"Physical therapy is not a subspecialty of the medical profession and physical therapists are not medical doctors; we are a separate profession that provides a unique service that physicians are unable and untrained to provide."

Letter to the AMA from the APTA, Dec 2009

Thursday, August 7, 2008

What Alternatives for Physical Therapy?

The Outpatient Therapy Payment Alternative Project Synopsis is at the point of data collection...
"In order to collect the needed data, the project involves (1) the development of a data collection strategy, including the recruitment of therapy providers to participate in data collection..."
The Project needs to collect data on how to measure the patients you see in physical therapy every day.

Medicare would like to know three things
  1. How disabled are they?
  2. How much will they improve with physical therapy?
  3. How disabled will they be at discharge?
"The Medicare Payment Advisory Committee (MedPAC), the Government Accountability Office (GAO), and outpatient therapy stakeholder organizations have suggested that the claims and administrative data currently available to CMS are not sufficient as the basis for developing better alternatives to the therapy caps."

Right now, the data collection instrument looks like it will be the Activity Measure for Post Acute Care (AM-PAC).
"the AM-PAC was designed to be used across patient diagnoses,
conditions and settings where post acute care is being provided"
I currently use the Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) and I like it.
This project may dovetail with other projects ongoing at Medicare.

The Physician Quality Reporting Initiative (PQRI), affectionately known as Pay for Performance (P4P)may become a part of the Alternative Payment Model.

The American Physical Therapy Association (APTA) is working on a payment model (an alternative to the 'Alternative') that will pay providers more when the patient gets better in less than the expected number of visits.

"Value Purchasing in Outpatient Physical Therapy" by Alphonse Amato, PT, MBA in 2006 laid out a similar-sounding plan.

Go read it.

It sounds like a blueprint for the future.

Depends on who gets their way.

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Tim Richardson, PT owns a private practice at Medical Arts Rehabilitation, Inc in Palmetto, Florida. The clinic website is at MedicalArtsRehab.com.

Bulletproof Expert Systems: Clinical Decision Support for Physical Therapists in the Outpatient Setting is a manager's workbook with stories, checklists, charts, graphs, tables, and templates describing how you can use paper-based or computerized tools to improve your clinic's Medicare compliance, process adherence and patient outcomes.

Tim has implemented a computerized Clinical Decision Support (CDS) system in his clinic since 2006 that serves as a Reminder, Alerting, Prompting and Predicting CDS using evidence-based tests and measures.

Tim can be reached at
TimRichPT@BulletproofPT.com .

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Consistent with the American Physical Therapy Association Vision Statement for Physical Therapy 2020, the American Physical Therapy Association supports exclusive physical therapist ownership and operation of physical therapy services.