"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

Sunday, March 14, 2010

Improper Payments the Focus of Obama's Speech

President Obama, in his Wednesday, March 10th, 2010 speech in St. Louis, Missouri, unfortunately chose to focus on Medicare inefficiencies and the estimated $100 billion dollars in 2009 improper payments as the main means to cost control and a way to pay for his proposed reform efforts.

Worse, he chose to laud the Recovery Audit Contractors (RACs) as potential saviors of healthcare and a major source of cost savings in his healthcare reform proposals.

The Improper Payments Elimination and Recovery Act (originally introduced in 2009) is designed to introduce RAC-style auditors to other, high-cost areas of government spending, like military defense and education.

When, in fact, the problem is not mainly inefficiencies in payment but the system itself: fee-for-service creates incentives to overutilize, overspend and overtreat.

Obama's health care reform has been appropriately criticized as health care financing reform.

An outcomes-based system for medical payments is years away and the transition is likely to be gradual and phased-in.

America has the highest health care 'unit prices' in the world but a middling rank in total outcomes (#34).

Rather than cast auditors as heroes (which, by contrast, paints doctors, hospitals and physical therapists as villains) let's put our efforts into accelerating the transition to real health care reform - outcomes.

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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.