Robert Hall

The inaugural APTA Payment Advocacy Summit, scheduled for July 10-11 in Portland, Oregon, may ultimately be significant not because of what happens during the two-day event, but because of what it leads to for the future of physical therapy.

For years, payment advocacy has often happened in silos. National efforts, chapter initiatives, commercial payer negotiations, and specialty-specific projects have all pursued similar goals, but frequently without a unified strategy. The Payment Advocacy Summit reflects a growing recognition that the profession’s payment challenges have become too large and too interconnected for isolated solutions.

The evidence supporting physical therapy has never been stronger. Study after study has shown that early physical therapy can reduce opioid exposure, decrease imaging utilization, lower overall healthcare spending, and improve outcomes for people with musculoskeletal conditions. Physical therapy offers tremendous value to patients, employers, and healthcare systems.

Despite the growing evidence, physical therapists continue to face prior authorization requirements, administrative burdens, credentialing delays, network restrictions, and payment rates that often fail to reflect the value they deliver. In many cases, the barriers preventing patients from receiving timely care have little to do with clinical evidence and everything to do with payment policy.

Several themes deserve attention as the summit approaches. First, administrative burden should be viewed as a payment issue. Time spent obtaining authorizations, appealing denials, and navigating payer requirements represents resources unavailable for patient care. Reducing unnecessary administrative complexity can be just as important as increasing reimbursement.

Second, evidence must play a larger role in coverage policy. APTA has spent decades building clinical practice guidelines and generating outcomes data. Those assets must be used to advocate for payer policies that reward evidence-based care rather than impede it. Concepts such as guideline-based authorization pathways and automatic approvals for selected conditions represent promising opportunities.

Third, payment reform requires collective action. Commercial insurers operate at regional and national scale. Effective advocacy requires collaboration among APTA, specialty academies, chapters, private practices, health systems, employers, and patients. No single organization or practice can solve these problems alone.

Ultimately, the success of the Payment Advocacy Summit should not be measured by attendance numbers or presentation slides. Success should be measured by what follows. Progress would include reduced administrative burden, improved payment, greater transparency, expanded value-based care opportunities, and policies that align with contemporary clinical evidence.

Private Practice physical therapists control the profession’s strongest asset for payer engagement: expertise in managing conditions responsible for enormous healthcare spending. That expertise can help shift payment conversations away from volume and toward value.

The Portland summit represents an opportunity to move beyond isolated advocacy efforts and begin building a coordinated national strategy for payment reform.

Physical therapy has spent decades building the evidence.

The next challenge is ensuring payment policy catches up.