ATI Physical Therapy Launches ATIFirst Program and Outcomes & Best Practices Initiative
Physical therapy first offers faster diagnosis and treatment, lower health care costs and no drugs needed. Industry is beginning to shift its view of the value of using physical therapy first for chronic musculoskeletal pain conditions.
In an effort to raise the profile of physical therapy (PT) during National Physical Therapy Awareness Month, ATI Physical Therapy, one of the largest PT chains with more than 860 clinic locations in the nation, is releasing its Outcomes & Best Practices Initiatives and ATIFirst program. These dual, patient privacy-protected programs are designed to use ATI’s vast network and millions of patient encounters to improve clinical care for patients and add value to the health care system. These programs lead the PT industry in reducing variability of care by adhering to evidence-based care patterns, leading to optimal outcomes to better meet the evolving needs of patients, payors and providers focused on higher levels of safety, efficiency and effectiveness. When PT is used as a first option, it has been shown to be more effective and less costly than traditional health care pathways, such as imaging, drugs and surgery.2
ATI is focusing on musculoskeletal (MSK) conditions because it is one of the fastest growing health care cost categories, contributes to significant overuse of health care resources and contributes to high costs to patients, employers and health plans. Recent evidence shows that PT can safely, effectively and conservatively manage MSK problems to alleviate pain, improve function and decrease one’s likelihood of accessing more expensive, potentially less effective and more invasive options.
“The collection and analysis of clinical outcomes is a tangible example of how PT providers, like ATI, can deliver on their promises to add value to patient care delivery,” says Labeed Diab, CEO of ATI Physical Therapy. “We’re proud to share our work to increase patient awareness, improve outcome standards and offer best practices in an effort to continue driving value-based care across the physical therapy discipline and the health care industry as a whole."
Over half of all U.S. adults are impacted by MSK conditions, greater than the number of people impacted by chronic heart and lung conditions, according to the Centers for Disease Control.1 Yet, the patient pathways for diagnosis and treatment of MSK conditions in the U.S. health care system are broken, mismanaged and economically unsustainable. Physical therapists can diagnose and treat over 70 percent of MSK disorders without any other provider intervention2 and contrary to public perception, patients do not need a physician referral to see a PT first. Further, PT’s are skilled at recognizing patient presentations that do not fall within the scope of PT treatment and need to be referred to another provider.2 However, despite the proven benefits, PT has not historically been front of the line for U.S. patient care programs.
Improving outcomes and reducing costs is even more relevant with the cost of employer-provided health care coverage surpassing $20,000 a year for the first time, according to the Kaiser Family Foundation’s annual poll of employers.4 The poll analyzed a variety of health care-related costs such as premiums, employee contributions and cost-sharing provisions, showing an increase of 5 percent from last year. With employers bearing 71 percent of that cost per year and employees responsible for the remaining balance ($6,015 plus the deductible), PT first provides a viable and attractive cost-saving option for all parties, backed by data on proven results and outcomes.2 It is estimated that 50 cents of every dollar earned by the millennial generation, over their lifetimes, will be spent on health care.5
“One of the biggest issues I see with patients presenting severe or chronic pain due to an MSK injury is that they don’t understand the goals, objectives or benefits of PT. Providers in the health care realm forget that re-education needs to happen to use PT at the right time, which is usually early on,” says Dr. Wajde Dabah, pain management specialist, Pain Therapy Associates. “No patient should get a prescription for pain killers without first having six weeks of PT first, which is conservative treatment. In recent weeks too, MRI referrals we’ve suggested for patients have been denied by insurance carriers without first seeing six weeks of PT. This is a big change. It’s promising to see the industry shift beginning to take hold.”
Physical therapy is a proven, conservative management method for treating MSK conditions. According to a study in the Journal of Orthopaedic & Sports Physical Therapy, 68 percent of patients with direct access to PT had resolved symptoms without further medical treatment, and patients who had direct access to PT for their neck or back pain had similar average improvement.2 The same study found patients who chose to enter care via the direct-access, PT-led program had lower total costs, of up to $1,543, than those seeking traditional medical referral2. Further, a study published in Health Services Research found that PT first may curb reliance on opioid pain killers. Patients who saw a PT before trying other treatments had an 89 percent lower probability of eventually needing an opioid prescription, a 28 percent lower probability of having any advanced imaging services and a 15 percent lower probability of making one or more of those costly ER visits.3
Patient Outcomes Registry
The primary goal of the ATI Patient Outcomes Registry is to leverage previous patient outcomes to improve future outcomes. Through the sharing of data and intelligence, as well as through collaboration with other scientists, research institutions and physicians, the Registry seeks to enhance patient care and clinical knowledge. Fully HIPAA-compliant, the Registry has been registered with ClinicalTrials.gov, listed in the Registry of Patient Registries and has been vetted by the U.S. National Institutes of Health and the U.S. Department of Health and Human Services’ Agency for Health care Research and Quality. ATI has been working on the Patient Outcomes Registry since 2015, by collecting, organizing and analyzing patient-reported outcomes and other medical data, consisting of more than 2.7 million data points from the cases seen by PTs at ATI clinics in 25 states across the U.S. ATI data formed the majority of the data used by the Alliance for Physical Therapy Quality and Innovation (APTQI) to generate the first-ever industry benchmarks in partnership with other PT providers earlier this year. Data is collected in real-time through its proprietary electronic medical record (EMR) system and catalogued in the Registry. While most PT outcomes registries are tailored to the PT industry alone, ATI’s Patient Outcomes Registry is aligned with health care practice standards from Centers for Medicare & Medicaid Services and the American Academy of Orthopedic Surgeons.
ATI Best Practices Program
The ATI Best Practices (ABP) program is designed to provide clinicians with pragmatic resources capable of facilitating real-time clinical decisions to optimize outcomes in the patient care setting. There are more than 50 guidelines in the program thus far, covering approximately 80 percent of ATI’s total patient population. Guidelines are constructed using best evidence from the American Physical Therapy Association (APTA) Clinical Practice Guidelines, peer-reviewed literature and data from the ATI Outcomes Registry. The ABP program includes proven diagnostic and interventional characteristics that provide a comprehensive view of the variables most likely to positively influence the outcomes of a patient’s episode of care.
ATIFirst aims to partner directly with employers to decrease the overall cost of health care. Through creative and innovative direct contracting options, either in conjunction with, or outside of, the employers health plan, all employees and their dependents can access PT, either onsite or at a community clinic, as a first option for MSK conditions. ATIFirst also offers on-site personnel for the purpose of preventative early intervention. A pilot program, conducted with Greenville (S.C.) Health System (now Prisma Health) in 2016-2018, generated $750,000 in net savings for annual health benefits for the health system’s 5,000 employees.2 The program also saw a 25 percent reduction in ER visits for MSK-related issues, a 50 percent reduction in imaging, a 21 percent reduction in specialty physician visits, a 52 percent reduction in total prescription spend, a 91 percent reduction in opioid use and a 40-48 percent increase in full function after a six-weeks of PT appointments2. Early data from more recent partnerships has consolidated these trends, further demonstrating that PT can be a safe and effective front-line health care provider for MSK conditions.
About ATI Physical Therapy
ATI is a privately held, nationally recognized health care company, specializing in outpatient rehabilitation and adjacent health care services. With a focus on delivering a remarkable experience to every patient, every day, ATI has more than 800 locations from coast to coast. ATI was named “Best Physical Therapy Practice in the Nation” by ADVANCE magazine and was one of the first physical therapy companies in the country to achieve URAC Core Accreditation, a mark of distinction that recognizes its commitment to quality health care. Based in Bolingbrook, Illinois, ATI gives back to communities across the country through the ATI Foundation, a non-profit established by ATI, which has provided more than $4 million in resources and funding to children with physical impairments. For more information on ATI Physical Therapy, and a complete list of clinic locations, services and the ATI Foundation, please visit ATIpt.com.
Clifton O’Neal, Director, Corporate Communications
- Most Frequently Reported Medical Conditions and Prevalence for Persons Age 18 and Over, with Subconditions, by Sex, United States 2015. Source: National Health Interview Survey (NHIS), Adult sample. www.cdc.gov/nchs/nhis/nhis_2015_data_release.htm
- Denninger, T.R., et al. The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis From a Physical Therapy Patient Registry, JOSPT. 2017.
- Frogner, B.K.,et al. Physical Therapy as the First Point of Care to Treat Lower Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs, HSR. 2018.
- Kaiser Family Foundation. 2019 Employer Health Benefits Survey, KFF. 2019
- Goldhill, David. Catastrophic Care: Why Everything We Think We Know about Health Care is Wrong, 2013.