For Immediate Release: DATE, 2011
Local Physical Therapists Urge Legislature to Make Patient Co-Pays Affordable Again, Improve Outcomes, Reduce Health Care Costs
(YOUR PT PTRACTICE) and thousands of physical therapists from across New York are urging State lawmakers to curb the skyrocketing cost of patient co-payments, which are threatening New Yorkers’ health while driving up the cost of the health care system.
Joined by patients and advocates, members of the New York Physical Therapy Association (NYPTA) met with State legislators in an effort to end the unfair and outrageous practice of “specialty” co-pays, which can cost patients thousands of additional dollars and result in foregone treatment.
In many cases, patients who already pay for health insurance policies that are required by law to cover physical therapy wind up reaching into their own pockets to pay the entire cost - or more - of each physical therapy session. Their insurance companies pay nothing.
As a result, many patients skip physical therapy sessions, risking re-injury, worsening their underlying condition and leading to costlier follow-up procedures that would not be necessary if a proper and timely physical therapy regimen could be afforded.
NYPTA urged State legislators to support A.187, sponsored by Assemblyman Kevin Cahill (D-Kingston) and the identical Senate bill, S.4870, sponsored by Senator John A. DeFrancisco (R-Syracuse). The bill would limit health care policy co-payments to 20 percent of total reimbursement to the provider of care.
(INSERT YOUR QUOTE HERE. Talk about your own experience and that of your patients.)
“Co-pays have become all-pays,” said NYPTA President Matthew R. Hyland, PT, PhD, MPA, CSCS. “These out-of-control co-payments hurt patients by forcing them to stretch out or forego the physical therapy critical to their rehabilitation, hurt physical therapists by depriving them of business, and hurt all New Yorkers who help support the cost of health care through their tax dollars and insurance premiums. The DeFrancisco-Cahill bill is critical to bringing the system back into balance, making physical therapy affordable and accessible to all New Yorkers, and helping people live happier, healthier and more productive lives.”
Managed care plans have been able to hike co-payments by classifying physical therapy as a “specialty.” Currently, co-pays are not limited and may (and often do) exceed the amount reimbursed to the physical therapist. For example, some co-pays are as much as $50 per visit for physical therapy treatments that require up to 20 or more sessions per month. That’s $1,000 per month. Meanwhile the PT reimbursement might only be $35 per visit, meaning the patient is paying more than 100 percent of the per visit costs, while the insurer pays none.
A 2010 Brown University study of more than 1.5 million Medicare patient observations from 2001 through 2006, published in the New England Journal of Medicine, found increased outpatient co-pays increase hospital costs and may have adverse health consequences and result in higher overall health care costs (http://www.nejm.org/doi/full/10.1056/NEJMsa0904533).
Similar studies by the University of Washington last year and the Intermountain Health Care System in 2008 on patients with lower back pain yielded similar conclusions, as did a project undertaken by Virginia Mason Medical Center in Seattle (http://blog.evidenceinmotion.com/files/wall-street-journal-2007-01-12-proactive-physicaltherapy-2.pdf).
“The DeFrancisco-Cahill bill will not only reduce short-term costs for all New Yorkers but will also reduce overall long-term health care costs for New York State,” Hyland said. “It’s a rare win-win for the taxpayers and the health care system.
“We will continue the fight each and every day in legislative districts around the state until this bill passes and New Yorkers have fair, reasonable and affordable co-pays for physical therapy and other essential health care services.”
For more information: http://stophighcopays.com/
About NYPTA: The New York Physical Therapy Association is a professional, non-profit association of approximately 12,000 Physical Therapists (PTs), Physical Therapist Assistants (PTAs) and PT/PTA students. The NYPTA is dedicated to serving the public's health interests, improving the standard of health for people of all ages and advancing the benefits of physical therapy and the interests of physical therapy professionals in state of New York. To learn more about the New York Physical Therapy Association please visit www.nypta.org.