Outpatient therapy services are composed of physical therapy (PT), occupational therapy (OT), and speech language pathology (SLP). These services have accounted for a small but growing share of the Medicare expenditures, accounting for about three percent of Medicare Part B spending in 2004. The past growth in Medicare expenditures led to increased attention to these services. Attempts to address the increased expenditures through payment policy changes led to the realization that CMS cannot adequately assess the appropriateness of utilization patterns or the impact of changes in payment policy without access to better information tied to patient need and the effectiveness of outpatient therapy services.
In 2008, the Centers for Medicare & Medicaid Services established a research project titled “Developing Outpatient Therapy Payment Alternatives” (DOTPA). The purposes of this project are to identify, collect, and analyze therapy-related information tied to beneficiary need and the effectiveness of outpatient therapy services. The ultimate goal is to develop payment method alternatives to the current financial cap on outpatient therapy services.
The five year contract for implementing DOTPA was awarded on January 29, 2008 to RTI International. This is the official website for this project.
CMS Project Summaries
Shorter (one-page) summary of this project
Project Year 4 Annual Report, (May, 2012)
Project Year 3 Annual Report, (July, 2011)
Slide presentation for Open Door Forum - August 19, 2010
Transcript from CMS Open Door Forum - This is the transcript from the CMS Open Door Forum that occurred August 19, 2010.
Audio Recording from CMS Open Door Forum - August 19, 2010
OMB Approved Assessment Tools (January, 2011)
2007 Medicare Outpatient Therapy Utilization Report. (June, 2009)