"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

Tuesday, July 23, 2013

Sustainable Growth Rate Replacement On Sale at the #PPSFlyIn !

Like treasure-seekers at a sidewalk scavenger sale physical therapists can get a little excited about the potential for meaningful Medicare payment reform this summer. 

The flawed Sustainable Growth Rate (SGR) formula is on sale for a limited time only and the Congress can buy this dusty artifact from the 1997 Balanced Budget Act with new legislation in 2013.

The Medicare Physician Payment Innovation Act (HR 574) will provide a clearly defined path to payment reform as well as a period of payment stability necessary for physical therapist and physician practices to transition to an alternative payment system, reports Jerry Connolly from the American Physical Therapy Association Private Practice Section Advocacy Fly-In in Washington DC.

The cost to replace the SGR has decreased over the last three years because the 2009 Great Recession and ObamaCare have both driven down healthcare cost growth. The decrease in cost growth, in turn, changes the 10-year estimate to replace the SGR.  This estimate is calculated by the Congressional Budget Office which announced that the new price is $139 billion, down from $330 billion.

Only in Washington DC is $139 billion seen as cheap.  It's like finding an old vinyl copy of Led Zeppelin's 1971 Stairway to Heaven for $2!

The SGR is used to calculate physical therapists' Medicare payments.  The SGR has also been a big distraction for the Congress every year as provider organizations lobby to prevent ever bigger Medicare cuts. 

The 2014 adjustment is projected to be negative 24%!  Now that's cheap!

Sunday, July 21, 2013

Why Physical Therapists Should Care About Interoperability

I just got back from the 2013 Florida Perspectives: Transforming Healthcare through Health Information Technology on Friday, July 19th, 3013 at the University of Central Florida, Lake Nona Medical Center in Orlando.

This program was put on by the Central and North Florida Health Information Management Systems Society (CNF-HIMSS).

Why should you care?
Physical therapists can help answer the problems of interoperability in healthcare which are far from solved. Nobody has all the answers yet - not policymakers, not administrators, not physicians and not even the technical gurus that help us keep our computers running.

Some of the challenges outlined by CNF-HIMSS are near-universal among healthcare workers and include the following:
  • How should we train our new clinicians to use Electronic Medical Records in our daily work?
  • How should we incorporate the legions of newly eligible patients under ObamaCare?
  • How should Florida structure its new Medicaid program?
  • Can the Florida legislature quickly reach agreement on important matters concerning healthcare?
  • For that matter, can the Federal Congress reach agreement on important issues regarding funding?
Rich Rasmussen, the Vice President of Member Relations of the Florida Hospital Association got up about midway through the meeting and issued a call to action...

"We're all in this together!" he said, referring to the importance of adequate funding for state Medicaid recipients accessing care through the emergency room... 

"My healthcare and your healthcare costs are about $1,100 per year higher than they would otherwise be because of these uninsured patients."

What can physical therapists do? We can stay informed of the issues and support those that dovetail with issues important to physical therapists.

For instance, most of my readers know that in 2012 the Florida House of Representatives failed to support Governor Rick Scott's proposal to accept Federal funds for about 1.3 million state Medicaid recipients. The Florida Senate passed the Governor's plan but the House responded with a plan that would cover only about 100,000 Floridians. That still left over 1 million uninsured Florida residents!

Physical therapists, especially physical therapist private practice owners, would probably like very much for those 1 million Floridians to have access to physical therapy. Rich Rasmussen wants those people to have access to his hospitals.

When we can find this common ground with hospitals and other advocacy groups then physical therapists can really come together with a common voice to speak to our legislators. We can show our leader that we really are in this together.

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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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