Payment Reform

Advocacy

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AAPM&R remains committed to pursuing fair reimbursement for physician-led care in the ever-changing health care environment. By educating all types of medical payers on the value of health and function, the Academy is helping establish our members as a critical piece of the new value-driven health care delivery landscape. The Academy is particularly concerned with the annual decreases to Medicare payment, which threaten the livelihood of our members. AAPM&R’s payment reform priorities include:

  • Partnering with a broad range of medical specialties to encourage Congress and Medicare to pursue payment reform, which would ensure Medicare payments keep up with inflation rates and the costs of operating a medical practice.
  • Taking an active role in the process that develops and modifies codes and their value.
    Learn more about the Academy’s work with the American Medical Association RVS Update Committee (RUC) and Current Procedural Terminology (CPT) Panel meetings.
  • Focusing on reimbursement issues that have substantial impacts to physiatry.
  • Making proactive strides to affirm the value of physiatric practice by showing the necessity of the cost-saving care our physicians provide. Learn more about these initiatives below.

Toolkits

AAPM&R Spine Care Toolkit

Spine care, including the management of low back pain (LBP), is one of the major areas of musculoskeletal treatment in our country. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Spine Care Toolkit is a clinical and educational resource that AAPM&R members, payers and healthcare systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value spine care.

This toolkit offers members the tools they need to develop a physiatrist-led spine care APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in spine care across the continuum.

AAPM&R Stroke Rehabilitation Toolkit

Stroke remains the second leading cause of death, the third leading cause of death and disability combined, and a leading cause of institutionalization in the world. Developed by the Academy’s Innovative Payment and Practice Models (IPPM) Committee, the Stroke Rehabilitation Toolkit is a clinical and educational resource that AAPM&R members, payers, and health care systems can utilize to develop care structures and alternative payment models (APMs) to allow for the provision of high value stroke rehabilitation care.

This toolkit offers members the tools they need to develop a physiatrist-led stroke rehabilitation APM, in which clinical outcomes and patient satisfaction will improve and costs will be reduced through consistent and direct involvement of physiatry in stroke rehabilitation care across the continuum.

 

Post-Acute Care (PAC) Toolkit

The Post-Acute Care (PAC) model is in the midst of an evolution. With today’s health care environment placing a greater emphasis on Value Based Purchasing (VBP), payors are examining both the quality and cost of care in PAC. As new payment models are being considered, recognizing the importance of patient oversight within PAC settings is critical.

The information provided in the Post-Acute Care (PAC) Toolkit aims to help you talk to your PAC administrators, fellow physicians, and other caregivers about your and your patients’ needs, and is based on Medicare regulations as Medicare is often the common guide for many payors.