Eli's Rehab Report

Published on Thu Jan 13, 2011 PDF

Quality reporting is optional now, but don't expect that to last.

Think potential clients aren't paying attention to your therapy outcomes? Think again -- and soon your results will be available to everyone.

"There's a lot of chatter at the Centers for Medicare & Medicaid Services making providers of all kinds more accountable" by providing proof of their quality on report cards like those already used by physicians, says Michael Weinper, PT, MPH, president of PTPN, a network of rehab professionals in private practice.

"The clear message from CMS and health reform legislation is that healthcare should move from paying for volume to paying for quality," says Ben Johnston, Jr., PT, CEO of Knoxville, TN-based Focus On Therapy Outcomes (FOTO), a company that provides evaluation tools and data management services to rehab providers.

Where Medicare goes, the rest of health care generally follows, Weinper points out. That means you can almost guarantee that if Medicare requires quality reporting, other payers will require it as well.

Now is the time to put the processes and procedures in place that will prepare you for extra quality scrutiny soon to come. Use these tried-and-true techniques to get started:

Step 1: Identify Your Outcomes

Challenge: The elusive component you must pin down if you hope to be report-card ready is your outcomes -- the positive improvements your clients experience over the course of treatment.

Now more than ever patients are choosing their care providers -- including rehab -- based on the value they can expect from the relationship, Weinper says. They will look to outcomes like measured improvement, patient satisfaction, and efficiency (the number of visits/cost necessary to get the measured improvement) when determining who to give their business.

Action plan: You must flag and collect these outcomes, Weinper urges. PTPN currently tracks how well its therapists adhere to quality assurance, how many facilities meet credentialing standards, patient satisfaction, outcomes percentile and participation, and efficiency and outcome benchmarks, he shares with Eli.

Rehab providers can also prepare for report cards by affiliating themselves with a "valid and proven quality measurement and reporting process that is moving toward public reporting," Johnston says.

Step 2: Prove Your Therapy Works

Now that you've determined your outcomes, you must track and measure them just as you do for your processes and structures. This will provide proof that your training or certification and number of therapy sessions resulted in improved quality of life for your patients.

Action plan: You can start small when measuring outcomes, Weinper notes. A pretreatment and post-treatment questionnaire allows patients to self-rate how successful their therapy was. You could also perform pre-treatment and post-treatment interviews or ask patients to evaluate their progress over the course of treatment.

The key is measuring results at different time points, Weinper says. "We recommend that practices measure results at the beginning of care, during care, and after treatment ends," he outlines.

Crucial: You must clearly define who is responsible for ensuring each outcome element is collected, Johnston notes. The information must be gathered consistently and maintained for future comparisons. Failing to gather even one component can throw off your results.

Step 3: Help Therapists Home In On Advantages

While patients will be in hot pursuit of therapy report cards, therapists may not be as excited at the prospect of being "judged" according to outcomes. "Therapists may fear that the service they provide isn't as good as they think it is or may fearpunishment if their outcomes aren't as good as others' are," Weinper explains.

Action plan: Get therapists' buy-in by showing them how knowing their outcomes can improve future results. "The reality is that therapists may be good at something and not at others -- but it's better to know so they can work on the weak areas," Weinper says. For instance, if your outcomes for shoulders are lower than your results for backs, you know it's time to beef up on shoulders.

The practice can offer inservices or seek out development opportunities that help therapists strengthen their weak areas. Or, a therapist who excels in a specific area can offer training for those whose results for that area aren't as strong.

And, as you ramp up your measurement efforts, skip discipline altogether, Weinper recommends. "Your focus should be on helping therapists improve," not penalizing them for needing to, he says. Your goal in the early stages is to figure out where you are and where you need to be.

Step 4: Act On All Measurement Results

Your therapists aren't the only ones that may end up with a low score initially. Your facilities or compliance may also falter.

Action plan: Start by looking at the areas where your facilities or therapists don't meet your expectations, Johnston suggests. Work on bringing those areas up to speed first, and then tackle the more-subtle issues.

"Report cards will distinguish providers who say they provide quality care from those who can prove it through external benchmark comparisons," Johnston asserts. Once you've accumulated some positive data, share it with existing clients, include it in your marketing efforts, and make it available to referral partners, he advises.

Final say: Though required reporting is still a few years away, the time will fly by. Getting started now will put you ahead of the curve and show both patients and insurers that your therapists provide only top-notch results.