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.