4 Take Home Points from Ascend 2017

WebPT’s 4th annual Ascend Conference took place in Washington, D.C. the weekend of September 29th. Rehab therapists from around the world attended business discussions on increasing revenue, outcomes, payment reform, Medicare audits, healthcare, and much more. There was SO much to learn over two full days. If you didn’t get a chance to attend, you can still benefit from the great material presented! Check out my main take away points below!

Be where your feet are

Whether you’re at home, work, lunch, or meeting someone for the first time, give him or her your utmost attention. We live in a world where distractions are everywhere. It’s not uncommon today to see two people dining together while staring at their phones instead of engaging in each other. This breaks my heart.

Alan Stein Jr.

Alan Stein Jr. hit this point home during the keynote address day 1 at WebPT’s Ascend Event. He emphasized giving everyone in your life your full attention while focusing on the things and people that make you the happiest throughout your day. It’s so easy to lose sight of what we cherish most in life. I challenge you to put your phone down, worry less, listen more, and be where your feet are.

 

Outcomes, outcomes, outcomes

Healthcare, as we know it today, is changing. We’re moving from a fee-for-service system to a value-based care system. So what does that mean? Currently, clinics get paid based off of the services they provide. $100 for an eval, $10 for a modality, whatever it may be. By 2019 this could be something of the past for Medicare payment. The Merit-Based Payment System or MIPS will provide payment based on quality and performance in the clinic. How can that be measured? OUTCOMES. MIPS will account for plus or minus 9% of your Medicare payments. Losing 9% for low performance on outcomes is a BIG deal. Check out my interview on the matter with CEO of WebPT, Nancy Ham. How can you lessen the stress of the payment reform? Prepare.

Prepare for Payment Reform

Discussing Payment Reform

Start now by using data-driven outcomes. Measure not only outcomes but also patient satisfaction. One of the biggest questions during the discussion on outcomes was, “What about non-compliance?” It’s not always easy to have a patient complete their plan of care and that can lead to loss of success with outcomes. Practice owners Mike Mundry and Mike Manzo gave great advice on how to increase participation in patient-reported outcome measures. When determining patient satisfaction, consider emailing the report straight from the clinician. Patients are more likely to open and respond when they know it came straight from their provider. Why not give a paper report in the clinic? This can skew results. If a clinician hands you a satisfaction survey and stands over you smiling would you be honest with your report? I’d feel pretty pressured. Accuracy is key.

What about those patients who never show up for a formal discharge? This is tricky. Try contacting the patient through multiple routes. Give a phone call and ask them to come in for one more visit and a new HEP, email the outcome directly, consider mailing the outcome to patients who might not use the computer as often. Start practicing these measures now and determine your faults and successes before the payment reform begins. Refine your skills, try different outcome measures, find what works best for you now so you don’t have to panic later when change comes.

CPT Codes are important

As you know, new CPT codes came out this year. CMS projected that initial evaluation complexity codes would add up to 25% low complexity, 50% moderate complexity, and 25% high complexity. WebPT researched their data from the first 6 months of the year to see if those projections are in alignment with what we’re seeing in the clinic. Guess what? They’re not. After collecting over 500,000 initial evaluation CPT codes reported, WebPT determined the rehab industry is actually submitting around 45% low complexity, 45% moderate complexity, and only 10% high complexity. What does this mean? As of right now, these complexities don’t reimburse differently, BUT one day they could.

Rick Gawenda, PT emphasized the importance of choosing the correct CPT code for your evaluation. Professionals need to report accurately because in the future each code could come with a dollar amount. Let’s say you’re choosing the low complexity CPT code for every evaluation because, right now, it doesn’t affect how much you’re getting paid. Then, CMS comes out and decides to pay a certain percentage more for high complexity and less for low complexity. If you start increasing your evaluation codes to higher complexities compared to what was first projected, you could be looking at a Medicare audit. Learn the identifiers for each complexity, choose accurately, avoid the audit.

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Check out the Talus Media Talks interview with Nancy Ham, CEO of WebPT:

RC 6-17: Definition of Professional Scope of PT Practice

RC 5-17 defines the components of the physical therapist scope of practice as personal, jurisdictional, and professional. RC 6-17 is an effort to better define the professional scope of practice. Currently, the professional scope reads as:

The profession’s unique body of knowledge, supported by educational preparation, a body of evidence, and existing or emerging practice frameworks.

 A new, more extensive definition will read:

Physical therapists’ professional scope of practice consists of patient and client management including diagnosis and prognosis to restore, correct, maintain, and maximize physical function, movement, performance, health, quality of life and to prevent, minimize, and mitigate the effects of disease, injury, congenital abnormalities, as well as other health conditions during the patient and client lifespan.

Physical therapists’ professional scope of practice is grounded in basic and clinical sciences. It is supported by educational preparation, based on a body of evidence, and linked to existing and emerging practice frameworks. Physical therapists’ professional scope of practice evolves in response to innovation, research, collaboration and changes in societal needs

kettle bells

There are both pros and cons to this change in language that has been proposed. This new definition allows for our scope to continue evolving, includes diagnosis, and prevention. Physical therapists are “movement specialists” and this definition emphasizes our role as such throughout an individual’s lifespan.

On the other hand, this new proposal is very broad and those against this change worry that it could be applied to a number of health care providers outside of the physical therapy realm. If someone in the general public wanted to research specifically what a physical therapist can provide, this definition may not give them the answers they are looking for. While there is a mention of prevention, some believe that there needs to be a better explanation of the importance of preventative therapy.

The professional scope of practice is the only component of the three that is up for a makeover. Members of the APTA Board of Directors believe the definitions of personal and jurisdictional scope are straightforward enough to remain the same. For more information, check out our post on the components of physical therapist practice proposed in RC 5-17 here. Have comments? Follow us and start a discussion on our Facebook page.

References:

American Physical Therapy Association. Packet I: Reference Committee 1-17. Alexandria, VA. 2016:16-18.

Gardner K. Professional Scope of Physical Therapist Practice. http://www.apta.org/ScopeOfPractice/Professional/. Accessed May 25, 2017.

The Hub : Forums : RC 5-17 Adopt: Components of the PT Scope of Practice. http://communities.apta.org/p/fo/st/thread=5532. Accessed May 25, 2017.

The Hub : Forums : RC 6-17 Adopt: Definition of Professional Scope of PT Practice. http://communities.apta.org/p/fo/st/thread=4857. Accessed May 26, 2017.

 

 

 

RC 5-17: Components of the Physical Therapist Scope of Practice

Treadmill StartThe House of Delegates (HOD) will review a change in the wording of the physical therapist scope of practice. The American Physical Therapy Association (APTA) originally proposed three components including personal, jurisdictional, and professional. The APTA defines each of these components separately.

One’s personal scope should include, “their own personal knowledge, skills, and abilities.” The APTA emphasizes that one should not provide a type of treatment or skill that they have not been trained in or have the knowledge base for.

A PTs jurisdictional scope is determined by the state in which they are licensed and practice in. That state’s practice act will include what a PT may or may not legally perform as treatment.

The professional scope is currently defined as, “the profession’s unique body of knowledge, supported by educational preparation, a body of evidence, and existing or emerging practice frameworks.” This definition has been proposed to change in RC 6-17.

Throughout the efforts to define the components of the physical therapist scope of practice, the APTA has now proposed to change the language to the “Physical Therapist Scope of Practice Definition.” This definition will still include the three components described above.

So what’s new? Why change? The physical therapist scope of practice is ever changing. A change in the language of the scope will allow physical therapists to evolve with their society and its needs. Whether there is a change in jurisdictional laws or advancements in research and technology, this language will allow a physical therapist to adapt and include the most up to date, evidence-based treatment in their practice.

 

References

American Physical Therapy Association. Packet I: Reference Committee 1-17. Alexandria, VA. 2016:16-18.

Gardner K. Personal Scope of Physical Therapist Practice. http://www.apta.org/ScopeOfPractice/Personal/. Accessed May 19, 2017.

The Hub : Forums : RC 5-17 Adopt: Components of the PT Scope of Practice. http://communities.apta.org/p/fo/st/thread=5532. Accessed May 21, 2017.