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.
CMS is rolling out new healthcare payment models.
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 OM1, 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.