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Direct Access: Reimbursement

Posted Sep 07 2008 8:40pm

Money_3 The entire concept of reimbursement for healthcare services is vast and complicated. But, examining costs for healthcare is not so complicated. Certain services are expensive, others less so. For example, orthopaedic surgeons are expensive with certain procedures like spinal fusion costing $40,000 or more. Pharmaceuticals, which are the tool of choice in primary care, and needless radiological imaging are also expensive. Very few of these expensive items are effective, yet reimbursement for them is provided all the time.

Conversely, direct access to physical therapists is not expensive and can produce outcomes superior to the expensive options noted above, yet coverage for this by payors is rare. When it does occur, costs go down.

Yet reimbursement for direct access to physical therapists is rare, despite a large transition of state practice acts to allow for this. Some in the profession think it is a matter of time before payers realize the potential savings and alter their policy, others are taking a more active approach through the legislature. Up next, a guest post furthering this discussion of reimbursement for direct access.

Image by TWCollins

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