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Creative Commons License

Creative Commons Attribution-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 License.

Abstract

Michigan’s Direct Access Provision of 2015 (Enrolled Senate Bill No. 690, 201), which aimed to increase patient access to physical therapy and reduce waiting times, has created hurdles for patient access and for physical therapy as an autonomous profession. The purposes of this policy analysis were: 1) to analyze the Direct Access (DA) policy including examining existing challenges resulting from implementation, 2) provide recommendations for implementing an alternative policy, and 3) outline the benefits of the alternative policy. The DA policy with provisions was examined using the Patton and Sawicki (1993) framework, which provides a basic approach that identifies the problem, explores alternatives, and helps select an alternative policy that best addresses the issues. Our analysis revealed several themes indicating that an alternative policy provides better access and autonomy as compared to DA, resulting in lower healthcare costs. While DA does allow a patient to access outpatient physical therapy for 10 visits or 21 days, an alternative policy, such as unrestricted access, would enable patients to access physical therapy services according to the medical necessity in collaboration with their physical therapist. The DA policy can delay patient access to physical therapy treatments; hence, there is a need for an alternative policy to reduce unnecessary delays through a structured, collaborative approach, thus enabling an optimal balance between safety and patient autonomy.

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