As more private payers join the value-based reimbursement movement, rehab therapy providers may want to take a good, hard look in the mirror to determine whether their data-collection efforts are up to par—and for good reason. Payment throughout the entire healthcare continuum will soon be tied to value, rather than volume. And to prove the efficacy of their treatment—and thus, ensure success in the long term—PTs must not only collect outcomes data, but also develop a consistent process for analyzing and leveraging it.

Speaking of the long term: Improving patient outcomes is a continual process. After all, evidence-based practice is constantly evolving as new research and information comes to light. That’s why it’s critical that therapy practices adopt a continuous learning system to determine, over time:

  • the areas in which their clinics are successful,
  • where they fall short, and
  • which educational opportunities they should embrace to close the gap.

Here’s why:

Suppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans - Regular BannerSuppressing Sticker Shock: How to Handle Your Patients’ High-Deductible Health Plans - Small Banner

CMS is rolling out new healthcare payment models.

MIPS

Rehab therapists may not be eligible for the Merit-based Incentive Payment System (MIPS) until at least 2019, but that doesn’t mean your clinical staff should kick up their legs just yet. As we’ve reported on the WebPT Blog, rehab therapists who get out of the habit of reporting quality data are shooting themselves in the feet, as many will “struggle to return successfully into the quality reporting space in 2019 under the constructs of an entirely new program.” So, what’s a potential solution? Well, if you’re a clinic owner or manager, you should embrace any opportunities to collect quality data now. That way, your practice can optimize its data-collection game—and avoid a stressful crash-course later.

More importantly, according to this Hospitals & Health Networks resource, your practice will have a chance to determine which quality measures truly matter to different stakeholders—including patients, therapists, referring providers, and payers. “Succeeding under value-based payment models will require measuring the outcomes that matter most to patients and the health care organization, as these will be the critical data not only for successful reimbursement and avoiding costly penalties, but for [also] providing good care at lower costs.”

Alternative Payment Models

Oh, but MIPS isn’t the only new payment development on the block. Over time, more and more healthcare providers will receive payment through alternative payment models (APMs). And in this new payment paradigm, it’s pretty important for outpatient rehab providers to understand how they can showcase their value. By 2018, CMS estimates that more than 50% of healthcare spending will fall under APMs. (Now, it’s worth noting that even if Medicare patients don’t account for a majority of your total visits, it would behoove you to adopt some level of data collection, because as history has taught us, private payers tend to follow CMS’ lead).

In fact, commercial carriers are already starting to latch on to APMs—thus providing even more motivation for clinics to track patient outcomes and adopt continuous learning systems to ensure they are delivering the best possible value. But, successful organizations that want to achieve the triple aim—and invest in their clinical staff for the long term—should already be looking beyond any current or future reporting requirements. Instead, they should embrace continuous learning systems that will transform their data into readily available information geared toward the patients they manage and the decisions they make.

Therapists can develop real-time patient insights.

Distill data into actionable information.

Aside from aligning your practice’s data-collection efforts with the above-mentioned mandates, adopting a continuous learning process has a lot of perks—namely, reducing wasted clinical efforts, streamlining treatment strategy and delivery, and allowing your practice to hold therapists accountable for the work they do. Of course, it’s not enough to simply perform tests and measures and record the results. To drive meaningful change, therapy practices must develop a mechanism for distilling that data into actionable information. (Hint: Adopting a sophisticated outcomes tracking and reporting solution is a great place to start.)

Be comfortable challenging the status quo.

According to this Issues in Science and Technology resource, to act on your information effectively, you’ll want to enlist the help of managers who are comfortable shaking things up and challenging the status-quo. “To this end, middle managers must be able to set priorities for improvement efforts, establish and implement continuous learning cycles, and foster a culture of respect among staff that empowers them to undertake continuous learning and improve patient care.” Bear in mind, though, that you’re probably not going to see any real results overnight. After all, continuous learning is a long-term endeavor. Furthermore, administrators and clinicians may struggle to make inroads in the areas of deficiency your data identifies—and that’s okay. It’s all part of the overall learning process. The important thing is that you don’t stop the cycle. That’s why clinic managers need to have full autonomy over a nimble continuous learning system that allows you and your staff to “refocus attention on the barriers to learning and improvement.”

Providers can form stronger relationships with their patients.

Involve patients in their treatment plans.

Most patients appreciate having open, direct conversations with their healthcare providers about their treatment goals, preferences, and progress. After all, when patients are active participants in clinical decision-making, they feel more empowered—and more trusting of their providers. Furthermore, patients who are engaged in the care delivery process are more willing to follow through on home exercise programs, as they can more clearly recognize the value of those plans. And all of this aligns perfectly with the overarching shift to a more patient-centered care environment.

Improve patient rapport—and satisfaction.

When it comes to communicating with your patients, data can be a highly effective tool. In fact, it can actually serve as a catalyst for improving your communication skills, because it gives you a jumping off point for having crucial conversations about their progress as well as their satisfaction. And speaking of satisfaction, when you show patients—and their families—solid evidence that the treatment you are providing is actually working, those patients likely will become even more invested in the care process. Plus, they’ll have even more reason to sing your praises to their friends and family.


Continuous learning is essential to clinicians’ ability to innovate, make self-improvements, and achieve excellence in healthcare delivery. Plus, having a nimble, inquisitive mind—and an eye toward the future—is never a bad thing, especially in a value-based care paradigm. What systems and processes does your clinic use to foster continual improvement? Or, if you don’t yet collect outcomes data, do you plan on doing so in the future? Share your thoughts in the comments section below.

  • Past, Present, and Possibility: The Progression of Pay-for-Performance Image

    articleMay 7, 2015 | 5 min. read

    Past, Present, and Possibility: The Progression of Pay-for-Performance

    For decades, healthcare leaders have searched for a way to balance the interests of providers, patients, and payers. The pay-for-performance paradigm has emerged as a front-runner in the race to drive down healthcare costs while simultaneously raising the quality of care and increasing patient satisfaction. But what, exactly, does this buzz term mean? Defining Pay-for-Performance As this Health Affairs article explains, the pay-for-performance umbrella encompasses any “initiatives aimed at improving the quality, efficiency, and overall value of …

  • Triumph in the Triple-Aim Game: The Healthcare Executive’s Guide to Readmission Reduction, Patient Safety Promotion, and ACO Success Image

    downloadSep 28, 2016

    Triumph in the Triple-Aim Game: The Healthcare Executive’s Guide to Readmission Reduction, Patient Safety Promotion, and ACO Success

    The Affordable Care Act (ACA) and other reform efforts have brought forth a renewed emphasis on care coordination at all points along the care continuum—including the period after hospital discharge. As part of this push, new financial incentives and penalties have put healthcare executives at the center of a high-pressure game of tug-of-war in which they must simultaneously improve care quality and reduce costs. Talk about a catch-22. Enter your email address below to download this guide …

  • 4 MIPS and MACRA Must-Knows for PTs, OTs, and SLPs Image

    articleNov 17, 2016 | 7 min. read

    4 MIPS and MACRA Must-Knows for PTs, OTs, and SLPs

    The holiday season is right around the corner, and while this time of year is always ripe for celebration—and rightfully so—the elimination of PQRS doesn’t mean you should bust out the confetti and noisemakers just yet. Wait, therapists no longer have to report PQRS data to Medicare—and that’s a bad thing? While that stand-alone decision may give you all the holiday feels , it should also give you pause: the truth is that because rehab therapists are …

  • articleSep 6, 2011 | 3 min. read

    CMS, Patient Level Data and Outcomes: What should we be measuring?

    What should we be measuring? Recently, there has been some debate from EMR providers over the type of data that should be provided to CMS when reporting clinical outcomes. CMS, in a newly proposed rule, wants to define and begin to use a new measure called CQM . CQM stands for Clinical Quality Measure and is used to establish the top tier providers for the effectiveness and necessity of specific treatments.   The Issue The issue here …

  • What PTs Need to Know About ACOs Image

    articleMay 19, 2015 | 5 min. read

    What PTs Need to Know About ACOs

    As a physical therapist, you’re likely well-versed in the acronyms that drive your documentation practices: HIPAA , CPT , CMS , PQRS , FLR , and FML (just kidding). But there’s one more to watch for: ACO. By now, you’ve probably heard this one being bandied about in discussions about healthcare reform and alternative payment models, but you might not be super familiar with what it means. So, here you go: In response to the Affordable Care …

  • America’s Next Top Payment Model: The Move to Pay-for-Quality Image

    articleMay 11, 2015 | 9 min. read

    America’s Next Top Payment Model: The Move to Pay-for-Quality

    Your mission, should you choose to accept it, is to provide higher-quality care at a lower cost. With the healthcare industry’s fast-moving transition to value-based —rather than service-based—payment systems, that’s the challenge many providers are facing. And while that mission may very well seem impossible, the truth is that rehab therapists and their peers in other medical fields don’t really have much of a choice as to whether they’ll accept it. [webform:1307:yellow inline] The winds of change …

  • 2016 Rehab Therapy Year in Review Image

    articleDec 27, 2016 | 10 min. read

    2016 Rehab Therapy Year in Review

    While we’re about to close the books on 2016, we thought it would be nice—and educational—to look back on some of the therapy industry trends, advancements, and hot topics that made headlines throughout the year. Plus, most of these items will impact you and your practice in 2017 and beyond—so, as we look back, don’t forget to look forward. Okay, here we go! Clinical Trends What are those weird suction cups all about? If you, like many …

  • ICD-10 Open Forum Image

    webinarOct 5, 2015

    ICD-10 Open Forum

    On October 1, the US officially said RIP to ICD-9 and brought ICD-10 to life. For some of you, the transition might’ve been all sugar and spice—a real treat. But for many others, the switch to the new code set might’ve left you feeling overwhelmed, tricked, or even a bit scared. At the very least, you might be haunted by some lingering questions. That’s where we can help. We’ve brewed a cauldron filled to the brim with …

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

    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 …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.