POPTS – A Profit Generating Mechanism for Doctors

It’s crystal clear – physician owned physical therapy services (POPTS) are designed to make money (putting profits before patient care).

1.  AAOS Primer- Exhibit #1 AB 1000 is cover for Self Referral for Profit.

Click here to download the document.

See pages 14-16
“Naturally on the primary benefits (of adding PT and OT services) is financial. Profit in excess of $100,000 per therapist per year is not unreasonable, and in many areas of the country the potential upside is even greater. “
“Next to Ambulatory Surgery Centers, therapy is often the most profitable ancillary tool orthopaedic surgeons wield.”

2011 Primer is “Enhancing Your Practice’s Revenue: Pearls and Pitfalls
Copyright- American Academy of Orthopaedic Surgeons

Other presentations and articles have confirmed our statements – some doctors are doing all they can to monetize their patients.

2. Numerous Studies Continuously Confirm the Referral for Profit Conflict of Interest

The APTA brochure is a well laid out summary of multiple studies. Inclusive is the Mercer Study that showed $233 million in wasted charges in California by POPTS operations.
The brochure also identifies the Inspector General Report showing POPTS clinics being none compliant with Medicare 91% of the time.Click here to download the APTA document.

Here is the classic Mercer study published in the NEJM that demonstrates the results of referral for profit.  Click here to download.

We’ve already referenced the Office of Inspector General Report here concluding 91% of care rendered in POPTS is substandard.

 

3. Our President and National Policy Leaders All Agree
Obama’s Budget, Simpson/Bowles Commission, BPC Cost Containment Report, AIM Study, & the Kaiser Foundation recommendations ALL DRAW THE SAME CONCLUSIONS.  Eliminate referral for profit!
National policy leaders, healthcare researchers and practicing clinicians see the damage and distortions that self referral for profit creates. AB1000, as currently written is bad public policy.  Here is the BPC Cost Containment Report – see page 66.

 

Click here to download the document.

 

As the Kaiser family foundation recommends- the only way the coordination of care benefits suggested by AAOS and CMS can be achieved with POPTS without abuse is when they are nested within an Accountable Care Organization that eliminates the profit from referral. Click here to download the document.

Page 190

OPTION 5.26
Narrow the in-office ancillary services (IOAS)
exception of the Stark self-referral regulation to
group practices that assume financial risk
Many physician practices have bought advanced imaging
and sophisticated radiation therapy equipment and
brought physical therapy services into their practice; as
a result, the volume of such services has grown sharply.
Given the evidence of substantially increasing volume,
some have suggested narrowing the exception. One
option would narrow the IOAS exception to group practices
that assume financial risk by participating in an
ACO.

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