Low back pain is very common, with 80% of people experiencing back pain at least once in their lifetime.¹
There are a multitude of studies that have been published through the years evaluating possible treatments for low back pain. In the last decade, there have been deeper studies to show correlation between the use of physical therapy intervention for low back pain and the average health care savings.
In 2004, Virginia Mason launched an in-depth study and self evaluation of their health care spending as a result of threats made by Aetna in collaboration with other large employers in the Seattle area. Results indicated early physical therapy intervention and decreased use of imaging not only decreased health care spending in addition decreased work lost and improved productivity.²
More recently, the Alliance for Physical Therapy Quality and Innovation (APTQI) engaged The Moran Company (TMC) to begin to assess different initial treatment interventions from a cost standpoint for low back pain within the Medicare program.³ The study population consisted of 472,000 Medicare Fee for Service (FFS) beneficiaries with an incident low back pain (lumbago) diagnosis from Medicare claims data in 2014.
Surprisingly, only 13% of those beneficiaries received physical therapy as their first line of treatment.
While the Virginia Mason model looked more specifically at health care costs utilizing imaging, this study compares costs to those who received injections or surgeries first. The analysis shows that those who received physical therapy intervention first had an average savings of 19% as compared to those who received injections and a savings of 75% of those who received surgery first. The study further analyzed the cost savings a year following the diagnosis which showed an 18% difference with those who received injections first and a 54% difference of those who received surgery first.
Further studies have looked into the timeliness of physical therapy intervention with relation to cost savings, return to work, and disability. All have shown that earlier intervention have positively affected each of these categories.³ ⁴ The APTQI and TMC collaboration determined that beneficiaries who received physical therapy intervention in the first 45 days show a 9% difference in spending while those who receive intervention within 15 days show a 27% difference in cost spending.
While many of your patients are concerned with the cost of physical therapy, there is significant research to support that early physical therapy intervention provides decreased cost savings to the consumer, including decreased spending on imaging, injections, and surgeries but also in missed days work and disability. The earlier start time further improves these costs.
- Flynn TW et al, Appropriate Use of Diagnostic Imaging in Low Back Pain: A Reminder that Unnecessary Imaging May Do as Much Harm as Good. J Orthop Sports Phys Ther 2011;41(11):838-846.
- Virginia Mason Model Overview: V. Fuhrmans, “A Novel Plan Helps Hospital Wean Itself Off Pricey Tests,” Wall Street Journal, 12 January 2007.
- Initial Treatment Intervention and Average Total Medicare A/B Costs for FFS Beneficiaries with an Incident Low Back Pain (Lumbago) Diagnosis in CY 2014, Prepared for APTQI, May 2017, The Moran Company.
- Julie M. Fritz, PhD, PT1; John S. Magel, PhD, PT1,2; Molly McFadden, MS1; et alCarl Asche, PhD3; Anne Thackeray, PhD, PT1,2; Whitney Meier, DPT1; Gerard Brennan, PhD, PT2. Early Physical Therapy vs Usual Care in Patients With Recent-Onset Low Back Pain: A Randomized Clinical Trial. JAMA. 2015;314(14):1459-1467.