• The Physical Therapist’s Crunch-Time Guide to ICD-10 Image

    downloadJun 24, 2015

    The Physical Therapist’s Crunch-Time Guide to ICD-10

    ICD-10 goes into effect on October 1, 2015, and if your practice is unprepared, you could suffer reduced payments—or worse, flat-out denials. Make sure that doesn’t happen. Get prepared with the Physical Therapist’s Crunch-Time Guide to ICD-10. Enter your email address below to download it.

  • New and Improved: Details on Sustainable Growth Rate Formula Replacement Image

    articleJun 1, 2015

    New and Improved: Details on Sustainable Growth Rate Formula Replacement

    Ding-dong—the Sustainable Growth Rate (SGR) formula is dead . As of April 16, 2015—after 17 temporary patches—the wizards in Washington have permanently repealed the flawed SGR formula that threatened to significantly cut Medicare payments. Now, when payments exceed the growth in per-capita gross domestic product, PTs will no longer face reduced payments. Instead, they can look forward to a bit more stability, simplicity, and cash flow for the next decade. The new payment determination process begins with …

  • Why PTs Should Approach ACOs with Caution Image

    articleMay 28, 2015

    Why PTs Should Approach ACOs with Caution

    While many ACOs are enjoying success , that hasn’t been the case for everyone—especially when it comes to CMS-sponsored programs. As of September 2014, only 19 of the original 32 organizations that joined the Medicare Pioneer Accountable Care Organization program were still involved. Despite the program’s total savings of more than $384 million over two years, the economic model didn’t work for all participants. Some of the Pioneer organizations weren’t able to make large enough improvements in …

  • 3 Newsworthy Notes about the HITECH Act in 2015 Image

    articleMay 27, 2015

    3 Newsworthy Notes about the HITECH Act in 2015

    The HITECH Act ignited a fervor in the healthcare industry in the early 2010s. Part of the American Recovery and Reinvestment Act (ARRA) of 2009, the Health Information Technology for Economic and Clinical Health Act (a.k.a. the HITECH Act) incentivizes the adoption and meaningful use of electronic health record (EHR) systems—and penalizes those who fail to do either. According to CMS , eligible providers could receive incentives up to $44, 000 through Medicare and up to $63, …

  • CMS Can See Clearly Now, Releases PQRS Strategic Vision Image

    articleMay 21, 2015

    CMS Can See Clearly Now, Releases PQRS Strategic Vision

    All month long, we’ve talked about the healthcare industry’s rapid evolution from the fee-for-service Stone Age to the pay-for-performance Enlightenment Period. Yes, payment reform is upon us , but don’t take our word for it—take it straight from America's largest payer of healthcare services: The Centers for Medicare and Medicaid Services (CMS). In an effort to “contribute to improved healthcare quality across the nation, ” CMS recently published the Physician Quality Reporting Programs Strategic Vision , detailing …

  • To ACO or Not to ACO: The Efficacy Question Image

    articleMay 20, 2015

    To ACO or Not to ACO: The Efficacy Question

    Yesterday, I told you about accountable care organizations (ACO) and how they might affect your physical therapy practice . Just one of several alternative payment models , the ACO approach seems to foster better and more expedient care, lower costs, and greater emphasis on physical therapists’ role as care coordinators. But CMS has experienced high dropout rates with its Pioneer program, and Medicare has already gone through three iterations of its ACO model, including the recent release …

  • What PTs Need to Know About ACOs Image

    articleMay 19, 2015

    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

    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.

    Download your guide to alternative payment models.

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    The winds of change …

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

    articleMay 7, 2015

    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 …

  • Evidence-Based Payment: Why Data is the Key to Pay-for-Performance Success Image

    articleMay 5, 2015

    Evidence-Based Payment: Why Data is the Key to Pay-for-Performance Success

    If I challenged you to find a rehab therapist who didn’t believe in the power of evidence, you’d be searching for a while—forever, hopefully. After all, PTs, OTs, and SLPs are steadfastly dedicated to evidence-based clinical practice, because they know it gives their patients the best possible chances for success. On the business side of therapy practice, however, the application of evidence—a.k.a. data—is something many rehab therapists have yet to fully embrace. Payers, on the other hand, …

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