On the WebPT Blog, we’ve extensively covered the benefits of tracking and accurately analyzing outcomes data—from why it’s essential for patient safety to why it’s necessary to brand physical therapists as neuromuscular experts. But, as we move toward a pay-for-performance healthcare paradigm, objective outcomes data won’t merely be beneficial to physical therapists; it will be necessary for them to get paid. Here’s why:

Down with Denials! 5 Claim Fixes to Make Sure Your PT Clinic Gets Paid - Regular BannerDown with Denials! 5 Claim Fixes to Make Sure Your PT Clinic Gets Paid - Small Banner

Payers Depend on Data

Payers are transitioning to reimbursement structures rooted in service value—rather than service volume. And to prove the value you provide, you need a way to communicate the efficacy of your care to payers. So, how will you do that? You guessed it: through tracking and analyzing outcomes data. If you’re a Medicare provider, data-tracking should already be part of your routine. After all, you’re already submitting data through a number of channels—including the PQRS and FLR programs. That said, there is a difference between outcomes data and the other data you’ve previously collected: outcomes data—particularly data collected via patient-reported outcome measures—emphasizes care quality and patient satisfaction, two important factors in care value.

New Initiatives are Paving the Way for Healthcare Payments

MIPS

One of the ways that the government is moving the entire US healthcare system toward a value-based mode of care delivery is through the introduction of the new Merit-based Incentive Payment System (MIPS). What is MIPS? Essentially, this new initiative consolidates three existing pay-for-performance programs and introduces one new program—all in an effort to more strongly encourage providers to deliver higher quality care at a lower cost. The whole shebang is set to go into effect in 2017. If you’re interested in learning more about the ins and outs of MIPS, check out this post.

So, how does MIPS impact rehab therapists? Unfortunately, as of right now, therapists aren’t eligible to participate. As Brooke Andrus explains in this article, a limited list of clinicians will be eligible to participate during the first two years of the program. These providers include:

  • physicians,
  • physician assistants (PAs), nurse practitioners (NPs), and clinical nurse specialists (CNSs),
  • certified registered nurse anesthetists, and
  • groups that include the above-listed professionals.

Now, while rehab therapists won’t be able to take part in MIPS right off the bat, PTs, OTs, and SLPs will become MIPS-eligible beginning in 2019. At that point, therapists may be required to report a variety of data points. To properly prepare for that day, therapy providers should get used to tracking quality data now—before their payments depend on it.

Alternative Payment Models

In addition to introducing programs like MIPS, the Centers for Medicare and Medicaid Services (CMS) is rolling out a host of programs to encourage provider participation in alternative payment models—and thus, move closer to the US Department of Health and Human Services’ (HHS) goal of tying 50% of all Medicare fee-for-service payments to alternative payment models by 2018. One example that’s already in place is the Comprehensive Care for Joint Replacement Model (CJR). CMS explains that the “CJR model holds participant hospitals financially accountable for the quality and cost of a CJR episode of care and incentivizes increased coordination of care among hospitals, physicians, and post-acute care providers.” This model holds providers accountable for care quality and cost—rather than reimbursing based on service volume alone.

Collaborative Care is the New Normal

In the next few years, the importance of proving the value of your services will only continue to grow. In the words of this Medical Economics article, “the shift from fee-for-service (FFS) to value-based reimbursement will be even more dramatic [in the next two to five years].” And that means providers must prepare now—or risk being left behind. Bottom line: the rehab therapy community has no time to waste. Furthermore, as this Modern Healthcare article explains, the healthcare powers that be clearly believe this transition is mission-critical—despite the massive investment of time, money, and labor that comes with it: “while the movement away from fee-for-service and toward value-based care requires a hefty investment in infrastructure, cultural changes around operational practices and intensive care-redesign efforts, these developments clearly illustrate that providers are being pushed to change and embrace a new normal.”

And that new normal includes a move to a more collaborative, patient-centered care delivery paradigm. In fact, that’s arguably the overarching goal of healthcare reform in general—and it’s one more reason outcomes tracking is crucial to rehab therapists’ ability to survive and thrive in the future. As the APTA explains, “the ability to measurably demonstrate objective results is critical in the pursuit and development of collaborative health care relationships. This will require you to be up-to-date on clinical practice guidelines and protocols as well as to be able to document your adherence to evidence-based practices sufficiently, and share your data with bundle partners.”


Are you tracking outcomes data? If not, what’s stopping you from embracing this new normal? Let us know in the comments section below.

  • You’ve Got Outcomes—Now What? Image

    articleMay 6, 2016 | 3 min. read

    You’ve Got Outcomes—Now What?

    The launch of WebPT Outcomes is officially complete—which means every single WebPT clinic now has the ability to collect and track patient outcomes data directly within the EMR. And as you may have heard from our president and founder, Dr. Heidi Jannenga, that’s kind of a big deal . But, as Uncle Ben (Peter Parker’s uncle—not the rice guy) once said, “With great power comes great responsibility.” We’d be doing our Members—and the entire healthcare community at …

  • WebPT Outcomes OMT Reference Guide Image

    downloadDec 22, 2016

    WebPT Outcomes OMT Reference Guide

    Ever feel like the results your patients achieve don’t match up to the statistics your payers bring to the negotiation table? Now you can prove them wrong. Collecting objective patient data can help you, the rehab therapist, yield better patient outcomes—and pad your bottom line in the process. And that’s kind of a big deal in today’s value-based healthcare system. Today, with the right practice management tools—including WebPT Outcomes—it’s easier than ever to set concrete performance goals …

  • Which Outcome Measurement Tool Should I Use and When? Image

    articleFeb 18, 2016 | 3 min. read

    Which Outcome Measurement Tool Should I Use and When?

    Earlier this month, we announced the launch of WebPT Outcomes , the first fully-integrated outcomes tracking software specifically for PTs and OTs. One big way that WebPT Outcomes differs from other rehab therapy outcomes tracking software is the outcome measurement tools (OMTs) our product contains. As WebPT president Heidi Jannenga explained in this month’s founder letter , “historically, therapists haven’t had access to outcomes tracking tools that (1) align with the type of care they provide, including …

  • Outcomes and OMT FAQ Image

    articleApr 26, 2016 | 11 min. read

    Outcomes and OMT FAQ

    In January, we hosted a webinar focused on the importance of outcomes tracking in physical therapy. In addition to explaining why it’s absolutely critical that therapists collect objective data on patient progress, we highlighted a few of the reports available in WebPT Outcomes . With the move to a value-based payment environment already in full swing, outcomes tracking is a hot topic in the physical therapy space, and that meant lots of thoughtful question from our webinar …

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

    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 …

  • Founder Letter: Why Data is Only One Part of the Value Story Image

    articleMar 9, 2016 | 7 min. read

    Founder Letter: Why Data is Only One Part of the Value Story

    Over the past several months, I’ve talked a lot about how therapists can prove their value (namely, through tracking outcomes data ). But, even though data provides the value proof we need, it’s not the end of the story. It’s up to us to turn that data into something meaningful—something we can act on that will actually help us demonstrate the value of our care. And that means using data in conjunction with defensible documentation to inform …

  • Founder Letter: PQRS is Dead, But Your Data-Analysis Efforts Should Live On Image

    articleDec 6, 2016 | 6 min. read

    Founder Letter: PQRS is Dead, But Your Data-Analysis Efforts Should Live On

    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. …

  • Founder Letter: Why I’m Betting on Outcomes Image

    articleFeb 4, 2016 | 5 min. read

    Founder Letter: Why I’m Betting on Outcomes

    I’m not much of a gambler. Some folks enjoy the rush that comes with putting all their chips on the table and risking everything on a single roll of the dice. Well, no offense to all you card sharks out there, but if I’m going to go all in, it better be on something I’m pretty darn sure of. So, when I say I’m betting on outcomes, you know I’m not bluffing. In fact, I’m 100% confident …

  • Is PT Valuable? Why Outcomes Data is the Proof We Need Image

    webinarFeb 3, 2016

    Is PT Valuable? Why Outcomes Data is the Proof We Need

    In this day and age, it seems like everybody wants more for less—and that’s certainly true in the healthcare realm. With nationwide reform efforts pushing providers to deliver higher-quality care at a lower cost, value—and the ability to prove it—is absolutely critical. Most rehab therapists will tell you the services they provide are more valuable than anyone knows. And that’s precisely the problem. No one knows the value of physical and occupational therapy. But outcomes tracking can …

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