According to Merriam-Webster, a prediction is “a statement about what will happen or might happen in the future.” I don’t know about you, but when I think about what’s in store for our industry, I’m not satisfied with applying that definition to my hopes for the future. Why? Because I’m about more than just making statements; I’m about taking action. So, how do we take steps to improve our bottom lines, the quality of our care, and the health of our communities in the future? Well, we can start by doing more than merely predicting change. In 2016, we have to progress toward that change. Here are six ways we can make strides for our profession in the coming year:
1. Data Collection
Data. Data. Data. Embracing data collection—and analysis—is crucially important. I’ve said it before, and I’ll say it again: we must prove our value through measurable and objective data. In 2016, we need to get more providers on board with tracking and analyzing data—especially with respect to patient outcomes. Now, the PT industry is still in the early adopter stage for outcomes tracking, but that means there’s plenty of room for improvement in 2016. To jumpstart PTs’ data-collection efforts, WebPT has already started beta-testing our new Outcomes solution. And even in the early stages of that testing, we’ve received tons of positive feedback from our Members. They love having the power to track standardized and meaningful data, and because they’re part of a community of more than 50,000 Members, they also have the benefit of power in numbers. With such a large pool of PT-specific data at their disposal, they’ll be well equipped to influence change not only in their own private practices and the PT profession overall, but also within the entire healthcare community at large.
In addition to outcomes data, the data collected through Medicare’s functional limitation reporting (FLR) and Physician Quality Reporting System (PQRS) programs will become increasingly important—like it or not. As we enter 2016, Medicare providers have been reporting FLR data for more than two years—and they’ve been submitting PQRS data for even longer than that. That means CMS has enough data to inform future changes to payment systems for outpatient therapy services.
So, even though collecting data requires more effort on your part, you have to start caring about these initiatives. Because before long, they will directly impact the financial well being of your practice. If you believe you can game the system and ignore data collection completely, you’re putting yourself and our profession at risk of getting left behind. Most businesses rely on data to drive their decision-making, and the same holds true for companies in the healthcare and insurance spaces. And unfortunately for the rehab industry, the data that’s currently being collected is not the data we want representing us. That’s a huge problem, because in most cases, data is all payers and other entities look at when they’re forming payment policies, schedules and contracts. That’s why, moving forward, we—as an entire profession—have to step up and take more control over the way we collect and present our data. In this day and age, anecdotal stories aren’t enough to prove value, and if we want to get the payment rates we deserve, that’s exactly what we need—proof of our value as healthcare providers.
2. Patient Engagement
In 2015—for the first time in history—physical therapists in all 50 states could legally provide some form of direct access care (i.e., all PTs can, at minimum, perform an initial evaluation without a referral). Now, have PTs embraced this opportunity? In my mind, no—not yet. At least not nearly to the extent that’s possible. But, 2016 offers yet another chance to provide your services in a way that not only helps your patients get better faster, but also saves them money. This APTA article perfectly sums up the benefits of direct access: “physical therapists practicing in a direct access capacity have the potential to decrease costs and improve outcomes in patients with musculoskeletal complaints without prescribing medications and ordering adjunctive testing that could introduce harm to the patient.”
That said, from a patient’s perspective, savings don’t always equate to value. To prove our value to our patients, we have to do more than save them money; we have to provide outstanding customer service, thus encouraging them to become our referral sources. Additionally, we have to be in tune with what’s important to our patients. One example that comes to mind is the use of wearables. Patients who are personally invested in tracking their own health and wellness data offer us a huge opportunity: by incorporating this kind of technology into their treatment plans, we can exponentially expand our reach as providers, improve outcomes, and increase patients’ perception of added value. All of that leads to increased patient satisfaction, and happy patients are the ones who will return—and who will tell their friends and family about their awesome rehab therapy experiences.
3. Big Business
In recent years, the fragmented nature of the outpatient PT private practice landscape made the industry ripe for consolidation. We’re seeing more—and larger—physical therapy companies and franchises, thanks in part to investments from hospitals, private equity organizations, and venture capital firms. But unlike the physician or corporate-owned PT conglomerate boom of the ’90s, this trend may not necessarily be a bad thing. Physical therapy business owners are finding it increasingly difficult to scale their businesses while maintaining a profit in such a regulation-heavy environment. By consolidating—or shifting to a franchise model—providers can create an environment that allows for the implementation of better technology, uniform policies, and scalable procedures. And centralized operations, solid processes, and reliable teams all pave the way for improved patient care. Businesses like Sportscare of America, Pivot Physical Therapy, ActiveRx, Fyzical, U.S. Physical Therapy, ATI, Drayer, Confluent Health, and Benchmark are all making moves on that front—and garnering positive attention in the press.
Like I said, we’ve been through a consolidation shift in the past, but I believe things will be different this time. That’s because by and large, the people running today’s large companies and franchises are PTs. That wasn’t always the case before; back in the “old” days, hired gun CEOs typically ran the show. But now, with PTs leading the charge, patients are more than dollar signs. We can’t stop the healthcare landscape from changing and evolving, and as that happens, these kinds of shifts are inevitable. But, as long as PTs are calling the shots—and as long as we continue to make decisions that improve the quality of care we provide—I’m confident the future of our profession will continue to shine bright for everyone.
As the population ages, the need for home-based medical treatment undoubtedly will rise. In fact, according to this Health IT Outcomes article, “The national market for telehealth is expected to reach nearly $3 billion over the next seven years.” To account for this growing trend, individual states will need to update their policies to allow for more treatment of this type. It’s imperative that physical therapists work to shape telemedicine legislation in our favor early (e.g., by pushing for a national licensure model with state-specific certifications). For now, the AMA has postponed its report of proposed recommendations for ethical practices in telemedicine, as the proposal will be discussed in Chicago in June 2016.
The age of server-based EMR and EHR systems has passed. This outdated technology simply doesn’t support the data exchange that will drive the future of health care, because server-based systems keep all of that information siloed and inaccessible. If we want to improve the quality and efficiency of healthcare delivery in this country, we need to improve the infrastructure that allows this information to flow between systems. In other words, we need interoperability. In 2015, we made a giant leap toward total interoperability (cough—ICD-10—cough). But, what good is more specific diagnostic data if it’s locked away behind an antiquated server? Cloud-based systems remove this blocker. Furthermore, thanks to an increase in published APIs (Application Program Interfaces), EMRs in different niche healthcare segments—like orthopedics, primary care, and podiatry—can easily exchange data (e.g., demographics, referrals, and treatment notes) digitally. Eventually, healthcare providers will be able to bid adieu to the fax machine for good—as it will no longer have a place in health care.
Just imagine what it would be like if your referrals automatically transferred from your referring provider’s EMR to your own. Pretty amazing, right? The future of interoperability is so exciting. And I foresee big changes within the WebPT application—sooner rather than later (wink, wink).
6. Payment Reform
CMS has clearly stated its goal “to move 30 percent of Medicare payments into alternative payment models by the end of 2016 and 50 percent into alternative payment models by the end of 2018.” Furthermore, CMS has defined alternative payment models as “models such as Accountable Care Organizations (ACOs), bundled payments, and advanced primary care medical homes.” So, a lot of changes are in store. But, the changes don’t stop with CMS. The APTA has proposed a change in CPT coding called the Alternative Payment System (APS). This new coding model aims to move away “from fee-for-service, to a more bundled, per-session coding system.”
But although the APTA has met with CMS on many occasions, the proposed changes have sparked opposition throughout the industry. I believe the transition will be delayed—even if only for six months to a year—but as it stands, the new CPT coding system could go into effect as early as 2017. Something to keep in mind: as we saw with ICD-10 implementation, a successful transition requires proper education and planning. And when it comes to the proposed APS, both of those things have been severely lacking. If this is a new concept to you, I implore you to keep an eye on the WebPT Blog, as Brooke Andrus will give us an honest look at this proposal—and the controversy surrounding it—in an upcoming blog series. It’s a big change—one that will affect all of us as clinicians—and you must be informed, educated, and completely cognizant of how it will impact your clinical workflow, practice management, and potentially your clinic’s top and bottom lines.
With 2015 drawing to a close, are you making predictions—or planning out your course of action? I hope you have your sights set on progress; the future of our industry depends on better data collection, patient engagement, processes, and preparation for regulatory changes. It’s time for us to get in front of the changes that lie ahead, and the transition to a new year provides the perfect opportunity to do just that.