The American Physical Therapy Association (APTA) and the Private Practice Section (PPS) have recently collaborated in the creation of the State Payer Advocacy Resource Center or SPARC. These resources have been compiled to support physical therapists in fighting Utilization Management companies and their administratively burdensome preauthorization requirements that limit patient access to physical therapist care. Learn more about the history of Utilization Management in the USA, as well as common challenges physical therapists face in navigating the Utilization Management Process in the linked documents. Today, nearly 40% of US practices employ staff whose responsibility it is to work exclusively on obtaining Prior Authorization.
The use of Prior Authorizations in providing physical therapist care should be linked to evidence-based medicine, not gatekeeping, and criteria for Prior Authorization should be clear and transparent. Inappropriate use of Prior Authorization processes waste time, increase the cost for providing care and contribute to patients abandoning their episodes of care. PPS hopes that these resources will “SPARC” reform in insurers’ use of Utilization Management!
PPS Members look forward to learning more about how they can effectively advocate for their patients at the upcoming PPS Annual Conference and Exhibition, November 2nd through 5th in Aurora, Colorado.