Survey: Clinicians Report Shifts in CTP Use Amid Regulatory Changes

Key Takeaways 

• A majority of clinicians reported changes in CTP utilization over the past 12 months, with shifts most commonly tied to cost management and documentation requirements. 
• Administrative burden and financial pressure led the reported impacts, with some clinicians also noting concerns about patient access. 
• Confidence in long-term policy stability remained mixed to low, with many respondents expressing concern about the future landscape. 

Clinicians Report Measurable Changes in CTP Utilization 

Among the 79 respondents, most indicated that their use of skin substitutes (CTPs) has changed over the past 12 months in the context of recent regulatory and reimbursement updates. 

The most common participants reported being physician-level providers, advanced practice providers, or registered nurses, although multiple other clinical designations were represented. The highest number of respondents reported caring for patients in mobile or home care, acute care, wound care centers, or outpatient offices.  

Eighty-five percent of this cohort reported significantly or somewhat changing their behavior related to CTP application in light of the regulations. When asked how their use has changed, the most selected responses included: 

• Switching to lower-cost products 

• Increasing documentation requirements 

• Reducing overall CTP utilization 

• Delaying or modifying treatment decisions 

These responses reflect a range of operational and clinical adjustments, with many clinicians selecting multiple changes, indicating that shifts in practice are often multifactorial rather than isolated. 

Reported Impacts Center on Administrative Burden and Financial Pressure 

Clinicians were also asked how they perceive the current regulatory environment for skin substitutes. Responses suggest that administrative burden is a leading concern, with many indicating that recent changes have increased workload without a corresponding improvement in care delivery. 

In addition to documentation demands, respondents frequently reported: 

• Increased financial pressure on practices 

• Constraints that may affect patient access to CTPs 

• Ongoing challenges in navigating coverage and utilization expectations 

While some clinicians indicated that current policies may support more appropriate utilization, this view was less commonly reported compared to concerns around burden and access. 

Confidence in Long-Term Stability Remains Limited 

When asked about confidence in the long-term stability of the current policy environment, responses were mixed but leaned toward concern. 

Many clinicians reported being: 

• Somewhat concerned or very concerned about future stability 

• A smaller portion indicated neutral or somewhat confident perspectives 

This distribution suggests a level of uncertainty among providers regarding how CTP-related policies may continue to evolve, particularly as regulatory and reimbursement frameworks remain in flux. 

Open-Ended Feedback Highlights Need for Clarity and Consistency 

Although open-ended responses varied in specificity, several consistent themes emerged. Clinicians frequently pointed to the need for: 

• Greater clarity in policy and coverage requirements 

• Adjustments to application limits 

• Reevaluation of reimbursement structures, including flat-rate thresholds 

These themes align with broader concerns around predictability and operational feasibility in CTP use. 

A Snapshot from the Field 

This survey, distributed via email, social media, and on-site engagement during the SAWC Spring meeting, provides a directional view of how clinicians describe their current experience with CTPs. 

While only a current snapshot, these findings offer a real-time pulse check from providers across practice settings, highlighting how clinicians are navigating a shifting landscape in wound care management. 

Table A1. Survey Domains, Questions, and Response Options