A new assessment of Medicare claims data indicates that physical therapy as first treatment may lead to lower initial and downstream costs.

In a recent publication, The Moran Company and The Alliance for Physical Therapy Quality and Innovation (APTQI) examined the costs of treatment interventions for low back pain following diagnosis. Medicare A/B claims data across service sites was used to compare average spending among beneficiaries who received either physical therapy, injections or surgery as first treatment.

The assessment found that beneficiaries who were first treated with physical therapy incurred ~19% lower cost on average than those who first received injections and ~75% less than the total average spending for those who first underwent surgery. In the year that followed, the physical therapy-first group saw similar spending trends, experiencing an 18% cost difference from the injection-first group and a 54% cost difference from the surgery-first group. Downstream spending was also observed to be lower among beneficiaries who received therapy treatment within 15 days of diagnosis versus 45-90 days after diagnosis.

While further investigation is needed, these findings indicate that the incorporation of early physical therapy into care redesign processes may be a lower-cost alternative to other forms of treatment.

Moran Company. 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.