A new report from the Government Accountability Office (GAO) shows that self-referral for physical therapy (PT) services may increase Medicare spending. According to a Fierce Healthcare news report, the GAO compared PT referrals for self-referring and non-self-referring providers after accounting for referring provider specialty, geographic location, and Medicare beneficiary practice size.

The GAO report indicates that physicians in family practice and internal medicine in urban areas were more likely to refer a Medicare patient to physical therapy if they had financial stakes in the services. The average number of Medicare beneficiaries referred by self-referring family practice providers in urban areas was 43% to 87% higher than for their non-self-referring counterparts.

The Fierce Healthcare news report notes that within a year of a practice starting self-referral, PT service referrals increased at a higher rate relative to non-self-referring providers in the same specialty, according to the GAO. Family practice providers that began self-referring in 2009 increased PT referrals 33% between 2008 and 2010. However, non-self-referring family practice providers increased their PT service referrals 14% during the same time.

Representative Sandy Levin (D-Mich), who requested the study, states, “It is clear based on the totality of the recent self-referral reports from the Government Accountability Office that we need to move toward a value-based healthcare system that promotes better care, not higher volume.” Levin notes that three previous reports found similar ties between financial interest and rate of referral, as indicated on the Fierce Healthcare news report.

Levin adds, “Viewed collectively, the four GAO reports show substantial evidence that financial incentives, not patients’ needs, are driving some referral patterns.”

To view the report, visit www.gao.gov/assets/670/662860.pdf.

[Source: Fierce Healthcare]