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June 02, 2014

GAO Study Confirms Importance of Integrated Care

Washington, DC—The U.S. Government Accountability Office (GAO) today released a study demonstrating that the integration of physical therapy services into physician practices has not led to overutilization of physical therapy services. In fact, physicians who owned physical therapy services utilized fewer physical therapy services than those provided in a non-physician owned setting. Specifically, the fewest services per beneficiary averages were by self-referring orthopaedic practices, and the data presented by GAO suggest that the overall increase in physical therapy utilization was primarily a result of utilization patterns by non-self-referring providers. This study validates the importance of physician oversight and management of self-owned physical therapy units in orthopaedic surgeon offices.

Frederick M. Azar, MD, President of the American Association of Orthopaedic Surgeons (AAOS), in responding to the study, stressed the importance of integrated care in providing the best value and quality for the patient.

“Physical therapy outcomes are best when a patient’s surgeon and therapist can work closely together,” Dr. Azar stated. “This study confirms the responsible use of in-office ancillary services by orthopaedic surgeons and the importance of maintaining the integration of those services in an orthopaedic surgeon’s office to allow for the continuation of care and to provide the best treatment option for patients.”

This study, one of several recently released by the GAO, has generated renewed discussion about the in-office ancillary services (IOAS) exception. The IOAS exception, which allows physicians to provide imaging and physical therapy services in their offices, is vital for providing efficient diagnoses and treatments. While some have called for limiting the exception, this important study shows such concern is not supported by the data on physical therapy utilization, and the AAOS and others urge decision makers to consider quality patient care and the patient-physician relationship.

“Limiting the IOAS exception would be counter-productive in terms of quality patient care, as it results in both fragmented care and higher costs to patients,” Dr. Azar stated. “The ability of orthopaedic surgeons to diagnose, initiate and oversee a treatment plan quickly and efficiently by offering physical therapy services in their offices is essential to restoring patient mobility and preventing future injury. Without access to in-office ancillary services, patients would be forced to receive ancillary services in new and unfamiliar settings with the probability of a less precise diagnosis, increased inefficiencies, and barriers to appropriate screenings and treatments.”

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Elizabeth Fassbender
(202) 548-4143
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