With Medicare’s Quality Payment Program up and running, the shift from fee-for-service to value-based care is finally in full swing. Every day, more public and commercial payers are exploring new possibilities for value-based contracts, and every day, more healthcare providers are participating in initiatives like the Merit-based Incentive Payment System (MIPS). Still, when it comes to physical therapy, most have yet to board the value-based train. It’s not that PTs are against the move to value—it’s just that for many, they don’t know where to begin.
With that in mind, we recently spoke with a number of physical therapy leaders who’ve made value-based care essential to their practice, and we asked them for any advice they might share to those who are just getting started. Their answers covered everything from value-based management to the top opportunities they see moving forward, but they all boiled down to the following five tips.
#1: Collect outcomes data
To succeed in value-based care, you must be able to prove the interventions you provide are actually helping your patients. “If you’re negotiating a contract with a company to treat and reduce incidence of low-back pain among employees, you need to have data that says you can get them this much better for this amount of money in this amount of time,” says Chris Hoekstra, PT, DPT, PhD, Director of Knowledge Management with Therapeutic Associates Physical Therapy in Oregon. He and others recommend leaning on technology for this purpose—ideally, a system that streamlines data gathering and reporting and integrates with your clinic’s EMR.
#2: Prioritize patient engagement
A key component of value-based care involves encouraging patients to be accountable for their own health. Healthy clients must know to contact you right away should they suffer any sort of musculoskeletal injury, and current patients should find it easy to reach you whenever they have questions about their home-exercise programs. “The more you can engage with people outside of the four walls of your clinic, the better prepared you’re going to be for value-based care,” says Jerry Henderson, PT, Co-founder and Vice President of Clinical Strategy with Clinicient.
#3: Communicate and collaborate
Value-based bundled-payment programs like the Comprehensive Care for Joint Replacement Model (CJR) incentivize providers to work together to help their patients get better faster. For this reason, recommends Janie Taylor, PT, DPT, OCS, Chief Executive Officer with Physical Therapy Central in Oklahoma, success requires an interdisciplinary approach. “I’m trying to lower costs and improve outcomes. How can I do that with my patient if I’m not communicating with their physician?”
#4: Start with MIPS
Whether or not your practice must participate in MIPS, it can benefit from enrolling in the program now. MIPS provides incentive payments to practices that use data collection and reporting to show they’ve hit certain quality-related benchmarks. Signing on early, recommends Kelly Sanders, PT, DPT, OCS, ATC, President at Team Movement for Life in California, is a way to build experience with value-based care before it and similar programs eventually become mandatory. “We saw it as a chance for us to work out the kinks before we faced penalties,” she says.
#5: Evolve your practice
Value-based payment models reward providers for efficiency and effectiveness—skills that depend on practical experience and on a commitment to continuing education and training. To succeed in this arena, says Stephen Hunter, PT, DPT, OCS, FAPTA, Director of Rehabilitation Services with Intermountain Healthcare, it’s important to ensure your practice keeps pace with the leading edge of the profession.
“You have to be willing to adapt as new evidence comes out,” and to recognize that “the way you treated this patient a year ago may not be the way you should be treating them now,” Hunter says. Make following best practice “part of your culture,” he recommends, and you’ll soon find that value-based care is one and the same as physical therapy itself.