Proving your value as a therapist might feel like an uphill battle. Because regardless of how much your patients improve—or how many healthcare dollars you save—your payments won’t necessarily change to reflect the value you provide. If you’re finding yourself struggling to negotiate with payers, I feel for you. As a former clinic director, I’ve been there, too. But, as health care moves toward a pay-for-performance environment, it’s crucial that we’re able to prove our value. And I know we can do just that if we’re armed with the right information: I’m talking about tracking, analyzing, and using outcomes data.
The Not-So-Distant Future
Now, you might believe that you can delay incorporating the use of data in your practice because the changes taking shape in the healthcare landscape won’t affect you right away. But, this mindset is a trap. Because according to the US Department of Health and Human Services (HHS), those changes are already happening. In fact, HHS:
- Has already met its 2016 goal of basing 30% of all Medicare fee-for-service (FFS) on alternative payment models, such as Accountable Care Organizations (ACOs) or bundled payment plans.
- Plans to increase that proportion to 50% by the end of 2018.
- Plans to link 85% of FFS payments to outcome measures by the end of 2016.
- Aims to bump that percentage to 90% by the end of 2018
These are some aggressive timelines, which means PTs have to step up now—or face a host of challenges later. And stepping up means taking control of the data that will inform your future payments.
The New Payment Paradigm
So, you’re not a Medicare provider—which means you don’t need to worry about the aforementioned payment projections, right? Not so fast. Remember, this isn’t just a Medicare payment shift; it’s a payment paradigm shift. That’s because historically speaking, private payers tend to follow Medicare’s lead. That means all providers—regardless of payer mix—will need to be prepared with valuable data—that is, data that’s universally accepted, risk-adjusted, and relevant to patients and practitioners in other healthcare specialties. After all, when you use data gleaned from nationally recognized outcomes measures, you can give your payers a clearer, more accurate representation of how your treatments get patients better faster—and for a lower cost—compared to other care options.
Wondering which nationally recognized outcomes measures you should track? During a recent WebPT webinar, I covered what outcome tools you should use and when. If you missed it, you can watch the full replay—and review the slides—on the WebPT Blog. In the meantime, here’s a breakdown of each self-assessment tool that I recommend:
This assessment uses 11 items to measure symptoms and physical function for patients with upper extremity musculoskeletal disorders. This survey has fewer questions compared to the full DASH and doesn’t include some of the more uncomfortable questions (namely, the ones that discourage patients from completing the full DASH). In the self-assessment portion of the QuickDASH, patients use a five-point scale to rate functional difficulty and interference with their daily lives.
Providers use this OMT for patients with lower extremity cases. To complete the self-reported questionnaire, patients rate how difficult it is for them to complete their daily tasks.
This test is one of the standard OMTs for patients with low back pain. Providers use this particular questionnaire to determine a low back pain patient’s quality of life and degree of disability.
This commonly used self-assessment can give insight into how a patient’s neck pain is affecting his or her daily life. It’s mostly used during evaluations for chronic neck pain, headaches, cervical radiculopathy, and whiplash injuries and associated disorders.
This self-assessment is used to determine a patient’s self-perceived effects of dizziness through assessing a patient’s gait, quality of life, social relationships, vestibular, and balance vestibular.
I suggest using these five OMTs to start, and then—depending on your patient population and specialty—adding other tests to your library. If you use an outcomes tracking software like WebPT Outcomes, then once you’ve collected your data, you’ll be able to run user-friendly reports to tell you exactly how you’re performing. You can then use that data to market your practice and negotiate for better payment rates, which in turn, will boost your bottom line.
Change is inevitable, but that doesn’t mean rehab therapists need to panic. With a little help from outcomes data, we can take control of our payment destiny. To learn more about how to better prepare for the future, download the PT’s guide to payment reform.
About the Author
Heidi Jannenga is co-founder and president of WebPT, the leading electronic medical record solution for physical therapists and a three-time Inc. 5000 honoree. She has more than 15 years of experience as a physical therapist and clinic director, and she’s an active member of the sports and private practice sections of the APTA as well as the PT-PAC Board of Trustees.