"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

Friday, April 1, 2011

Medicare Accountable Care Organizations May Help Physical Therapists

New guidelines for Medicare Accountable Care Organizations (ACO) may help physical therapists become more important players in America's healthcare system.

However, physical therapists are currently not categorized as ACO professionals by the Secretary of Health and Human Services (HHS).

The new guidlelines will, hopefully, add clarity to vague promises and hopeful expectations currently voiced by Medicare officials:
"An ACO will be rewarded for providing better care and investing in the health and lives of patients," said CMS Administrator Donald M. Berwick.

"ACOs are not just a new way to pay for care but a new model for the organization and delivery of care."
Leaders in the commercial healthcare marketplace are more forthcoming. Karen Ignani, CEO of America's Health Insurance Plans, said ACOs presented...
"an opportunity for Medicare and Medicaid to build on the successes of the innovative payment systems that exist in the private marketplace today to improve the quality and safety of patient care and help put the health care system on a sustainable path."
I can't help but think that Ms. Ignani was speaking of innovative delevery models, like the Virginia Mason experiment from 2006, where patients with lower back pain went first to physical therapy, skipping the expensive MRI and neurosurgical referral.
Virginia Mason makes sense except in the current econoomic model: fee-for service.

Fee for service rewards greater productivity but not innovation.

The more cost-effective Virginia Mason became, the bigger financial hit the medical center took.
"Everyone gained but Virginia Mason," says its chief of medicine, Robert Mecklenburg.
The promise of the ACO model is more experimentation like Virginia Mason but the risk is that providers will try to consolidate to gain market share and drive up prices.

Again, Karen Ignani:
"...ACOs could accelerate the trend of provider consolidation that drives up medical prices and result in additional cost-shifting to families and employers with private coverage.

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.