So, you want to deliver value-driven care? There are plenty of formal programs in play that are designed to foster value-driven care throughout the healthcare system (MIPS, PCMHs, and ACOs, to name a few). But even if it doesn't make sense for your practice to participate in these programs—or you're not eligible to do so—you can still foster a culture of value-driven care in your own organization. For starters, you can standardize the use of physical therapy outcome measures—and the collection and analysis of the resulting data. And you should. After all, in doing so, you’re committing to not only delivering the best possible care to each individual patient, but also moving the entire healthcare ecosystem in the right direction. With that in mind, here are six best practices for delivering value-driven care in your PT practice:
1. Leverage physical therapy outcomes data to inform treatment plans and provide appropriate staff education.
We’ve been discussing the benefits of clinic-wide outcomes tracking for years now, because it can help providers improve care delivery, motivate patients, and establish objective standards to communicate the value of their care to other providers and payers. But it can also provide exceptional insight into staff strengths and weaknesses. If some providers in your practice are racking up excellent OMT scores for patients who are recovering from, say, shoulder surgery—and others aren’t—then you can tag your skilled PTs and have them share best practices via a lunch ‘n’ learn session, thus leveling up your entire team. This can also help you identify specific niches that your practice is well-equipped to address, thus providing even more valuable care to your community. To learn more about the types of outcome measures you should be tracking, check out this guide.
2. Ask patients about their experience; then, address their feedback.
The best way to ensure you’re providing the most valuable care to your patients is to ask them how they feel about the care they received (or, better yet, are currently receiving). Beyond having patients complete outcome measures to assess their progress, it’s also a good idea to request feedback about their experience. After all, in today’s healthcare environment, excellent care extends well beyond physical intervention and into the less-tangible aspects of patient touchpoints—from a patient’s first interaction with your practice through the last.
While you could attempt to source this information via satisfaction surveys, these come with their own issues, including a propensity for bias. Instead, WebPT recommends using Net Promoter Score® (NPS®), a one-question, easy-to-digest survey that assesses how likely a patient is to recommend your practice to a friend. Add in a freeform text box to capture anything else patients would like to share, and you’ll have a wealth of actionable insight at your fingertips. This data will allow you to not only address individual concerns before they become big enough issues to cause patient dropout, but also identify practice-wide trends to continually exceed patient expectations. (As a bonus, you’ll also know which pleased patients to ask for reviews that will help you further market your value-driven services.)
3. Equip patients with the tools they need to achieve the best possible results.
You can give your patients your all while they’re in the clinic, but so much of their success depends on their follow-through outside of appointment hours, which is why it’s imperative that you provide them with tools that support care plan adherence. That includes an intuitive, multimedia home exercise program that they can access anywhere (think mobile-friendly)—as well as a communication channel to reach you with questions about that exercise program in real time. After all, nothing stalls patient progress more than being confused by an exercise and having no one to ask for help before the next appointment.
4. Provide ample opportunities for staff to improve and expand knowledge.
Your people are your biggest asset, which means it’s imperative that you provide them with opportunities to learn and grow—for their sake as well as your patients’. For your clinical staff, we recommend going beyond state CEU requirements. After all, those can be variable, and they are often formed based on the minimum necessary to ensure providers stay current, which isn’t always enough to achieve excellence. In addition to providing outcomes-focused lunch ‘n’ learn opportunities, get to know your staff and find out what interests them most. Then, design learning opportunities to help them achieve their goals—or support them in finding those learning opportunities outside of your clinic. As we explained here, autonomy, mastery, and purpose are key to intrinsic motivation, and a culture that prioritizes those things is bound to yield therapists who provide exceptional, value-driven care.
5. Incorporate more metrics that aren’t volume-based.
With the current state of rehab therapy reimbursements, it might seem like the best way to boost your bottom line is to increase the pressure on providers to see more patients per day. But these types of volume-based productivity metrics can (and often do) backfire with staff burnout and sub-par patient care—neither of which will help you achieve your goal of delivering real value. Instead, this could seriously damage your reputation with patients, payers, and referral partners.
Thus, consider employing metrics that tap into care quality and patient experience (via outcomes data and NPS scores) and, as Meredith Castin explains here, even “soft skills and non-clinical skills such as leadership and attitude.” According to Castin, “You can also monitor your therapists’ participation in community events, track their patient satisfaction scores, and look at how they’ve been involved in interdisciplinary outreach and other collaborative efforts. All of these show commitment to one’s job and one’s profession—without relying on a single productivity number to assess an employee’s worth.”
6. Create a team environment that holds all providers—including assistants—to a high standard of care.
Speaking of reimbursement rates, Medicare will be reducing payments for therapy-assistant provided services by 15% in the coming years, which means providers absolutely must re-evaluate their use of assistants to ensure they’re maximizing everyone’s time—while also providing the best care for their patients.
According to WebPT Founder and Chief Clinical Officer Heidi Jannenga, the best way to do that is to ensure that everyone is working together as a team and practicing to the highest level of certification: “Logistically speaking, we should be leveraging assistants to improve efficiency and increase patient volume,” she said. “That means having PTs and OTs administer services that specifically require their specialized skill set, and letting PTAs and OTAs do the rest.” Furthermore, “Rehab therapists must get out of the mindset that PTs and OTs need to stay with their patients throughout the entirety of the appointment, because that frankly is not always the case. And despite what you may think, sharing a patient with an assistant won’t necessarily take away from the patient’s experience or satisfaction with his or her care.”
There is one word of caution when it comes to this approach, though: as Jannenga explains, “it’s crucial that everyone on the team—therapists and assistants alike—consistently deliver the same top-notch level of care and practice at the peak of their ability. The patients must know the clear goals and objectives of the treatment plan and believe that there’s no drop in the quality of the care they are receiving—regardless of who’s providing it.” To learn more about adjusting your scheduling methodology to empower assistants—and help offset the PTA and OTA reimbursement cuts—check out this blog post.
There you have it: six best practices for delivering value-driven care in your PT clinic. Have your own best practices for achieving excellence in patient care? Share them below. We’d love to hear what works for you.