Physical Therapists Learn from the Best in the Business

Physical therapists learning from each other - that's what we've always done.

The 2012 Florida Physical Therapists in Private Practice (FLPTPP) Meeting is August 17th to 19th, 2012 in Orlando, Florida.

Armin Loges, PT and crew have lined up a dynamite cast of presenters for you.

Florida Physical Therapists in Private Practice 2012 Annual Meeting

Pick the educational courses that you need this year - all come with CME credits!

Saturday, August 18th (morning)	Medicare Compliance	Nancy Beckley, MS, MBA, CHC
Saturday, August 18th (morning)	Pelvic Floor Dysfunction	Tricia Trinque, MHE, PT
Saturday, August 18th (morning)	Dry Needling	Brian Ruchin, PT, DPT
Saturday, August 18th (afternoon)	Marketing Your PT Practice	Nitin Chhoda, DPT
Saturday, August 18th (afternoon)	Cervical Thrust Manipulation	James Dunning, FAAOMPT, MMACP
Saturday, August 18th (afternoon)	Business 101 for Physical Therapists	Dick Hillyer, DPT, MBA, MSM
Saturday, August 18th (afternoon)	Innovation in Physical Therapy	Matthew Harkness, MPT, MTC, TATC, CEAS
Sunday, August 19th (morning)	New Florida PIP law	Dick Hillyer, DPT, MBA
Sunday, August 19th (morning)	Red Flags for Cervical Instability	Eric Douglass, DPT, OCS, FAAOMPT
Sunday, August 19th (morning)	Legal Implications for Physical Therapists	Michael Magidson, Esq.
Sunday, August 19th (morning)	Acupuncture	Irene Hujsa, PT, OCS and Julietta Planchart, PT, CNS
Sunday, August 19th (afternoon)	DME and PTPP	Timothy Beury

Last year's conference was important just because of the energy in the room and the excitement it generated (as well as the MANY new members of the FLPTPP that joined!)

This year's conference promises to be MUCH bigger, MUCH better and MUCH more exciting.

We'll see you there!

Sign up here!

Wellness Programs Are Not Poular Among Hopital CEOs

Hospital CEOs say that their wellness programs are "nice to have" but they are not getting paid for them.

As one hospital CEO puts it:

“I’m not getting paid for it so it goes to the bottom of my priorities.”

Hospital CEOs should pay attention to the practice of many physical therapist leaders who are positioning their organizations to impact patient health in a way that will impact population health.

Population health are the set of metrics that look at how physical therapists' interventions actually make a difference in peoples' lives:

• Are patients happy with their physical therapist? (#4)
• Can patients go back to work? Can they play with and lift their babies up? (#7)
• Did the doctor/therapist ask about or measure the following:
  
  • their weight? (#31, #47)
  • their Blood Pressure? (#32, #41, #58)
  • their tobacco use? (#33, #38)
  • did the the PT screen them for depression? (#34)
• Did their physical therapist screen for future falls risk and implement a plan of care? (#63)

As you can see, there are many of the 65 ACO Quality Measures that physical therapists can impact.

Payment may change as Medicare Accountable Care Organizations (ACO) begin in 2012 to pay providers based on outcome, not volume.

Wellness programs have great potential to impact some of the biggest, modifiable drivers of healthcare consumption:

• obesity
• smoking and alcohol consumption
• activity avoidance
• mood disorders.

Medicare Accountable Care Organizations have hospital CEOs fretting about their 2012 revenues since the new program gives hospitals the incentive to cut costs on some unnecessary procedures.

Medicare will reward hospitals that save from 2% to 3.8% of their prior year's revenues up to 7.5% of the "shared savings".

Forward-looking CEOs are aligning their organizations to achieve shared savings since the only alternative is steep, permanent cuts in Medicare and commercial reimbursement.

Forward-looking physical therapist leaders and clinic owners should also seek to align their organizations in a wellness model that impacts the biggest health care driver of them all:

Patient behavior

How can we help people who may not be able to help themselves?

Physical Therapists: Ready for some Risk?

Manatee Memorial Hospital - an acute care hospital at risk

Medicare wants to push $26 billion dollars in risk onto America's private health care providers.

Are you ready?

The timeline is 2010 - just over six months from now.

The risk is in managing the 'episode of care' rather than the patient visit.

The 'episode of care' is gaining traction as an alternative payment model designed to stem Medicare spending increases due greater 'per person' use of the system, not just more users.

What is the episode of care?

For instance, a patient goes into the hospital to get her knee replaced, she stays two days, sees three doctors and gets discharged with home health PT for two weeks - then she gets sent to outpatient PT for one month. All costs, including the pre-hospitalization exam and imaging studies would be 'bundled' into one flat rate.

The current payment model is mainly fee for service during a patient visit - you do the work, you bill for it and you get paid. Fee for service risk is borne almost entirely by Medicare - the private practice or hospital provider only has the risk that not enough patients will show up to cover rent, utilities, salary, etc.

The current administration's budget proposal recommends the 'episode of care' that pays acute care hospitals a single payment for all services connected with a single episode of care, such as a total knee replacement.

This new version of the episode of care as the acute care hospital as 'the banker' - doling out payments to providers down the chain: doctors, surgeons, home health agencies and independent physical therapists.

Surgeons are currently paid using the episode of care model for surgeries.

Physical therapy is considered 'ancillary service' (I hate that term) which is not currently bundled with the surgeon's service.
 
Some of the details are described in the President's budget proposal, this APTA response letter to Senator Max Baucus (D-MT) and in other sources.

Where does risk come from?

Hospital risk is mainly from re-admissions within 30 days of discharge.

Private practice physical therapy risk comes from visit outliers that use more therapy visits than expected.

How can physical therapists manage "Episode Risk"?

Outpatient facilities are judged on functional outcomes - rated by the therapist or self-reported by the patient.

What can you do to improve your patients' functional outcomes?

• Ask your patients about medication compliance (especially use of prescription inhalers for COPD patients).


• Screen each patient for medical pathology (eg: DVT, depression, elevated fear-avoidance beliefs).


• Provide standardized functional outcomes.
  


• Treat pain early - don't use the emergency room for medication refills.

Am I ready for risk?

Other than providing high-quality, patient-centered care I don't feel qualified to evaluate the risks in contracting with acute care hospitals, accepting a fixed payment and bearing the cost if the patient takes 20 visits to get better instead of 10 visits.

Are you ready?