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Our Goals for this Meeting

Athletic Training in Wisconsin A 2016 Update: State of Wisconsin Division of Medicaid Services Joe Greene OrthoVise LLC CEO and Owner. Our Goals for this Meeting. Describe the Profession of Athletic Training Define the Current State of Athletic Training

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Our Goals for this Meeting

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  1. Athletic Training in Wisconsin A 2016 Update: State of Wisconsin Division of Medicaid ServicesJoe GreeneOrthoVise LLC CEO and Owner

  2. Our Goals for this Meeting • Describe the Profession of Athletic Training • Define the Current State of Athletic Training • Describe how Athletic Trainers Optimize Cost Avoidance for Payors • Clarify our Request of DMS • Answer your Questions

  3. The Profession of Athletic Training

  4. Athletic Training • The NATA was founded in 1950 • AMA recognition in 1990 • Licensure achieved in Wisconsin in 1999 • 43,000 NATA Members • 1200 Licensed Athletic Trainers in Wisconsin • Masters Entry Level Degree Adopted

  5. Athletic Training Competencies (7) • Evidence Based Practice • Clinical Examination and Diagnosis • Prevention and Health Promotion • Acute Care of Injuries and Illnesses • Therapeutic Interventions - Physical Rehabilitation and Modalities • Psychosocial Strategies and Referral • Healthcare Administration

  6. The Current State of Athletic Training

  7. Athletic Training in 2016 • Professional Sports : 2% • Collegiate Teams : 19% • High Schools : 18% • Hospitals and Clinics : 17% • Students : 27% • Emerging Settings : 2%

  8. Athletic Training and Cost Avoidance

  9. Athletic Training and Healthcare • Corporate Healthcare Model • Resource Utilization Optimization • Rural Healthcare Growth • Diverse and Versatile Provider • Epic Systems Foundation System Inclusion • Front Line of Concussion Management

  10. Outcomes

  11. CommercialFull Recognition (7) • Anthem • Dean • Unity • Physicians Plus • Aurora BayCare • FortCare Cerner • Sysco

  12. CommercialRecognition with Prior Authorization (9) • Cigna • Group Health Cooperative • Health Partners • Aetna • Humana • Medica • United • WEA • WPS

  13. Confirmed PayorsWorkers Compensation (36) • Cincinnati Insurance • CNA Claims Plus • Corvel • Frankenmuth Mutual • Gallager Bassett • Heartland • Horizon Management Group • Liberty Mutual • Pekin Insurance • Preferred • Secura • Sedgwick • Sentry • Acuity • Aegis • AIG • America WC • Amtrust North America • Argent • Berkley Agri-Business • Broadspire • Chubb • CBCS • CCI, Columbia County • Society Insurance • State of Wisconsin • Travelers Indemnity • Travelers Property • Tyson • United Heartland • United WI • Wausau • West Bend Mutual • Western National WC • WI State Historical Society • Zurich American

  14. Our Request of the State of Wisconsin Division of Medicaid Services

  15. Request Recognition and Reimbursement of Athletic Training as Autonomous Rehabilitation Providers in an Outpatient Rehabilitation Setting

  16. Request Clarification • Reimbursement for services in the Outpatient Rehabilitation Setting • Recognition of CPT Codes • 97169 : Low Complexity Athletic Training Evaluation • 97170 : Moderate Complexity Athletic Training Evaluation • 97171 : High Complexity Athletic Training Evaluation • 97172 : Re-Evaluation of Existing Condition • Recognition of 97xxx Physical Medicine Codes • Recognition of 951 Revenue Code • State Practice Act Referral Requirement • MD, DO, DC, PA, NP, PT, DPM, DDS

  17. State Practice Act Considerations

  18. 2010 State Practice Act Changes • Athletic Trainers Care for the Physically Active • Referral Requirement : Outpatient Rehabilitation

  19. State Practice Act • Direct Access Clarity with the exception of Outpatient Rehabilitation Setting

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