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Congress must lock in gains from the virtual revolution in physical therapy

As recently as five years ago, access to physical therapy meant a trip to a physical therapist. For millions of Americans now, it’s as close as their smartphones.

Virtual physical therapy, once a niche service, has gone mainstream, transforming how we heal and manage pain.

But unless Congress acts, patients will lose access to these services at the end of the year.

The COVID-19 pandemic was the catalyst for the shift, forcing a rapid expansion of virtual health care services across the board, including physical therapy. In 2020, at the height of the COVID-19 pandemic, nearly half all PT sessions involved telehealth. Medicare and private insurers temporarily broadened coverage, allowing millions to access care safely from home.

Virtual PT has become more than just a pandemic-era convenience. It’s a powerful tool for democratizing health care. Consider this: Black and Hispanic Americans, as well as those in rural areas, have long faced significant barriers to rehabilitation services. Virtual care is changing that equation.

Research suggests that virtual PT improves health outcomes for Black and Hispanic patients. For rural communities, virtual PT has demonstrated retention rates of 77%, even higher than the 74% seen in urban areas. These findings suggest that virtual PT could be a key to addressing long-standing health care disparities.

The impact on patient outcomes is equally impressive. Research on patients recovering from knee replacements found that tele-rehabilitation was as effective as in-person therapy. Another study revealed that patients using virtual PT experienced improvements in functionality — and reduced suffering due to pain — compared to those receiving usual care without any PT.

We’ve seen these results firsthand at the Hospital for Special Surgery, where our team works with numerous virtual PT patients.

Virtual PT is also proving to be a game-changer for older adults, challenging assumptions about technology adoption among seniors. Studies have found that patients over 65 often engage more with virtual platforms, completing more exercises per week than younger users. One study reported that patients over 65 performed an average of 3.1 exercises per week, compared to 2.5 for younger patients. This increased engagement translates to better adherence to treatment plans, quicker recovery and fewer complications.

This progress, however, is at risk. At the end of 2024, Medicare’s expanded coverage for virtual PT services is set to expire unless Congress acts. Failure would leave millions without access to this vital option.

Fortunately, some lawmakers have proposed bills that aim to extend such coverage. For the most part, however, these bills only extend Medicare coverage of virtual PT for another two years — which is a great first step, but not enough on its own. Congress should embrace this health care revolution by making Medicare coverage for virtual PT permanent.

The case for virtual PT is compelling. In our experience, patients are highly satisfied with this efficient, safe and cost-effective offering. It expands access to underserved communities. It delivers outcomes comparable to traditional care. And it empowers patients to take control of their healing process. Now it's up to Congress to ensure this vital service remains available to all who need it.

Cathy MacLean is Chief Value Medical Officer and Charles Fisher is VP of Rehabilitation and Performance at Hospital for Special Surgery. This piece originally ran in RealClearHealth.

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