Matthews, who has taken on Ontario's pharmacists and doctors to reduce health-care costs, said she won't back down.
"Bring it on," she said Thursday after announcing the changes at the Toronto Rehabilitation Institute.
"I think the numbers speak for themselves. We can serve twice as many people with virtually the same amount of money. Why wouldn't I make this change?"
The province will spend $156 million — $10 million more than last year — to provide services to about 200,000 more people starting Aug. 1, she said.
More seniors and patients will have access to one-on-one physiotherapy in nursing homes, group exercise classes and services to prevent falls, she said.
They'll also be able to get physiotherapy in their homes, she said. And there will be more access to exercise and falls prevention classes in their communities.
There are no changes to the eligibility rules, Matthews said. The government is simply changing who's getting the money to deliver the services.
The funds will go to Local Health Integration Networks and Community Care Access Centres across the province, rather than dispensing the money to designated physiotherapy clinics that bill the province for their services.
The new system will provide better value for money and access to services in more communities, Matthews said.
For example, there are only two designated physiotherapy clinics in northern Ontario and they're both in Sault Ste. Marie, she said.
"What this means is we're going to be able to extend access geographically," Matthews said.
But giving the money to the LHINs and CCACs will increase the cost of administering the services — money that should go to front-line care, said the Designated Physiotherapy Clinics' Association, which represents 94 clinics.
The province is also cutting the amount of money spent on physiotherapy services, down from over $200 million, said executive director Tony Melles.
"We believe that there's absolutely no way that they can provide more services as they've promised today because they're going to be doing it with less dollars and with a more expensive mechanism," he said.
The government is also jeopardizing nearly 100 clinics and their employees, who provide services at the lowest cost, he said. The association will fight to make sure the funding is spent effectively and provides the best care for patients.
"I'm saddened by the spin that was put on this, because I think ultimately what's going to happen is that the seniors who currently receive services from our group are going to notice a huge decrease in the number and the quality of the services," Melles said.
Progressive Conservative critic Christine Elliott echoed his comments, saying thousands of seniors in retirement homes won't receive services.
"What we're really supposed to be doing is trying to keep seniors in good health longer to keep them out of hospitals and long-term care facilities, and keeping them mobile through the use of physiotherapy," she said.
But the Ontario Physiotherapy Association is supporting the move, saying the old system wasn't fully accessible to seniors who live in the community.
The bigger challenge isn't being addressed, said NDP health critic France Gelinas. Patients who aren't seniors and not collecting social assistance also need access to physiotherapy, but the Liberals cut them off when they delisted it in 2005.
"There is still a huge access issue to physiotherapy for a whole lot of Ontarians, and this has not been looked at," she said.
Providing more access to physiotherapy — particularly to those on limited incomes — was among the recommendations of a report last December to help guide the government's strategy for seniors.
The "Living Longer, Living Well" report noted that the number of seniors in Ontario will double over the next 20 years.
In 2011, there were almost 1.9 million people aged 65 and older in the province, representing 14.6 per cent of the population but accounting for nearly half of health-care spending, the report said.
"If left unaddressed, our demographic challenge could bankrupt the province," it said.