"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, August 13, 2011

Physical Therapists Have Questions about Medicare Accountable Care Organizations (ACO)

First of all let me say that NONE of us are going to figure out the Medicare ACO puzzle alone - we'll each other to share knowledge, network and learn best practices for improving population health.

This is uncharted territory. We're used to treating patients, not populations of (healthy?) people.

Some of the early ACO resources I used are listed here:

The APTA Private Practice Section has two excellent webinars that are available as a free member benefit to PPS members. Go to the APTA Private Practice section website here.

...and click "Health Care Reform" - you will be asked for your APTA-PPS member log-in.

For non-members, the APTA has publicly posted its comments on the Medicare Shared Savings Program.

The APTA is advocating on behalf all practice settings and I was pleased that the ACO Comments addressed concerns of Private Practice Physical Therapists. Particularly, I noticed that the APTA urged CMs to...
"...waive uneccesary and inconsistent Medicare regulations for ACOs including, but not limited to... the requirement for physician signature/certification of the Plan of Care for physical therapy." (page 10)
Finally, a resource that I found helpful was the Dept. Health and Human Services/Center for Medicare/Medicaid Services 10-page primer
Improving Quality of Care for Medicare Patients: Accountable Care Organizations.

Particularly pay attention to the 65 Quality Measures ACOs must meet in order to participate in shared savings - this is where I believe the physical therapist and the physical therapist assistant have the opportunity to shine.

I counted at least 7 of the 65 Quality Measures that are part of the PT/PTA
scope of practice that could improve quality at low cost.

If physical therapists get Direct Access the number of Quality Measures PT/PTAs could impact could rise substantially.

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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 .

"Make Decisions like Doctors"

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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.