Justine Dee's research in Archives of Physical Medicine and Rehabilitation

Congratulations to Justine Dee, PT, MS, Assistant Professor of Movement Science, on the recent publication of her work on Medicare policies about physical and occupational therapy for chronic conditions. 

Justine Dee, Benjamin Littenberg. Did Clarification of Medicare Guidelines Change Outpatient Physical Therapy and Occupational Therapy Usage? A Retrospective Analysis. Archives of Physical Medicine and Rehabilitation, Volume 100, Issue 1,2019, Pages 78-85,

Objective: To determine if there was a change in the number of outpatient physical therapy (PT) and occupational therapy (OT) visits for Medicare beneficiaries, and in the number of beneficiaries receiving extended courses of >12 therapy visits, after the Jimmo vs Sebelius settlement.

Design: Cross-sectional analysis of the Medical Expenditure Panel Survey (MEPS) comparing calendar years 2011-2012 to 2014-2015.

Setting: Community in-home survey.

Participants: Medicare Part-B recipients who received outpatient PT/OT (N=1183, median age 70.8) during pre–Jimmo settlement (2011-2012) and post–Jimmo settlement (2014-2015) time periods.

Intervention: Not applicable.

Main Outcome Measures: Number of therapy visits/patient/year and number of subjects who received >12 therapy visits/year estimated by linear and logistic regressions controlling for potential confounders (age, body mass index [BMI], and geographic region).

Results: The unadjusted median number of therapy visits/year increased from 7 to 8 after the settlement. Linear regression estimated a 1.02 increase in the number of therapy visits after the settlement (95% confidence interval [CI] 0.23, 1.80; P=.01). The odds of having >12 therapy visits/year increased (odds ratio=1.41; 95% CI 1.02,1.96; P=.04). We observed a significant interaction between race and the effect of the settlement on the odds of having >12 therapy visits (OR 3.64; 95% CI 1.58, 8.39). Non-Hispanic white subjects saw an increase in utilization while a combined group of black, Hispanic and Asian subjects’ utilization declined.

Conclusion: Utilization of outpatient PT/OT changed after the 2013 Jimmo settlement. Further research is needed to determine the effect on patient outcomes and cost.

The full article is available here: https://authors.elsevier.com/c/1YGNIwCfyeCb