"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

Saturday, June 19, 2010

Stark Loophole not the only bright light in the new MedPAC report

The new MedPAC Report to the Congress: Aligning Incentives in Medicare is gaining attention amongst physical therapists primarily for its recommendation to close the "Stark Loophole" but also should be credited for emphasizing the collection of clinical data as a condition of payment.

MedPAC Report to Congress
MedPAC suggested in its recent report that the US Congress remove outpatient therapy from its list of services qualifying for the "in-office ancillary services exception" because physicians are not using the exception for its intended purpose and because costs are climbing too quickly.

MedPAC also suggested collecting clinical data as a condition of payment, called Coverage with Evidence Development (CED).

I propose Medicare could deliver better OUTCOMES, save more MONEY and get better VALUE for beneficiaries and taxpayers if collection of clinical data is in place of burdensome, centrally-mandated process measures that waste time, generate excess paperwork and distract highly-paid and well-educated physical therapists from face-to-face interactions with their patients.

Asking physical therapists to examine, evaluate and record patient data is 100% in line with the Guide to Physical Therapist patient management model.

Coverage with Evidence Development could be a positive force leading to a change in physical therapist culture: a shift to a culture of measurement.

If CED were in place of arbitrary process measures as a condition of payment then we could reduce Medicare audits by accountants and lawyers.

However, if CED is just one more centrally-mandated and administrated process measure then we'll all just be working harder.

Free Tutorial

Get free stuff at BulletproofPT.com

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 .

"Make Decisions like Doctors"

Copyright 2007-2010 by Tim Richardson, PT.
No reproduction without authorization.

Share PTD with your Peers!

American Physical Therapy Association

American Physical Therapy Association
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.