Insurance status affects access to physical therapy following rotator cuff repair surgery: A comparison of privately insured and Medicaid patients

Rogers, Miranda J.; Penvose, Ian R.; Curry, Emily J.; Galvin, Joseph W.; Li, Xinning

doi:10.4081/or.2019.7989

Cited by 29 publications

(28 citation statements)

References 12 publications

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“…Patterson et al 6 found that the likelihood of being able to make an appointment for PT to manage an acute rotator cuff tear in North Carolina was 8.8 times higher (95% CI: 2.5%-31.5%) for patients who were privately insured compared with patients with Medicaid insurance. Similarly, Rogers et al 7 found that in the Greater Boston Area, only 51.4% of practices accepted Medicaid insurance, while 96.4% accepted private insurance ( P = .02) for PT appointments after RCR. This is similar to the national acceptance rates we have found in this study with only 52.7% of practices accepting Medicaid vs. 94.9% accepting private insurance.…”

Section: Discussionmentioning

confidence: 90%

“…A recent study evaluating access to PT services after RCR in the Greater Boston Area found that only 51.4% of PT practices accepted Medicaid as compared with 96.4% accepting private insurance. 7 Among those practices accepting Medicaid insurance, Medicaid patients experienced significantly longer wait times as compared with privately insured patients. This finding is particularly concerning as Massachusetts has one of the most robust Medicaid expansion plans in the United States.…”

mentioning

confidence: 99%

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National disparities in access to physical therapy after rotator cuff repair between patients with Medicaid vs. private health insurance

Curry¹,

Penvose²,

Knapp³

et al. 2021

JSES International

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Background Arthroscopic rotator cuff repair is an effective treatment for patients with symptomatic rotator cuff tears. Ensuring timely and appropriate postoperative access to physical therapy (PT) is paramount to the achievement of optimal patient outcomes. Extended immobility due to a lack of formal rehabilitation can lead to decreased range of motion, continued pain, and potential reoperation for stiffness. The purpose of this study is to evaluate national disparities in access to PT services after rotator cuff repair between patients with private vs. Medicaid insurance. This study will further evaluate differences in access to PT services between states that have previously undergone Medicaid expansion as compared with those states which have not. Methods The American Physical Therapy Association Website was used to identify 10 physical therapy practices from the capital city in every state. Each physical therapy practice was contacted using a mock-patient script for a patient with Medicaid insurance or private (Blue Cross Blue Shield) insurance. To maintain anonymity, calls were made by two separate investigators. Univariate analysis included independent sample t-test for differences between the study groups for continuous variables. Chi square or Fisher's exact test assessed differences in discrete variables between the study groups. Results Contact was made with 465 of 510 (91.2%) physical therapy practices. Overall, 52.7% accepted Medicaid insurance, while 94.9% accepted private insurance ( P < .001). Medicaid insurance was more likely to be accepted in a Medicaid expansion state than a nonexpansion state (56.1% vs. 46.3%, P = .05). Private insurance was also more likely to be accepted in a Medicaid expansion state than a nonexpansion state (96.7% vs. 91.3%, P = .01). The time to first appointment varied more in Medicaid expansion states (private range: 0-43 days, Medicaid range: 0-72 days) than in nonexpansion states (private range: 0-11 days, medicaid range: 0-10 days). Conclusion Significantly fewer PT practices accepted Medicaid insurance nationally compared with private insurance, which suggests that patients with Medicaid insurance have greater difficulty accessing PT after rotator cuff repair in the United States compared with patients with private insurance. While Medicaid insurance was more likely to be accepted in a Medicaid expansion state, this finding was only borderline significant, which indicates that patients in Medicaid expansion states are still having difficulty accessing PT, despite efforts to expand government insurance coverage to improve access to care. Orthopedic surgeons should counsel their patients with Medicaid insurance to seek out PT as early as possible in the postoperative period to avoid delays in rehabilitation.

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Section: Discussionmentioning

confidence: 90%

mentioning

confidence: 99%

National disparities in access to physical therapy after rotator cuff repair between patients with Medicaid vs. private health insurance

Curry¹,

Penvose²,

Knapp³

et al. 2021

JSES International

Self Cite

View full text Add to dashboard Cite

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“…It is important to underscore the close relationship between access and outcome for rotator cuff repair. In studies by Rogers, et al 44 , and Patterson, et al 39 , Medicaid patients experienced longer wait times for appointments for physical therapy and orthopedic consult, respectively. Additionally, patients in Curry, et al 12 , were offered fewer appointments for care.…”

Section: Discussionmentioning

confidence: 96%

“…Further, worse postoperative outcomes associated with low SES persist in orthopedic surgeries, such as total joint arthroplasties 13,59 and spine surgery 31,35 . Several studies observe similar trends in care for rotator cuff tear 8,12,24,30,39,44,48 .…”

mentioning

confidence: 83%

“…In both studies, Medicaid insurance was accepted less often than private insurance. Rogers, et al 44 , found that Medicaid patients encountered longer average days to first appointment, and low community income measures had no significant impact. Curry, et al 12 , found the opposite, with an insignificant difference in wait time and physical therapy clinics more likely to accept Medicaid lower household income communities.…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

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Low socioeconomic status worsens access to care and outcomes for rotator cuff repair: a scoping review

Gatto

Lansdown

2022

JSES Reviews, Reports, and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Payor Type is Associated With Increased Rates of Reoperation and Health-care Utilization Following Unicompartmental Knee Arthroplasty: A National Database Study

Sequeira

Boucher

2023

Arthroplasty Today

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Insurance status affects access to physical therapy following rotator cuff repair surgery: A comparison of privately insured and Medicaid patients

Cited by 29 publications

References 12 publications

National disparities in access to physical therapy after rotator cuff repair between patients with Medicaid vs. private health insurance

National disparities in access to physical therapy after rotator cuff repair between patients with Medicaid vs. private health insurance

Low socioeconomic status worsens access to care and outcomes for rotator cuff repair: a scoping review

Payor Type is Associated With Increased Rates of Reoperation and Health-care Utilization Following Unicompartmental Knee Arthroplasty: A National Database Study

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