Previous Pilot Studies



Enabling Physical Therapy Health Services Research: the Development of a Crosswalk for Functional Measures in Post-Acute Medicare Claims

Aims of the Study: The overall objective is to promote physical therapy health services research and training across the continuum of physical therapy services using Medicare administrative data. The Specific Aim is to create cross-walks for the functional measures used in the Medicare post-acute assessment files. This project will enable physical therapy researchers to address quality, comparative effectiveness, cost-effectiveness, and service delivery models across post-acute care in large representative samples of Medicare beneficiaries.

McDonough maintains, “This project will overcome limitations of Medicare data and enable physical therapy researchers to answer important questions about the value of physical therapy. This could mean questions about different ways of delivering PT, or comparing the impact of PT to the impact of interventions in other disciplines. One critical contribution of this project will be to allow analysis across post-acute care in large representative samples of Medicare beneficiaries.”

Development and Preliminary Implementation of a Registry for Physical Therapists’ Management of Knee Pain

Aims of the Study:

  1. Identify key demographic, examination, classification, intervention, and outcome variables to be included in the registry and collected during care provided at physical therapy sites throughout the United States.
  2. Pilot test use of the registry to collect process of care and outcomes data during standard care and examine the feasibility of the data collection process (adherence and barriers to data collection, level of therapist and patient burden) and quality of data obtained.
  3. Use the results of the pilot test to revise and finalize the registry for implementation on a national scale.

Data registries provide the infrastructure needed to examine physical therapy practice patterns and clinical outcomes. CoHSTAR funding supports a pilot study to develop and implement a national registry for patients with knee pain.

“This registry will provide a tool that can be used for individual and organizational quality improvement efforts,” states Irrgang. “This project will enable determination of adherence to clinical practice guidelines to determine if interventions matched to the patient’s classification lead to improved outcomes and value.”

Associations between Continuity of Care (CoC) and Health Care Utilization and Costs in Patients with Low Back Pain

Aims of the Study:

  1. Examine the associations between physical therapist PC (1 PT vs. more than 1 PT) and future LBP-related healthcare utilization of advanced imaging, emergency department visits, epidural steroid injections, spine surgeon consultations and spine surgery as well as total costs for LBP over a 1-year period following primary care referral to physical therapy.
  2. Examine the associations between receiving physical therapy for LBP inside vs. outside the PCP’s healthcare delivery system and future LBP-related healthcare utilization of advanced imaging, emergency department visits, epidural steroid injections, spine surgeon consultations and spine surgery as well as total costs for LBP over a 1-year period following primary care referral to physical therapy.

This pilot study has the potential to affect management decisions, improve patient care and reduce societal costs related to LBP.

“CoHSTAR funding allows us to carry out this important project in which we expect to identify important opportunities to improve the quality of care for patients with low back pain,” notes Magle.

The Impact of Physical Therapy on Improving Function and Reducing Hospitalizations in Medicare Home Health (HH) Populations

Aims of the Study:

  1. Determine if the number of therapy visits (No therapy, <5 visits, 5-13 visits,  or >13 visits) delivered during a home health episode of care are independent predictors of functional recovery after adjusting for socio-demographics, medical complexity, and other non-therapy service utilization.
  2. Determine if the number of therapy visits (No therapy, <5 visits, 5-13 visits,or >13 visits) delivered during a home health episode of care independently reduce odds for hospitalization during a HH episode of care after adjusting for socio-demographics, medical complexity, and other non-therapy service utilization.

This CoHSTAR-funded pilot study aims to determine if there is a dose-dependent relationship between physical therapy visits and meaningful improvements in physical function and reductions in hospitalizations for Medicare beneficiaries who receive home care services. This is the first study to assess the impact of home health therapy on functional recovery and hospitalizations among Medicare beneficiaries in a large secondary database. The study will determine if the number of therapy visits delivered predict functional recovery and reduce odds for hospitalization during a home health episode of care. The findings from this study will improve understanding of how therapy services are associated with home health outcomes, and could provide evidence to protect reimbursement for therapy services in home settings.

Stevens-Lapsley observes, “CoHSTAR pilot study funding allows us to access two large secondary Medicare databases, and evaluate how patients referred to home health benefit from physical therapy services.”