According to the Occupational Outlook Handbook, physical therapists (PT) play a vital role in helping injured people improve their movement and manage their pain. These highly trained professionals provide rehabilitation and treatment of chronic conditions, illnesses, or injuries. Sometimes a patient recovers quickly and needs only a few treatments, while in other instances the road to recovery requires months or even years. The need for physical therapy care knows no boundaries. Missourians all across the state need access a licensed PT, and they often need insurance to help pay for that care. Both can be challenging.

 

Physical Therapy Care & Uninsured Rural Missourians

 

A recent report from the Missouri Department of Insurance, Financial Institutions & Professional Registration reveals the counties that have the highest percentages of uninsured residents. For example, nearly 1/3 of working-age adults living in Knox County are uninsured, and there are no practicing physical therapists. Here’s a breakdown:

 

 

Access to Licensed PTs in Counties with High Uninsured Rates

 

Access to Licensed PTs in Missouri Counties with High Uninsured Rates

 

*15.3 – 21.9% of residents in these counties were uninsured in 2016.

 

Limited Physical Therapy Care Health Coverage

 

In general, healthcare coverage options are limited for individuals living in the Show-Me State. Most rural counties in Missouri have access to only one insurance company: Anthem, which operates mostly on the eastern part of the state or Ambetter, which serves mostly western Missouri. In most instances, physical therapy care is limited under standard policies. For example, a typical silver plan covers 20 PT in-network visits per year. Even if they have access to a physical therapist in their area, individuals who aren’t covered by Medicare or additional plans often can’t afford to receive the rehabilitation care they need after exhausting their insurance benefits.

 

One Option: Physical Therapy Care from Miles Away

 

Telemedicine is gaining traction as one option to provide healthcare access, particularly in rural areas. But could it be viable when it comes to physical therapy? Maybe, according to the Federation of State Boards of Physical Therapy (FSBPT). In its 2015 policy recommendation, telehealth could fit a vital need in those areas where there’s a shortage of qualified physical therapists. This includes underserved populations such as those who live in rural areas, and typically would involve video conferencing between patient and physical therapist.

However, providers’ professional and legal responsibilities remain intact, regardless of whether care if provided within the traditional setting or at a distance via telehealth methods. The Federation provided a blueprint for how PTs can ensure a quality patient experience while using technology tools from miles away. The guidelines from a professional organization are necessary. Many states’ laws don’t yet contain specific regulatory and oversight language regulating physical therapy practice using telehealth.

 

Caveats and Calls to Action

 

Telehealth may be an answer to ensuring that all Missourians would have access to physical therapy care. However, some challenges still remain. For example:

 

• This model could provide only basic diagnosis and care. However, if there was a physical therapy assistant available, that person could administer patient care under the guidance and supervision of a licensed PT.
• Video conferencing requires high-speed (broadband) internet connectivity, which still isn’t available in most rural homes. Until such residential access is made available, groups such as the Missouri Physical Therapy Association should consider partnering with local chambers of commerce, county health departments, schools, or other entities with the goal of establishing one telehealth system in every town where no access to affordable physical therapy is available.
• Insurance providers should offer telehealth coverage for physical therapy at a reduced cost. This is similar to how telemedicine care options are handled.

 

 

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One Missouri is committed to  research, education, advocacy, and policy development on behalf of all Missourians.

 

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Top Photo Credit: fnu.edu