Press Release

OHP Announces Coverage of PT & OT for Back Pain

Beginning on July 1, 2016, Oregon Health Plan (OHP) has expanded coverage of treatments for back pain, including physical therapy and occupational therapy.
Portland, Ore., July 1, 2016

Clinicient Inc., a leader in outpatient rehabilitation business solutions, today announced its full support for Oregon Health Plan’s (OHP) expanded coverage of non-pharmacologic treatments for back pain, including physical therapy and occupational therapy. Until now, OHP, Oregon’s state Medicaid program, has limited back pain treatment to patients who have muscle weakness or other signs of nerve damage. Beginning on July 1, 2016, treatments will be available for all back conditions. The coverage expansion is expected to reduce opioid prescription abuse, which is often set into motion during treatment of chronic back pain.

When a patient is suffering from back pain, physicians typically rely on three primary courses of action: recommend physical therapy, suggest surgery, and/or prescribe opioids. Unfortunately, the latter is the most frequently selected, as the amount of prescription painkillers in the U.S. quadrupled since 1999. In 2014 alone, OHP spent $9.5 million Medicaid dollars on back pain-related surgery and $4.3 million on opioid prescriptions. Approximately 8 percent of OHP Medicaid members saw a healthcare provider for back conditions in 2013, and more than half of those people received narcotic drug prescriptions- often for extended periods.

“We applaud the initiative and foresight of the Oregon Health Plan in establishing a new policy for conservative care of low back pain that will improve health, decrease costs, and save lives,” said Jerry Henderson, PT, vice president of Therapist Success at Clinicient. “It is Clinicient’s position that the clinically and financially cost-effective outcomes delivered by physical therapy make it the logical first-step in a pain remediation protocol.”

Oregon providers will now assess patients to determine their level of risk for chronic back pain, and whether they meet criteria for a surgical consultation. Based on the results, they will be prescribed a variety of treatments that best fit their individual needs, with physical and occupational therapy positioned as leading interventions. Depending on OHP’s success with their overhauled coverage, experts believe this model could be replicated by states across the U.S. to reduce utilization costs and prevent patients from possible addiction to opioid-based painkillers. A full list of available treatments is available here.

Clinicient plays a critical role in supporting physical therapists to clearly demonstrate clinical and financial outcomes, which is a necessary action they must take to claim a primary and preliminary role in a back pain patients encounter with the healthcare continuum.

About Clinicient

Founded in 2004, Clinicient helps outpatient rehabilitation therapy businesses optimize their clinical and financial operations from patient to payment, through a combination of cloud-based EMR, practice management and revenue cycle management (RCM) solutions. By combining its process automation technologies with expert professional services, such as data-driven practice management coaching, Clinicient enables thousands of therapists across the United States to deliver more effective clinical outcomes, and maximizes their collection of nearly $1 billion in payments annually. Clinicient is headquartered in Portland, Oregon; for more information call (877) 312-6494 or visit http://www.clinicient.com or follow Clinicient on Twitter @Clinicient.