisfaction with care and a faster return to work.
The data is out there proves physical therapy is the cheapest and most effective treatment for most people’s low back pain.
It’s clear that people with back pain should start treatment with their physical therapist, but most don’t. TRICARE’s pilot program that waives copays for up to three PT visits aims to change that. If successful it will lead to lower costs for both TRICARE and their members while delivering better outcomes in less time. Currently, Molina makes sure their members start PT for their musculoskeletal injuries before they get any other type of treatment such as pain injections. By following such protocols, insurance companies are ensuring earlier access to PT to avoid prolonged disability.
With the success of TRICARE’s initiative to encourage PT for their members, there is a good chance other insurance companies will come up with their own program so more people choose PT over other modes of treatment.
If you are suffering from pain and thinking to start PT, call us now to find out how your insurance might cover your PT treatment.
Do not delay your recovery by worrying about the cost. Take the first step to reduce your pain.
Back pain is a huge problem in developed nations worldwide. It has or will affect most of us.
The current estimate is that 80% of people will experience back pain at least once. It is the single biggest cause for disability and the third most common reason for doctor visits.
It is one of the most common reasons for missing work.
Even locally in south-east Michigan, back pain is one of the most common condition that people suffer from.
In Sterling Heights, Michigan, where we are located, we have seen many patients suffering from back pain. Total cases of lower back pain is much higher than any other conditions people suffer from.
Back and neck pain makes up the biggest healthcare expense in the US
With higher number of cases of lower back and neck pain it is also very expensive.
Back and neck pain makes up the biggest healthcare expense in the US, totaling $134 billion spent in 2016.
The next two most expensive conditions were diabetes — $111 billion in spending — and ischemic heart disease at $89 billion.
Diabetes and heart disease being so expensive to treat doesn’t surprise most folks – they can both lead to other major problems, require long term medication, could require surgery, and both can be fatal.
Back pain won’t kill you, usually doesn’t require long term medication, and usually doesn’t require surgery either.
Then why is it costing this much to our healthcare system?
Why is it so expensive?
The first reason is that it’s so common.
The second reason is that our current system isn’t very good at treating it.
Current recommendations include starting with activity modification, and active treatments like physical therapy. Research backs this up, showing better outcomes and lower costs with early PT.
Unfortunately, only 2% of people with back pain start with PT, and only 7% get to PT within 90 days.
At the same time, a study looking at about 2.5 million people with back pain in JAMA showed that 32.3% of these patients received imaging within 30 days of diagnosis and 35.3% received imaging without a trial of physical therapy.
Both of these things go against current practice guidelines for treatment of back pain.
Current trends that we have noticed includes medications, followed by injections to treat back pain by the PCP and if that does not solve the problem may be patient will be referred to PT.
A Major Reset is Needed to Change The Healthcare Mindset.
A major reset is required to change the healthcare practice and to treat back pain and other musculoskeletal conditions in general.
It is important that not only patients byut
A new pilot program being rolled out by TRICARE, the insurance system used throughout the US military is waiving the payment owed by the patient for up to three PT sessions in an attempt to improve the use of what the Defense Health Agency calls “high value” treatment for low back pain.
The theory is that once a person sees some benefit from PT treatment, they’re likely to go back for more.
This is the “try it before you buy it” approach – think of the 7-day free trial Netflix offers, free samples poured in wineries and craft breweries, or the folks you see standing around in supermarkets with food on toothpicks. TRICARE’s data seems to indicate that it works just as well for healthcare as it does for other businesses.
In a press release they state that once people attend one session of physical therapy, they’re likely to go back for more, no matter what their co-pay is.
But TRICARE found that higher co-pays could be a barrier to people trying that first visit. For the group of patients with the highest co-pays in the system, only 38% of the people prescribed PT attended the first visit. That’s about half the rate of attendance found in the lowest co-pay group.
The fact that such a major insurer is looking into the value of PT is great news for everyone.
If TRICARE can show that lowering the cost of PT for patients can improve outcomes and save insurance companies money, other major insurers will likely follow.
This could improve the lives of millions of people every year while reducing the huge cost of treating low back pain for the country.
That seems like a win for everyone involved.
Share your thoughts here by commenting. We will love to hear your thoughts.
Are you suffering from lower back pain?
If you are suffering from back pain and trying to find your option.
Start by scheduling a free Discovery Visit now.
Just click on the link below and fill out a contact form or call us at (248)432-1618 and we will get in touch with you soon.
Lower back pain is a sensation all too familiar to millions of people. This ache can hinder many aspects of your life: working, spending time with friends and family, partaking in the activities you enjoy, and even just relaxing. The World Health Organization estimates that in the United States, 149 million days of work are lost due to low back pain. It is the leading cause of inactivity among adults, and it can result in other health issues if left untreated. It is also extremely common, appearing in 60-70% of people across industrialized nations.
If lower back pain is plaguing your everyday life, it is important that you find relief as soon as you can. For more information on how we can help get you back to a pain-free life, call ActiveKare Physical Therapy in Sterling Heights, MI, today.
How can physical therapy help?
Physical therapists focus specifically on pain and injury to help their patients regain function, comfort, and mobility. Physical therapy treatments are used to alleviate pain, promote healing, and bring restored function and movement to the painful area. When you come in for a consultation, your physical therapist will provide you with an extensive evaluation, discovering what form of treatment will be best for whatever orthopedic, neurologic, or cardiovascular condition you are facing.
Physical therapy also consists of two categorized types of treatments: passive physical therapy and active physical therapy:
Passive physical therapy
The purpose of passive physical therapy is to help pain become more manageable, and hopefully to alleviate it altogether. Lower back pain can be a debilitating condition, impeding your physical abilities. Because of this, physical therapists work hard to reduce pain as much as possible. Passive physical therapy can include any combination of these specialty treatments, as deemed fit by your physical therapist:
Some of these methods are used to reduce pain and swelling, such as heat/ice packs and massage therapy. Electrical stimulation, while it sounds intimidating, is a painless treatment that delivers minuscule waves of electricity throughout your nervous system. This also helps with pain relief, and it can also help in decreasing muscle spasms, as well as encouraging your body to produce pain-relieving hormones. Hydrotherapy is an aquatic-based treatment, in which patients will perform low-intensity movements in water, thus relieving any muscle pressure they may be experiencing and allowing their joints to move freely and comfortably. These techniques are more commonly used for the treatment of lower back pain than others, although any could be prescribed based on your physical therapist’s discretion.
Active physical therapy
The purpose of active physical therapy is to provide exercises that the patient can do on their own in the later stages of their physical therapy treatment. Once your lower back pain has subsided enough that your physical therapist believes you are ready for active physical therapy, he or she will set up and exercise schedule specific to your needs. This can include any combination of stretching, strength training, and stability training, and it is all geared toward helping you gain back your flexibility, range of motion, and muscle strength. These exercises will help provide support to the painful area and will guide you further in your recovery process.
What will my visits look like?
At your initial consultation, your physical therapist will ask you several questions regarding your medical history, lifestyle, and painful area(s). This information will assist your physical therapist in creating the best treatment plan for you and your specific needs, so you can be provided with long-term results.
After your consultation, your evaluation process will begin. Your physical therapist will examine you by assessing your posture, coordination, strength, balance, flexibility, blood pressure, and/or heart rate, depending on your pain and symptoms. This evaluation will be both manual and visual.
When you’ve completed your thorough evaluation, your physical therapist will then create your treatment plan, beginning with passive physical therapy and leading into active physical therapy. You may also be given exercises to do at home, during your time away from treatments. This is all done in order to reduce pain, avoid further injury, and provide you with the quickest recovery time possible.
If you believe your lower back pain could benefit from our physical therapy services, give our office a call today to schedule your initial consultation. We’ll help you stand up to your back pain!
Lower back pain is the nemesis of many. That familiar ache can limit time spent working, relaxing, and enjoying life. It can lead to irritability and a whole host of other health problems. And, yet, it’s surprisingly common.
The World Health Organization estimates that in the United States, 149 million days of work are lost due to low back pain. Back pain is the leading cause of inactivity and loss of work, and it appears in 60 to 70 percent of people in industrialized nations.
If you’re experiencing this type of pain, you know how important it is to find relief. Fortunately, a qualified physical therapist can guide you towards a pain-free life. Here are some ways that ActiveKare Physical Therapy can help, and reasons to call our office today.
What Is Physical Therapy?
Physical therapy includes treatments that focus on the management of disabilities and injuries. It helps to alleviate lower back pain, encourage healing, and bring about restored function and movement. It is performed by a trained physical therapist who is knowledgeable in evaluation and conservative management, including rehabilitation, of orthopedic, neurologic, and cardiovascular conditions.
There are two components to most physical therapy programs: passive physical therapy to reduce the patient’s pain so that it becomes more manageable, and active exercises that the patient engages in independently.
Passive Physical Therapy
When you’re suffering from lower back pain, it can be debilitating and makes it so you can’t be as active as you would like. As such, it’s important for a physical therapist to reduce your pain as much as possible so that you can actively participate in your treatment. These tools are often used as a form of ‘passive therapy’ because they are done to a patient by the physical therapist.
We use some of these methods, such as hot/cold packs and massage therapy, to improve blood flow to the affected area, thereby reducing pain and swelling. We also utilize electrical stimulation therapy, which is a painless treatment that delivers tiny electrical waves through your nervous system to relieve pain, reduce muscle spasms, and encourage your body to produce pain-relieving hormones. Some of our clients are best suited for hydrotherapy treatment. This involves performing low-intensity movements in water which relieves pressure on muscles while allowing you to move your joints without discomfort.
Active Physical Therapy
Active physical therapy treatments are exercises performed by the patient and are often used in the later stages of physical therapy — once the lower back pain has subsided enough so that the patient can perform them without excessive discomfort. There are many different types of exercises that a physical therapist may recommend, including stretching, stability training, and strength training. Some of these will help you with your flexibility and range of motion, while others help build the muscles around the painful area to provide those parts of the body with support.
What to Expect During Your Visits
When you first visit our clinic, your therapist will ask you several questions about your health, history, and lower back pain specifically. Having this information will help your therapist provide you with the best treatment plan possible so that you see long-lasting results as quickly as possible.
Your therapist will also provide a thorough examination. Depending on your symptoms, your physical therapist may assess your strength, flexibility, coordination, balance, posture, blood pressure, and heart and respiration rates. This may include using his or her hands to palpate your back and surrounding area, as well as a visual examination of your mobility.
You may learn special exercises to perform at home so that you can minimize pain, avoid re-injury, lessen strain, and speed up your recovery time. Your PT specialist may recommend special equipment and will undoubtedly spend a great deal of time educating you about your source of pain and pain management strategies. He or she will also perform hands-on exercises to deliver you immediate relief.
When you’re ready to alleviate or eliminate your pain, contact our office located in Sterling Heights MI, to see how physical therapy can help you live a pain-free life.
Ask any physical therapist, and you’ll get confirmation that lower back pain is the most frequent complaint they’re asked to treat. Often, back strain goes away on their own, especially with the classic “RICE” treatment. But when rest, ice, compression and elevation just can’t cut the pain, physical therapy is often your most reliable path back to a pain-free life.
Where Does LBP Come From — and What Can Prevent it?
Among the most common causes of lower back pain (LBP) is an improperly aligned spine, stemming from incorrect posture. Most office desk setups don’t provide lumbar support or ergonomic positioning, while poor work habits keep us from giving our spines much-needed relief by moving around during the day.
Non-desk jobs have their own perils. Standing all day, especially when combined with heavy lifting or frequent bending, is also bad for spinal health. The muscles surrounding the abs and lower back may not get the support they need as you pace, bend and lift, resulting in LBP.
In either case, supporting those back muscles is key to reducing the risk of chronic lower back pain. Insist on an ergonomic desk chair, or at least take the opportunity to stretch and move around more frequently. If you’re a cashier, wait staff or warehouse worker, invest in shoes with good arch support, which helps keep your entire body better aligned. If needed, wear a specialized brace to help support heavy lifting.
How Physical Therapy Can Help
Physical therapy is one of the most effective ways for easing lower back pain. Medical professionals generally urge their patients to try PT before turning to prescription medications or surgery. The reasons are obvious: Some medications can have long-term health consequences, despite the advantages of delivering temporary pain relief, while invasive procedures carry risk of complication and prolonged recovery time.
Lower back pain PT typically takes the two-pronged approach of using both active and passive physical therapy, unless the therapist has a reason to recommend one over the other.
Passive PT includes the application of specialized ice packs and heating pads. The therapist may also use various types of pulsing equipment, which stimulate nerves and release pain.
Active PT involves the patient performing stretches and exercises that build the kind of flexibility and strength needed to both prevent future flare-ups and reduce current pain. Some of these are done under a physical therapist’s supervision, on specialized equipment, while others can be carried out at home after the patient learns the basics.
Causes of Low Back Pain & How Physical Therapy Can Help
Lower back pain is one of the most common reasons people cite for making an appointment with a physical therapist. Most people suffer from lower back pain to varying degrees at some point in their lives. Sometimes, lower back pain is more of an annoyance than anything else, but when lower back pain becomes severe, it can be seriously debilitating and prevent you from living your life. Typically, the sooner you seek treatment for lower back pain, the sooner you can find lasting relief.
Common Causes of Lower Back Pain
There are numerous potential causes for lower back pain. These days, poor posture and alignment of the spine is becoming an increasingly common cause—likely due to the fact that more people work in sedentary desk jobs than ever before. Without the proper lumbar support from an ergonomic desk chair, lower back pain can quickly occur as a result of poor posture and limited movement of the spinal joints throughout the day. Even those who are on their feet most of the day can suffer from lower back pain due to poor spinal and abdominal muscle support and lack of proper coordination of the spinal muscles.
While lower back pain cannot always be prevented, it is possible to reduce your risk of lower back injuries and pain by making sure your back is well supported with proper posture throughout the day. For desk workers, this could mean investing in an ergonomic desk chair. For others, it may mean purchasing a quality pair of athletic shoes that will provide the proper level of foot and back support throughout the day.
Physical Therapy for Back Pain Relief
The good news is that if you’re suffering from lower back pain, physical therapy may be able to help. Seeking physical therapy as treatment for your lower back pain is always recommended before you decide to start taking any prescription medications. After all, anti-inflammatory and other medication may relieve your back pain in the short-term, but can also lead to long-term side effects. With physical therapy, you can enjoy a non-invasive and drug-free approach to long-term back pain relief. And physical therapy should always be attempted before taking any drastic measures, such as having back surgery done.
There are two common forms of physical therapy used for the treatment of lower back pain. These are passive and active physical therapy, and they differ greatly in their techniques and methods.
Passive physical therapy relies on techniques performed directly on the patient. This can include anything from applying heat or ice packs to the affected area or even stimulating the area with controlled electricity. Other modalities used here may include ultrasonography, TENS units, and iontophoresis.
Active physical therapy, on the other hand, refers to steps the patient will take (as instructed by a therapist) to treat and reduce lower back pain. Typically, this comes in the form of different exercises and stretches that are designed to reduce lower back pain and minimize future flare-ups as well. Some common examples of active physical therapy may include low-impact aerobic conditioning and back strengthening exercises. These can be done in your physical therapist’s office or at home, depending on your specific needs.
Overall, physical therapy can be a great option for treating just about any level of lower back pain. Through a combination of active and passive physical therapy, you can work towards reducing your pain and increasing your lower back strength to avoid future problems. Contact our team today to find out more about how we can help you overcome lower back pain.