Wednesday, February 10, 2010

TennCare cuts would drop speech, physical, occupational therapy

By Getahn Ward • THE TENNESSEAN • February 10, 2010 Hospitals aren't the only health-care providers bracing for effects to their bottom lines from changes planned to TennCare. Under Gov. Phil Bredesen's budget plan, the state's Medicaid program would no longer cover speech, physical and occupational therapy for adults. The state expects to save $3.4 million each year from that move. Results Physiotherapy Centers, the Franklin-based for-profit operator of 26 out-patient-only physical therapy clinics across the state, expects to lose $420,000 in revenue a year, said C. Jason Richardson, its vice president of clinical operations. "If the TennCare cuts do go through as proposed by the governor's office, we won't be able to serve that population at all," said Richardson, also secretary of the Tennessee Physical Therapy Association. "They're actually shooting themselves in the foot because we're the best option for reducing disabilities without the need for surgeries, expensive imaging studies such as MRIs and CAT scans and also prescription medications." Under TennCare, Results Physiotherapy gets reimbursed about $70 on average per patient visit. As a group, TennCare beneficiaries make up 7 percent of the company's overall patient population, Richardson said. Overall, he said, the rehabilitation services to be eliminated account for about 3 percent of TennCare's health-care costs. Kelly Gunderson, a TennCare spokesman, said the budget plan reflects fiscal challenges faced by the state. "We have a huge hole to fill, and there's not that many places left to find that kind of money," she said. The budget plan also includes a $10,000 cap on in-patient hospital care. Hospitals that provide speech, physical, and occupational therapy services also would see effects from elimination of pay for those services. The hospice industry is one group that won't be affected by changes planned to TennCare. Although the governor's original budget proposal had called for eliminating hospice benefits for adults, the industry convinced TennCare officials that the expected savings weren't going to happen, said Mike Dietrich, executive director of the Tennessee Hospice Organization. Specifically, Dietrich said the amount of potential savings was inflated because the state had included the nursing home portion of beneficiaries' care as hospice costs. "They thought that they'd be saving a lot more than the reality of that situation," Dietrich said. Getahn Ward covers the business of health care. He can be reached at 615-726-5968 or

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