The overarching theme of Ascend 2017—the fourth-annual installment of rehab therapy’s premier business summit—was, quite simply, “Think big.” But, based on what we learned from our esteemed group of speakers over the course of two inspiration-filled days in Washington, DC, a more accurate tagline for this year’s conference might have been, “Think differently.”
After all, in a field as complex as health care, grand aspirations are not enough. To solve the problems plaguing this industry, we must challenge the status quo—and we must do so together. With that in mind, here are a few key takeaways from this year’s conference, which you can put into action whether or not you joined us this past weekend.
1. Get back to basics.
In one of this year’s most memorable talks, day one keynote speaker Alan Stein, Jr.—a veteran basketball performance coach to the likes of NBA stars Kobe Bryant and Kevin Durant—underscored the importance of the mundane. To illustrate that concept, he told the audience a story about a time he met Bryant for an early morning workout (and when I say early, I’m talkin’ 4:00 AM—well before most of us even think about hitting the first of four snooze buttons).
Don’t confuse simplicity with ease.
Now, I’m no stranger to predawn workouts—it’s the curse of many a desert-dwelling distance runner—but what he described was enough to drop my jaw to the floor: when he arrived at around 3:30 (yes, in the morning) to the gym where Bryant was practicing, he found the elite athlete already soaked in sweat. Why? Because Bryant knows that maintaining his mastery of basic skills is crucial to staying at the top of his game. As Stein put it, “Just because something is basic, doesn’t mean it is easy.” In this day and age, everyone is looking for a shortcut—a way to bypass the tasks we view as tedious or unworthy of our time and talents. So, we skip; we glaze over; we get lazy. And that’s a slippery slope—especially in this new, patient-centric era of health care.
Pay attention to detail.
Rehab therapists—like all providers—are practicing under a powerful microscope. But, it’s not just government agencies or insurance companies that are scrutinizing their every move; it’s their patients. And everything those patients experience—from the moment they walk through a clinic’s doors for the first time to the moment they walk out for the last time—influences their perceived value of the care they have received.
So, be mindful of the details. Resist the urge to take the path of least resistance—with respect to clinic operations, data-tracking, documentation, patient engagement, and, of course, patient care. When you put forth the effort to be at the top of your game on all fronts, it shows. Plus, as Medicare experts Rick Gawenda, PT, and Mary Daulong, PT, CHC, CHP, explained during their sessions, if you’re ever faced with something like a Medicare audit, all of that attention to detail could save you a lot of stress—and, potentially, money.
2. Empower your patients as much as possible.
There’s no use fighting the forces pushing patients back to the center of care. And honestly, I think most rehab therapists would agree that’s how it should have been all along. Somewhere along the way, though, big medicine took over—physicians and insurance companies began dictating the patient journey, and all too often, that journey has led patients suffering from neuromusculoskeletal conditions straight to the pharmacy or the operating room.
But, what if those patients had the power to dictate their own care journeys? More importantly, what if they had the resources and knowledge necessary to make truly informed decisions about their care—decisions based on their own best interests, in terms of both clinical and financial outcomes? I’m betting a lot more patients would end up in physical therapy treatment instead of surgery, and isn’t that exactly what we all want to see happen?
Pinpoint—and promote—the value you provide.
PT thought leaders have been talking about the physical therapy “branding problem” for years—and that topic certainly permeated the sessions at Ascend 2017. As Barton N. Bishop, DPT, SCS, TPI CGFI-MP2, CSCS, told a jam-packed crowd during an expert panel discussion on partnering with other care providers in order to increase practice revenue, “I’m not sure what the true value of physical therapy is.” That’s quite a bold—and honest—statement for someone with the letters “DPT” after his name. Of course, he was speaking from the consumer’s perspective, but still, the challenge is clear.
While many speakers touted the importance of advancing—and actually leveraging—direct access laws, others argued that until patients and the other members of their care teams understand the benefits of seeing a physical therapist first, having the legal ability to do so doesn’t really mean much.
3. Smash the silos.
Siloed care isn’t an issue unique to rehab therapy. The entire healthcare community is struggling to catch up to the technology-driven—and now, reform-driven—pressure to connect and collaborate. “Interoperability” has been a hot industry buzzword for a while now, but as Karen DeSalvo, MD, MPH, MSC, the former Assistant Secretary of Health for the US Department of Health and Human Services (HHS), told WebPT CEO Nancy Ham during their fireside chat on the current state of health care, even that concept has grown outdated.
Embrace data access and exchange.
According to DeSalvo, the traditional concept of interoperability is rooted in point-to-point connections; it’s about connecting all of the islands—hospital-to-hospital, hospital-to-outpatient, outpatient-to-home health, and so on. Now, the conversation has shifted to what DeSalvo described as a free-data model: “What you really want is for the data to be free…to have a routing system,” she explained. “We’re on the cusp of that world.” And that, she went on to say, opens up all sorts of exciting new doors for artificial intelligence, preemptive behavioral pattern analysis, genetics-based prescription, and, of course, unprecedented consumer access to personal health data.
At the same time, the entire system is desperately searching for ways to reduce spending. “No matter who you are in health care, or where you are, pulling cost out of the system is important to you,” DeSalvo said. And that can’t happen without provider-to-provider communication and information exchange. Otherwise, disparate providers will continue to practice in silos—and patients will continue to receive treatment that is unnecessary, redundant, and needlessly invasive or expensive.
4. Measure what matters—to your patients.
In the very succinct words of Mike Manzo, PT, MPT, “If you do not measure it, you cannot improve it.” He was, of course, referencing Atlantic Physical Therapy Center’s robust—and highly successful—outcomes-tracking program. Manzo and his colleagues at Atlantic’s 14 locations have used their outcomes data to not only bolster their patient- and referring physician-facing marketing efforts, but also identify and correct specific areas of clinical weakness. In fact, those metrics have started to take precedence over more traditional PT business metrics like billed units and visit count, because, as Manzo’s colleague Mike Mundry explained, “It’s not just about the volume of care; it’s about the value now.”
And on the topic of value, while patient-reported outcome measures (PROMs) are certainly the building blocks of an effective patient-centered care delivery model, several Ascend 2017 speakers highlighted the growing importance of patient satisfaction tracking—namely, via tools like Net Promoter Score (NPS).
Focus on loyalty rather than satisfaction.
And actually, as Ryan Klepps, DPT, and Scott Hebert, DPT—the co-founders of Strive Labs—explained during their presentation, NPS isn’t so much a measure of patient satisfaction as it is a measure of patient loyalty—and that’s what makes it so valuable. After all, satisfaction is easy—it’s simply meeting someone’s expectations. Loyalty, on the other hand, is more difficult to win. But, it’s a prize worth striving (see what I did there?) for—because the effect is exponential. Loyal patients won’t just come back to you; they’ll also tell everyone they know to come to you, too. And in the age of the patient-consumer, it really doesn’t get any better than that.
But, the benefits of NPS tracking aren’t limited to capitalizing on your most loyal customers (e.g., your promoters); you can also use this metric to identify those patients who are the least satisfied—and thus, the most likely to bail on treatment before they’ve completed their courses of care. That’s not just good for your practice (acquiring a new customer is five to 25 times more expensive than retaining an existing one)—it’s also good for the entire rehab therapy profession. Remember, by preventing one patient from leaving therapy unhappy, you could be preventing hundreds of potential patients from having their perception of rehab therapy tainted by one negative opinion—from a friend, family member, or online review. Plus, according to Hebert, some groups are starting to use NPS as a bargaining chip with payers and referring providers. “Net Promoter is the outcomes survey of the experience,” he said. “Increasingly, they are looking at that.”
5. Look beyond the “blue box.”
During her chat with Ham, DeSalvo showed a graphic depicting the distribution of factors that influence health outcomes. According to that resource, health care itself only accounts for about 20% of overall health outcomes—a segment shaded in blue on DeSalvo’s illustration. The other main factors are genetics (which makes up 20% of health outcomes) and social, environmental, and behavioral factors, which together account for 60% of outcomes. Her argument: Perhaps those on the regulatory front aren’t focusing on the right things. “There’s a big mismatch in how we are spending our dollars,” she said. “We’re spending way more on the care itself, and less ‘outside of the blue box.’” For example, she explained, in some cities, where you live—and thus, your socioeconomic situation and access to things like housing and transportation—has a major impact on your health status. In those areas, “zip code affects our health more than our genetic code,” she explained, adding that disparities in life expectancy can amount to as much as 25 years from one zip code to the next.
Recognize the non-healthcare factors that influence health.
Although she is seeing change happening—albeit slowly—DeSalvo emphasized that there’s still much work to be done. “It’s not just someone else’s problem,” she said. “We all have to be in this together.”
As the panel moderator for the discussion on partnering to increase revenue, Dr. Heidi Jannenga, PT, DPT, ATC/L, the president and co-founder of WebPT, echoed DeSalvo’s sentiment, urging providers to not only measure things like cancellations and no-shows, but also look beyond the problem to the source. Why are people not making it to their appointments, and how can you help change that?
6. Commit to one change at a time.
There’s nothing like a conference as inspiring and energizing as Ascend to get your passion bubbling. If you attended this year’s conference—or heck, even if you’ve made it this far in this blog recap (congratulations and thank you, by the way)—then I’m betting you can barely contain your eagerness to implement everything you learned as soon as humanly possible. And that’s fantastic; after all, it’s kind of the point.
Still, as you draw up your plans and finalize your checklists, think back to what Stein cautioned—and Chris and Heidi Powell, transformation specialists and co-hosts of ABC’s documentary-style series, “Extreme Weight Loss,” reiterated during their keynote talk on the national fight against obesity—regarding best practices for achieving lasting change: studies show that if you commit to changing one thing at a time, you have a much greater chance of success (somewhere in the range of 80%). But, with each subsequent change goal you add to the list, the projected success rate drops—big time (the average success rate for two simultaneous changes: a mere 30%).
Sub-divide your goals.
Whether you’re on a path to creating a healthier lifestyle, trying to become a better leader, turning a greater focus to your family and personal life, or looking to elevate your rehab therapy practice’s business performance, don’t fall into the frustrating trap of trying to change everything at once. Instead, break it all down into mini-goals. Commit to:
- Getting 15 extra minutes of sleep.
- Spending 5 minutes a day being totally present in a conversation with an employee.
- Carving out at least 30 minutes of quality time with a loved one every day.
- Putting together a plan to collect NPS in your practice.
Of course, these are just a few examples curated from our amazing speakers at Ascend 2017. The possibilities are endless—and the effect is cumulative: If we all commit to changing ourselves, our businesses, and our profession for the better, then together, we can achieve big things.