{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T19:14:57Z","timestamp":1773774897523,"version":"3.50.1"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Insurance status has been shown to impact clinical outcomes after several orthopaedic procedures. Current evidence examining the role of insurance provider on outcomes following anterior cruciate ligament (ACL) reconstruction is limited. Therefore, the purpose of this investigation was to explore the effect that insurance carrier had on physical therapy (PT) access, knee range of motion (ROM), and Knee Outcome Survey (KOS) scores. A retrospective cohort study identified patients who underwent ACL reconstruction at an academic health system from January 1, 2019 to December 31, 2021. Patients were partitioned into two cohorts based on their insurance provider: Managed care (MC) or commercial (COM). Outcomes recorded change in knee active range of motion (AROM), passive ROM (PROM), KOS score, and reason for conclusion of PT. Univariate and multivariate analyses were performed by chi-squared tests, Welch's t-tests, as well as multivariable logistic and linear regression with Bonferroni corrections applied to control the family-wise error rate. The study cohort included 149 patients who underwent ACL reconstruction and completed rehabilitation within affiliated PT locations. The MC cohort experienced a longer time until the first PT visit, shorter duration of PT, fewer total PT visits as well as insurance-authorized visits, and a smaller maximum number of visits per patient's benefit. However, there was no difference between cohorts in the number of visits divided over the treatment duration or the number of visits attended over the total number authorized. Both the groups displayed statistically similar improvements in AROM, PROM, and KOS in addition to comparable reasons for concluding PT. Furthermore, regression demonstrated that no insurance parameter predicted changes in AROM, PROM, KOS, or reason for concluding PT. MC-provided patients who underwent ACL reconstruction had inferior access to PT compared with those insured by COM. However, MC and COM yielded a similar percentage utilization of authorized PT visits and number of insurance denials leading to early PT termination. Both the cohorts also demonstrated similar improvements in AROM, PROM, and KOS.<\/jats:p>","DOI":"10.1055\/a-2640-3314","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T23:47:32Z","timestamp":1752623252000},"page":"754-758","source":"Crossref","is-referenced-by-count":1,"title":["Medicaid-Insured Patients Exhibit Similar Improvements in Knee Range of Motion Compared to Commercially Insured Patients Despite Inferior Access to Physical Therapy Following ACL Reconstruction"],"prefix":"10.1055","volume":"38","author":[{"given":"Eric V.","family":"Neufeld","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, New Hyde Park, New York"},{"name":"Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Tarazi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, New Hyde Park, New York"},{"name":"Department of Orthopaedic Surgery, Huntington Hospital, Huntington, New York"},{"name":"Department of Orthopaedic Surgery, Long Island Jewish Valley Stream, Valley Stream, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Wickes","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, New Hyde Park, New York"},{"name":"Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon J.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, New Hyde Park, New York"},{"name":"Department of Orthopaedic Surgery, Huntington Hospital, Huntington, New York"},{"name":"Department of Orthopaedic Surgery, Long Island Jewish Valley Stream, Valley Stream, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa A.","family":"Colleluori","sequence":"additional","affiliation":[{"name":"Sports Therapy and Rehabilitation Services (STARS), Eisenhower Park, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randy M.","family":"Cohn","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, New Hyde Park, New York"},{"name":"Department of Orthopaedic Surgery, Long Island Jewish Valley Stream, Valley Stream, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Goodwillie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Northwell Health, New Hyde Park, New York"},{"name":"Department of Orthopaedic Surgery, Long Island Jewish Medical Center, New Hyde Park, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,7,15]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/s00167-021-06825-z","article-title":"Current trends in the anterior cruciate ligament part II: evaluation, surgical technique, prevention, and rehabilitation","volume":"30","author":"V Musahl","year":"2022","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"2959","DOI":"10.1177\/0363546515603053","article-title":"Does racial variation influence preoperative characteristics and intraoperative findings in patients undergoing anterior cruciate ligament reconstruction?","volume":"43","author":"R A Navarro","year":"2015","journal-title":"Am J Sports Med"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1002\/pmrj.12831","article-title":"Health disparities in the management of ACL injuries: how socioeconomic status, insurance, and race influence care","volume":"14","author":"C D Stafford II","year":"2022","journal-title":"PM R"},{"issue":"17","key":"ref4","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.2106\/JBJS.18.01408","article-title":"The association between race\/ethnicity and revision following ACL reconstruction in a universally insured cohort","volume":"101","author":"R A Navarro","year":"2019","journal-title":"J Bone Joint Surg Am"},{"issue":"23","key":"ref5","doi-asserted-by":"crossref","first-page":"823","DOI":"10.5435\/JAAOS-D-17-00410","article-title":"Current concepts in orthopaedic care disparities","volume":"26","author":"N K Pandya","year":"2018","journal-title":"J Am Acad Orthop Surg"},{"issue":"17","key":"ref6","doi-asserted-by":"crossref","first-page":"e15361","DOI":"10.1097\/MD.0000000000015361","article-title":"Socioeconomic status impacts outcomes following pediatric anterior cruciate ligament reconstruction","volume":"98","author":"A R Patel","year":"2019","journal-title":"Medicine (Baltimore)"},{"issue":"09","key":"ref7","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/j.arth.2015.03.015","article-title":"The effect of insurance type on patient access to knee arthroplasty and revision under the Affordable Care Act","volume":"30","author":"C Y Kim","year":"2015","journal-title":"J Arthroplasty"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1016\/j.arth.2020.02.023","article-title":"Do patient point of entry and Medicaid status affect quality outcomes following total knee arthroplasty?","volume":"35","author":"J E Feng","year":"2020","journal-title":"J Arthroplasty"},{"issue":"04","key":"ref9","doi-asserted-by":"crossref","first-page":"e0085","DOI":"10.2106\/JBJS.RVW.19.00085","article-title":"The relationship between Medicaid coverage and outcomes following total knee arthroplasty: a systematic review","volume":"8","author":"N Lakomkin","year":"2020","journal-title":"JBJS Rev"},{"issue":"23","key":"ref10","doi-asserted-by":"crossref","first-page":"2041","DOI":"10.2106\/JBJS.17.00834","article-title":"Medicaid payer status is associated with increased 90-day morbidity and resource utilization following primary total hip arthroplasty: a propensity-score-matched analysis","volume":"100","author":"D Shau","year":"2018","journal-title":"J Bone Joint Surg Am"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"2325967118763353","DOI":"10.1177\/2325967118763353","article-title":"Medicaid health insurance status limits patient accessibility to rehabilitation services following ACL reconstruction surgery","volume":"6","author":"M J Rogers","year":"2018","journal-title":"Orthop J Sports Med"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"e1457","DOI":"10.1016\/j.asmr.2022.05.005","article-title":"Patients with Medicaid insurance undergoing anterior cruciate ligament reconstruction have lower postoperative international Knee Documentation Committee scores and are less likely to return to sport than privately insured patients","volume":"4","author":"N S Chava","year":"2022","journal-title":"Arthrosc Sports Med Rehabil"},{"issue":"24","key":"ref14","doi-asserted-by":"crossref","first-page":"e183","DOI":"10.2106\/JBJS.K.00852","article-title":"Anterior cruciate ligament injury and access to care in South Florida: does insurance status play a role?","volume":"94","author":"M G Baraga","year":"2012","journal-title":"J Bone Joint Surg Am"},{"issue":"08","key":"ref15","doi-asserted-by":"crossref","first-page":"2325967114548176","DOI":"10.1177\/2325967114548176","article-title":"Delay to reconstruction of the adolescent anterior cruciate ligament: the socioeconomic impact on treatment","volume":"2","author":"J T Newman","year":"2014","journal-title":"Orthop J Sports Med"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1123\/jsr.2017-0176","article-title":"Relationship between physical therapy characteristics, surgical procedure, and clinical outcomes in patients after ACL reconstruction","volume":"28","author":"I J Dempsey","year":"2019","journal-title":"J Sport Rehabil"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1007\/s11999-016-4813-4","article-title":"Value-based healthcare: patient-reported outcomes in clinical decision making","volume":"474","author":"J F Baumhauer","year":"2016","journal-title":"Clin Orthop Relat Res"}],"container-title":["The Journal of Knee Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2640-3314.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T23:48:26Z","timestamp":1762991306000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2640-3314"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,15]]},"references-count":16,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,11,12]]},"published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2640-3314","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1538-8506","1938-2480"],"issn-type":[{"value":"1538-8506","type":"print"},{"value":"1938-2480","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,15]]}}}