by Dr. Troy Vander Molen, PT, DPT
Over the past couple of decades, your personal responsibility for health care costs has increased dramatically. Medical costs have escalated substantially over that time, and with those increases there has been a rise in high-deductible health plans and confusing cost and payment structures by insurers. The result is that many people today struggle to afford the health care they need.
According to a June 28, 2017 article in Forbes, patient payments now account for 35% of medical provider revenue. By comparison, in 2000 patients paid just 5% of healthcare provider revenue.
Because of these unfortunate realities, people often delay seeking medical treatment, which can increase the problem since many health conditions are more easily managed – at a lower cost – early in the process.
It is important to be a wise health care consumer. At Kinetic Edge, we are proud to provide effective care for musculoskeletal conditions that costs a fraction compared to other options.
However, the way that health care is distributed in America – often through large, multi-specialty institutions – physical therapists aren’t getting the credit or the patients they deserve.
Consider something as common as lower back pain. It’s common for an individual to initially ignore the problem or try to manage it with home remedies. While a small percentage of these people may experience improvements, if the problem isn’t identified and fixed, the pain usually returns and the problem worsens over time.
When it’s clear that the problem isn’t going way, it is understandable that people will then usually schedule an appointment with their family physician, a trusted person who best understands their overall health. Typical treatments suggested by the medical establishment for the treatment of lower back pain include medications, diagnostic testing, injections, and, in some cases, surgery. At Kinetic Edge, many of the people we work with have been dealing with lower back pain for months if not years.
Physical therapy is not only an effective way to reduce pain and restore function for most lower back conditions, it is also very cost-effective.
Take a look below at the cost of a typical course of physical therapy (10 visits) at Kinetic Edge compared to other common treatment options.
At Kinetic Edge, we earn $972 on average for a typical physical therapy course of care. Health insurance usually picks up a portion of that cost, an amount that varies depending upon your insurance plan specifics. If you have a plan that covers a portion of the cost, your personal financial responsibility for physical therapy will pale in comparison to the costs of other common treatment options.
Don’t get me wrong. We know that your personal responsibility for a portion of the $972 isn’t chump change, but the value of any product or service is determined by whether or not it delivers a benefit that makes the investment worthwhile.
Did you know that seeing your physical therapist first for lower back pain can reduce your total cost of care by 50%?
According to articles published in December 2016 in the Journal of the American Medical Association on health care spending and an article by Fritz, et al in a December 2012 edition of Spine, starting physical therapy within the first 14 days of pain can save you on average $2,700 compared to the costs accrued managing lower back pain if you delay your visit to a physical therapist. Given that Americans spend $87.6 billion annually on lower back and neck pain, seeing a physical therapist first and early could save a tremendous amount of money and pain.
Here’s why. After self-treatment fails, many people choose to visit their primary care physician for treatment. A 2017 Merritt Hawkins study found that the average wait time to see a physician is 24 days. For over three weeks, a person seeking medical care is simply waiting and worsening.
By the time you consult with your doctor, he/she may prescribe medications, refer you for a diagnostic test, or send you to an orthopedic specialist where you might be referred for a series of injections. This drawn-out process can set you back weeks and several insurance co-pays.
In recent months, much has been written about the dangerous consequences of long-term opioid use, which include increased risk for addiction and overdose-related deaths. A 2017 study published in the Journal of the American Board of Family Medicine proved that people referred to physical therapy were 35% less likely to be prescribed opioids, even if they didn’t attend any sessions after the initial evaluation.
And what about that MRI? A 2015 Health Services Research study found that costs associated with the management of lower back pain increase dramatically if a person has an MRI first compared to seeing a physical therapist first.
The average cost of medical care for lower back pain was found to be $4,793 more if an MRI occurs first instead of physical therapy.
Might I suggest that, unless you have problems with muscle function, you shouldn’t pursue an MRI until you have consulted with a physical therapist, or you might pay for it… literally.
Surgery, of course, is costly, which may not necessarily be a bad investment if the outcome is good. However, a 2015 study in the Annals of Internal Medicine showed that physical therapy is equally beneficial to surgery for symptoms related to spinal stenosis, and physical therapy costs are substantially lower than surgery.
There is a lot of compelling evidence that supports the value of physical therapy. But, the question remains:
Why isn’t early access to physical therapy the norm?
Given that physical therapy is both beneficial and cost-effective, you’d think it would be the natural first choice for musculoskeletal care.
The benefits particularly for lower back pain are obvious, which was proven in a unique way nearly two decades ago at the Virginia Mason Medical Center in Seattle, where they used Toyota Production System’s “lean” methodology to streamline the care of lower back pain after local employers complained that they were paying more for care there than any other health system in the area.
Employers collaborated with Virginia Mason administrators and providers to find ways to cut out inefficiencies in care and increase value to the patients. The primary change that occurred following this process was that patients complaining of lower back pain were immediately referred for physical therapy to receive evidence-based care, which reduced costs related to unnecessary diagnostic tests, enhanced return to function, and significantly improved patient satisfaction.
That is an awesome outcome! So why hasn’t this model of care for lower back pain become the norm? Simply put: The medical establishment lost money.
Effective but less expensive services like physical therapy did not result in enough payments to support the gigantic health system. Under the old, ineffective system, Virginia Mason made $100 on every case; under the new, effective system, they now realized a $200 loss on every case. Each MRI that was avoided resulted in $450 losses for the medical establishment.
It is disappointing that our American health care system does not have priorities that align with the patients they are serving.
The fact is that getting physical therapy first is not sustainable in traditional health care systems. Fortunately for you, Kinetic Edge is not a traditional company, and you have the power.
At Kinetic Edge, a private, therapist-owned therapy practice, our priorities are aligned with yours. We provide effective musculoskeletal treatments at a fraction of the costs of other providers and at rates way lower than other less effective treatment options. Kinetic Edge benefits when you choose us for physical therapy, and so do you!
And, though most people do not understand it, you do have the power to make your own health care choices. At Kinetic Edge and any other physical therapy clinic in the state of Iowa, you do not need a referral for physical therapy. Most insurance companies no longer require a physician’s referral, and we communicate closely with your family physician to ensure that they are aware of your condition and the medical necessity of your physical therapy care.
Why should you choose Kinetic Edge to be your first choice for your physical therapy care? Aren’t all PTs the same? There are many quality physical therapists in our markets, and many of them don’t work at Kinetic Edge. But, the value of physical therapy is related to both the benefit and the cost, and this is what separates Kinetic Edge from the competition.
According to data obtained from the Workers’ Compensation Research Institute in 2015, the average cost per episode of physical therapy care was $1,734. Kinetic Edge’s average cost per episode in 2017 was $972.
Physical therapy at Kinetic Edge costs 44% less than the national average!
We are honored when people choose Kinetic Edge for their therapy care, and we are proud of the service we provide because we know it produces excellent outcomes at a low cost. Kinetic Edge is a great value!
Nonetheless, we know that people don’t buy a car without first taking a test drive. So, we welcome you to contact our clinic at 866-588-0230 to claim a free injury screen. During that free session, you can talk with our musculoskeletal experts and after a brief movement screen they can provide for you a summary of your potential to overcome your pain and dysfunction.
Thank you for helping us live out our mission to transform lives and restore hope!