2020 is shaping up to be a busy year for healthcare and physical therapy is no exception. There is an abundance of topics that will be at the top of many people’s minds. From Medicare to medical technology, we have the inside scoop.
1. Medicare's new PTA/OTA modifiers are here
Medicare’s final rule was released in November 2019 and one of the biggest changes is the new modifier requirements for Physical Therapy Assistants (PTAs) and Occupational Therapy Assistants (OTAs). Starting on 1/1/2020, these new modifiers need to be applied to any service line that was provided “in-part” by a PTA or OTA. For 2020 and 2021, the modifiers need to be applied with no changes to payments. In 2022, Medicare will begin to use these modifiers to reduce payments for these services (85%)
2. Medicare's potential 8% reduction in PT Payments
The Center for Medicare and Medicaid Services (CMS) finalized a part of the rule that changes how the values of certain charges are calculated. In particular, they lowered the “work impact” and the “practice expense” value of PT/OT charges. The published final rule could have a combined impact of an 8% reduction in payments; this is certainly a cause for concern for physical therapists and occupational therapists nationwide.
The American Physical Therapy Association (APTA) has expressed concern and plans to advocate against this change. The concern is justified and planned advocacy is important. As a bit of a counterbalance, it’s important to note that it’s impossible to know the exact codes which have been impacted. It’s uncertain exactly what an individual physical therapy practice should expect. In July of 2020, Medicare will release its next proposed rule. At that point, more information will be available and impacts can truly be assessed. Interestingly, Medicare seems to be shifting focus in this same change (and generally) to primary care and related areas.
3. Growing patient expectations for technology
Everyday life becomes more digital and healthcare is no exception. Patients have heightened exceptions and expect things like digital reminders, at home exercise programs and other online tools. Many prefer to receive communications and information electronically as opposed to on paper. Private practices will need to continue to evolve (along with their EMRs) to meet this need. 2020 will provide many leaps forward in healthcare technology and IT. While we’re at it, it’s important to note that happy patients = more referrals!
4. Bring your own device is in for clinical staff
In the old days, practices would spend the cash to buy a lot of devices; often times all the same devices. This is still common practice but recently more practices have been allowing providers to use their own device. This has benefits for both parties but also has some important considerations for practice owners.
With a good strategy in place, you can jump on this trend and make the most of it. It can be a win-win for practice owners and staff alike.
5. Patient responsibilities continue to grow
As insurance companies change plans to respond to the demands from policy holders, the payment shift continues with patients bearing more cost directly. This is a continuing trend in the healthcare space and means everyone needs to adjust (providers, practices, referrers and patients). These costs come in many different forms:
That means that practices need to have solid and thought-out collection strategies in place from end-to-end. Practices may need to consider sending outstanding balances to a formal collections process whereas in the past amounts were written off. Look for this trend to continue to grow in 2020.
The bottom line
2020 is shaping up to be an interesting year. There are opportunities and threats around. With a positive attitude and the right tools, your physical therapy can thrive! Stay tuned to our blog for more!