Reducing Specialized Therapy Opportunities is the Wrong Idea for N.C.

October is National Physical Therapy Month

October is National Physical Therapy Month, and there’s a lot to celebrate. Physical therapy provides numerous benefits for patients. Physical therapy boosts patient recovery times, limits the risk of falls in the home, gives patients needed exercise, and improves independence.

At Liberty HomeCare and Hospice Services, we know these benefits have a direct, positive effect on our healthcare system. However, new guidelines being discussed in North Carolina would dramatically limit the amount of physical therapy that would be available to Medicaid recipients.

Latest Proposal by the NC Department of Health and Human Services

According to the latest proposal by the North Carolina Department of Health and Human Services, Medicaid recipients would only be eligible for a total of three home health therapy visits per year. This includes physical therapy, speech therapy, and occupational therapy combined.

That is a dramatic decrease from current standards. Currently, patients receive physician ordered therapy according to the patient’s individual needs.  Giving them the opportunity to achieve optimal outcomes and avoid the costly complication of re-hospitalization.

There are also several serious issues that need to be addressed about the proposal. How will a doctor know whether a patient has used up their three visits for the year (no such database currently exists for them), and how will the new limitations affect physicians’ recommendations? Limiting the patient to only three visits would dramatically reduce any benefit they can receive from such services. In fact, allowing only three visits is not much better than eliminating their availability entirely.

All of that is potentially bad news for Medicaid patients in North Carolina.  This was the result when the legislature passed the new state budget.  This reduction doesn’t benefit anyone.  This new policy doesn’t help the patient, and it doesn’t help the Medicaid system, because less therapy will create more re-hospitalizations. That will further strain the system and cause costs to continue to rise.

Why push for a plan where nobody wins? There has to be a better way.

Tony Zizzamia

President, Liberty HomeCare & Hospice Services