If there’s one thing I know about rehab therapists, it’s that we are all very busy people. If your to-do list is anything like mine, it’s growing faster than you can prune it—and has probably expanded onto multiple sheets of paper (or maybe even into multiple notebooks). And regardless of the value associated with each item on the docket, we tend to refer to these tasks as things we “have” to do—not things we “get” to do. Let’s be honest—when’s the last time you uttered the words, “Awesome—I get to catch up on my notes this afternoon”?

Often, though, the things we are least excited about are the ones that are the most important—and I would definitely put data collection in that bucket. Unfortunately, not all of my physical, occupational, and speech therapy comrades feel the same way—and their sentiment was quite evident following the official announcement that CMS will discontinue PQRS in 2017. That’s because, with PQRS out of the way—and CMS rendering PTs, OTs, and SLPs ineligible for MIPS (the PQRS heir-apparent) until 2019—rehab therapists can cross quality data-reporting off their collective to-do list for the next two years, at least. We no longer “have” to report quality data to Medicare.

Many therapists will take great joy in scratching off that particular line-item—and part of me can’t blame them. From WebPT’s standpoint as a certified PQRS registry, this program hasn’t exactly been a walk in the park. But, the other part of me wishes we could all take a step back and look at this through a wider lens. If we did, we might not be celebrating the demise of PQRS—and our apparent get-out-of-MIPS free card—with such fervor. Instead, we might be asking why PTs, OTs, and SLPs don’t “get” to participate in such a large-scale data-collection effort from the get-go like our peers in other disciplines. After all, at the end of our two-year hiatus, our to-do lists will be just as long as ever—but our MIPS data stores will be totally empty. And what happens when Medicare—and potentially other payers, agencies, and organizations—start using that data to inform new payment or regulatory initiatives? Where will rehab therapists be left? Well, we will “have” to accept the consequences of our data dearth—unless, of course, we take matters into our own hands.

Whether or not CMS ends up allowing rehab therapists to participate in MIPS on a practice basis—so far, we’ve yet to see any details around the voluntary reporting option CMS alluded to in the MACRA final rule—therapists must make sure they “get” to collect quality data of some sort. It might not come in the form of PQRS, MIPS, or any other federal program (although, as a side note, functional limitation reporting is still in effect for the foreseeable future). And maybe it shouldn’t. There are plenty of other ways for rehab therapists to represent their value through data—by using patient-reported outcomes, for example—and most of them might actually prove more effective than PQRS. That’s especially true if therapists unite in their data collection efforts—that is, if we all commit to adding the same data-tracking to-do to our individual lists.

And honestly, this is a task we should never actually cross off of those lists, because if we want to use our data intelligently—if we want to glean powerful, actionable insights that can help us not only demonstrate, but also improve, the value we provide within the greater healthcare community—then we need to collect, analyze, and compare that data consistently. Furthermore, we need to be thoughtful about the type of data we are collecting. I would argue that historically, the information we’ve tracked has not actually been “quality” data, and this reprieve from mandatory data reporting is our chance to finally slow down, regroup, and come up with a feasible, well thought-out plan for collecting—and more importantly, effectively leveraging—data in a way that will allow us to improve not only our own practices, but also the profession overall. It’s a huge undertaking, but a mission-critical one. I know the whole value-based payment shift still feels a bit abstract to most of you, but trust me: it’s happening. We cannot escape it, even if—at least for the time being—we can escape a federally required obligation to report quality data.

As for all you revelers who are dancing on the grave of PQRS, I challenge you to—at the very least—take some time to consider what this means for the future of our profession. With a massive data gap looming, how do we step up to fill it with meaningful information ourselves? As Tim Flynn, PT, PhD, says in this video, data doesn’t change behavior—and I agree. But, if we harness the power of the data we have, then we can change the story about our value. We can finally paint a strong, objective, data-backed picture of the incredible outcomes we are achieving in our clinics every day. Millions of patients are restoring function—and living longer, happier, healthier lives—as a direct result of the treatment we provide, and it’s about time the rest of the world knew the true value we bring to the healthcare table.

This is about more than performing a few tests and reporting a few extra codes. This is about asserting ourselves as the premier healthcare practitioner for pain and musculoskeletal issues—and making sure we’re included in such significant legislation as MACRA. This is about disrupting the current medical model that routes patients to dangerously invasive treatments like surgery and opioid prescription. This is about building a better future—for ourselves, our patients, and the next generation of rehab therapists. This is about taking control of our destiny. And if you ask me, that to-do should be at the very top of every rehab therapist’s list.

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  • Odd Provider Out: Why PT Exclusion from MIPS is Bad for Future Payments Image

    articleMay 4, 2016 | 6 min. read

    Odd Provider Out: Why PT Exclusion from MIPS is Bad for Future Payments

    It’s official: rehab therapists are just a sashay away from exiting the PQRS dance floor. That’s because last week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed final rule that, if adopted, will put into effect the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA). And that, in turn, will give the green light to the Merit-based Incentive Payment System (MIPS) , a brand spankin’-new quality data reporting program that consolidates PQRS , …

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    articleNov 9, 2016 | 8 min. read

    Hot Out of the Oven: Highlights of the 2017 Final Rule for PTs, OTs, and SLPs

    Halloween may be over, but if you didn’t get your fill of scares, I’ve got the perfect activity for you: reading through 1,401 pages of pure Medicare gobbledygook. Screaming yet? (Or should I check back at around page 500?) I kid, of course; there’s no need for you to slog through this year’s extra meaty Final Rule —which details the Medicare fee schedule and other important Medicare regulatory and reimbursement changes for physical therapy, occupational therapy, and …

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    articleOct 17, 2016 | 4 min. read

    Breaking News: 2017 MACRA Final Rule Hits

    After months of heated debate and public commentary—much of it coming from physicians who felt they needed more time to prepare themselves to participate in a brand-new quality reporting program—the Department of Health & Human Services (HHS) on Friday released its final rule on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) . This act, which will go into effect January 1, 2017, reimburses eligible Medicare physicians based on the quality of care they deliver …

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    articleJul 19, 2016 | 9 min. read

    CPT Update: Why the Valuation of the New PT and OT Eval Codes is Problematic

    The purpose of any type of reform is to drive change. And that’s certainly true when it comes to healthcare—and healthcare payment—reform. But, change often comes slowly—and in the wake of Medicare’s recently issued proposed physician fee schedule for 2017 , I have to wonder whether it’ll come too slowly for physical and occupational therapists. That’s because, while the Centers for Medicare & Medicaid Services (CMS) voiced its support for replacing the existing CPT codes for physical …

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    articleNov 9, 2016 | 6 min. read

    The Bundle Conundrum: Should PTs Participate in CJR?

    There a lot of hot topics in health care right now. Among top trending terms like “Affordable Care Act,” “pay-for-performance,” and “value-based care,” you’ve also probably heard “Medicare bundled payments”—specifically, “CJR” (or Comprehensive Care for Joint Replacement ). It’s a new bundled payment model from CMS, and it is of particular importance to outpatient rehab providers. As this article explains, “CJR will support better care for patients who are undergoing elective hip and knee replacement surgeries—the two …

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    webinarJan 5, 2017

    Cloudy with a Chance of Reform: 5 Key Healthcare Forecasts for 2017

    Predicting the weather is tough—just ask any meteorologist who has called for sun on the day of a major downpour. Well, predicting the fate of the US healthcare system isn’t much easier—there’s a lot up in the air, after all. But, even without a healthcare equivalent of Doppler Radar, there are a few key trends that are sure to have a major impact on PTs, OTs, and SLPs in 2017 and beyond. And to keep your practice …

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    articleNov 3, 2016 | 5 min. read

    Founder Letter: My Evaluation of the New PT and OT Eval Codes

    Over the last several years, healthcare providers in general—and rehab therapists, specifically—have been hit with a seemingly constant barrage of regulatory requirements. And the vast majority of these initiatives—PQRS, functional limitation reporting, MPPR, ICD-10, and the like—have either: Had a direct negative impact on our payments, or Forced us to devote extra time to satisfying the criteria of the requirements—with zero compensation for that time. So, it should come as no surprise that the rehab therapy community …

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    webinarFeb 23, 2017

    Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans

    Copayments, coinsurances, unresolved balances—oh my! Any one of these can cause headaches for healthcare providers, but as healthcare reform efforts shift more and more financial burden to insurance beneficiaries, today’s practitioners are increasingly facing all three. And these challenges are not only hurting their patient acquisition and retention rates, but also their bottom lines. Tired of spending time verifying benefits only to lose those patients to copay sticker shock? Stuck in a constant cycle of pursuing past-due …

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    articleMar 31, 2017 | 33 min. read

    Common Questions from Our Patient Sticker Shock Webinar

    From copays and deductibles to payer contracts and benefits verification, understanding all the nuances of third-party insurances is tough enough for healthcare providers—let alone their patients. In WebPT’s most recent webinar— Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans —co-hosts Heidi Jannenga, PT, DPT, ATC/L, the cofounder and president of WebPT, and WebPT CEO Nancy Ham provided a lot of great advice on how to have productive conversations about healthcare costs with your patients—without …

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