There’s no denying that functional limitation reporting is a little more work to get the same (or less if you consider MPPR) reimbursement and that ignites fear among some in our industry. But you shouldn’t be fearful; you should be frustrated at our own inability to document to a standard that shows our clinical relevance and the amazing outcomes we achieve every day in clinics across the US. We haven’t effectively demonstrated evidence-based practice yet, nor have we properly articulated progress through functional gain. Medicare has been warning us that something like this was coming, and we never ponied up. Now, we have functional limitation reporting (FLR).
I believe we’re moving toward a pay-for-performance structure. FLR is the initial facilitation of that with Medicare patients, and it’s only a matter of time before other carriers follow suit. Essentially, resistance is futile. But why resist? That’s my point in this month’s founder letter: do not resist; do not be afraid; and do not let frustration get the best of you. Because FLR is actually good. How? This reporting affords us the opportunity to demonstrate our expertise and relevancy—and get paid for it. You are essentially already completing these things every day in your clinical practice—now you just have to document it. So get fired up. We need to prove ourselves, and prove ourselves we will. Let’s tell Medicare to bring it on!
With that said, FLR is not about crosswalking a score for an objective measure to a category of severity—in fact, doing so would defeat the purpose of FLR. In reality, FLR is about using your clinical expertise to determine limitation and severity. It’s about your clinical judgment. How many times do you give a patient a self-evaluative outcome measurement tool to complete and the results leave you wondering how he or she came to those conclusions? It’s clear that the patient has an entirely false sense of self, and you know it. FLR requires that you incorporate your clinical judgment to truly assess the severity of a patient’s functional limitation as well as his or her progress. Ultimately, you shouldn't rely solely on a patient’s’ potentially faulty self-assessment as you develop your plan of care. Instead, you should apply your expertise to provide better, more objective treatment.
I cannot stress it enough: you’re proving your worth and getting paid for it. So, stop getting bogged down on modifiers, codes, and progress notes. Really, once you “get it,” FLR becomes second nature in your documentation workflow. (Plus, this month WebPT will launch a fully-integrated FLR feature, so it’ll be super streamlined.) You’re simply telling the story in a way that validates your services.
With FLR, we finally have an outlet to prove that what we do clinically is relevant and deserves payment. We should all view these new requirements as an opportunity for us to finally demonstrate the value of our profession. We’re badasses; we know this. Now let’s show it.