Table 2.
Impact of PT bundle on PT utilization and total medical cost
| Observation period | #Member-month observations (N) | Count of PT visit (per 1,000 per month) |
Total medical allowed ($ PMPM) |
||||||
|---|---|---|---|---|---|---|---|---|---|
| Obs | Exp | Diff | p-value | Obs | Exp | Diff | p-value | ||
| Prior to PT preauthorization | 18,467 | 183 | 183 | 0 | – | 828 | 828 | 0 | – |
| After PT Auth: 1–3 months | 6,483 | 3,145 | 1,770 | 1,375 | 0.000 | 1,346 | 1,144 | 203 | 0.059 |
| After PT Auth: 4–6 months | 5,785 | 512 | 246 | 266 | 0.000 | 994 | 824 | 170 | 0.096 |
| After PT Auth: 7–9 months | 3,517 | 270 | 181 | 89 | 0.068 | 883 | 686 | 197 | 0.106 |
| After PT Auth: >9 months | 1,801 | 147 | 313 | –166 | 0.005 | 809 | 577 | 231 | 0.178 |
Note:
#
represents the number of member-month observations in the sample rather than the number of unique members. ‘–’ indicates not available.
Abbreviations: PT, physical therapy; Obs, observed; Exp, expected; Diff, difference; PMPM, per-member-per-month.