When it comes to payment reform, the wheels of change are already in motion—and as you’ve learned in this post on payment models and this one on the proposed PT payment system overhaul, there’s no stopping this train. But forward motion is typically a sign of progress, and that certainly holds true in this case. Because by aligning themselves with the push to reform payment structures and processes to better align with the so-called triple aim—that is, the nationwide push for better access, lower cost, and improved accountability in health care—PTs will set themselves up for success in a world where value will drive the manner in which providers deliver care.
However, jumping on the alternative payment model bandwagon doesn’t make sense for every practice, and the proposed alternative payment system is still a ways off from implementation. So, what’s a forward-thinking PT to do? The good news is that there’s plenty you can do now to ensure the evolution of your practice moves with—not against—the currents of payment reform. Here are the biggest action items on your short list of to-dos:
Own Your Role as a Care Coordinator
The transition to a healthcare system that emphasizes value—in terms of cost, outcomes, and care quality—represents a huge opportunity for PTs. As you know, physical therapy is, in many cases, a cost-effective alternative to more expensive—and invasive—treatment options such as surgery. And that gives PTs some pretty serious leverage in the healthcare community at large. With this shift in payment philosophy, PTs have a chance to step up and claim their roles as care coordinators. That means:
- Embracing the direct access movement and your ability to serve as a patient’s first medical point of contact.
- Marketing yourself, and the entire PT profession, with the goal of ensuring that patients come to you first whenever they experiences musculoskeletal issues.
- Practicing at the top of your license and making appropriate referrals to other medical professionals when you, as a clinical expert, decide it’s in the patient’s best interest to do so.
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Get on the Fast Track to Outcomes Tracking
Of course, the key to being taken seriously—and valued—as a care coordinator is proving that you deserve that title. And as any proponent of evidence-based practice knows, the only way to do that is through the use of objective data. Enter: outcomes tracking.
By measuring patient outcomes through the use of standardized tools, PTs can amass an arsenal of objective proof underscoring their value and importance as members of a patient’s overall medical team. But to maximize the power of that proof, it’s crucial that PTs collect the right kind of data—that is, information that’s:
- comparable, and
Furthermore, they’ve got to use the right kind of tools. As it stands, the library of outcome measurement tools PTs are using is not only vast and varied, but also largely inapplicable to professionals outside of the PT space—and that weakens the impact of the data those tools generate. Essentially, without a standardized set of widely accepted outcome tools, PTs are diminishing the power of the information they collect.
In addition to carefully selecting the tools and software they use to track outcomes, PTs also would be wise to form a plan for how they’ll use the data. Otherwise, they’ll just end up with a huge bank of meaningless facts and figures—but no real knowledge. In other words, they shouldn’t set out to find the answer before they’ve even asked the question. Most practices start with internal improvement goals—things like:
- streamlining operations,
- more effectively marketing themselves to referring providers,
- determining best practices, and
- informing business strategies and personnel decisions.
And of course, all of those endeavors play into the overarching push to deliver higher-quality care more efficiently. But once you’ve got a handle on your clinic-level outcomes tracking efforts, it’s time to start looking at the big picture. That means thinking about ways PTs can band together and pool their data power to:
- influence payment rates,
- cultivate a PT-first attitude in the healthcare community at large,
- strengthen their bargaining power in the push for pro-PT legislation, and
- protect themselves from penalties associated with pay-for-performance payment structures.
Be Part of the Conversation
We already covered this in the intro, but just to reiterate: the healthcare reform train is already in motion, and there’s nothing anyone can do to stop it. We’ve already seen massive legislative action—ahem, the Affordable Care Act—and the healthcare policy pen isn’t going back in the drawer anytime soon. That means now, more than ever, it’s crucial that PTs and private practice owners claim a seat at the table where the policies that will shape their future—including those that will affect the manner in which they receive payment for their services—are created. That means:
- Becoming actively involved with PT advocacy organizations, including the APTA and the PT-PAC.
- Using the tools available to you to connect with political influencers who can help see pro-PT legislation through to enactment.
- Making a phone call or sending a letter to tell congressional representatives why they should support, co-sponsor, or sponsor bills that benefit physical therapists (hint: massive downstream healthcare savings and better patient outcomes).
Whatever your strategy for getting your practice on the pay-for-quality track, the important thing is that you actually have one—a strategy, that is. Because the absolute worst thing you could do is to do nothing at all. So, whether you’re ready to consider participating in an alternative model, or you’re looking to implement outcomes tracking in your practice, make sure your plans account for the changing payment landscape.