Nor’easters and Wicked Good Chowdah at CSM 2024

The end of the winter season coincides with the conclusion of another Combined Sections Meeting (CSM). And while many attendees wondered why the American Physical Therapy Association (APTA) chose to hold the largest gathering of physical therapists in the country in Boston, MA, during a Nor’easter, on Valentine’s Day, and in the winter, most every attendee was well-rewarded for the trip. 

Having spent nearly four years of my travel career in New England, I was excited to return to my old stomping grounds to visit with past colleagues while seeing the timeless sights and get a bowl of seafood “chowdah.” With the convention center located in South Boston’s Seaport district, I was treated to an area under revival, transitioning from an industrial port complex to a bustling center of modern amenities teeming with life. Thus, a theme for my CSM 2024 was born—revitalizing the physical therapy industry.

A vibe can be found everywhere, for everyone.

Trying to decide which session to attend at CSM is a lot like finding a needle in a haystack. Unless a person is familiar with a speaker already or some form of outreach pre-notified said person, there’s a good chance many sessions go unnoticed. That nearly happened with my first session, but with a 7:00 AM post-run scroll of the schedule, I found “It’s a Vibe: A Revolution of the PT Experience.” I was treated to an exciting, invigorating two-hour presentation on how each and every clinic—large and small—has a vibe and must foster that vibe if they want to be successful.

With mentions of the purple cow from Seth Godin’s “Purple Cow: Transform Your Business by Being Remarkable,” or the book “Pre-Suasion: A Revolutionary Way to Influence and Persuade,” by Robert Cialdini, the PTs from PT Revolution opened the weekend with thought provoking and empowering ideas for clinic owners. Of particular note was the concept of having a niche for your clinic. Some attendees expressed trepidation initially with the hard line drawn that every clinic needs a niche, but the story quickly turned to show that the niche concept was in fact a lifeline for almost any clinic. By honing in on your clinic’s niche, you create an identity that feeds that vibe and almost inevitably brings in other patients (customers) outside that niche looking to experience that vibe.

I could have listened to the guys at PT Revolution talk for hours, but the day had to continue, and more sessions were calling. But before moving on, I must mention the take-home message that beer, raffles, and good-cotton t-shirts are essential to building successful community engagement events—something many private practices should keep in mind for the next educational outreach or local expo they attend.

Small leaks sink great ships.

If the PT profession—and the private practices that make up the bulk of the industry—is going to forge ahead revitalized in these hard financial times, then internal controls and processes of the business must be in ship-shape. As John Wallace, PT, MS, OCS, Senior VP of Member Value and Chief Business Development Officer of RCM at WebPT, covered in his presentation, “People, Processes, and Internal Controls: Key Elements to Scaling Your Billing Operations,” the RCM cycle is the vital internal workings of any healthy PT practice. 

In today’s tight environment of shrinking margins and declining reimbursements, practices cannot afford to let dollars and cents slip through the cracks. To ensure each clinic’s RCM cycle is running correctly, Wallace opened with the quote by Louis V. Gerstner former CEO and Chairman of IBM and the Carlyle Group, “People don’t do what you expect but what you inspect.” And on that note, Wallace launched into why and how practice owners—or their representatives—must be prepared to “touch” 15-20% of their claims in order to get them paid correctly. 

Beyond the RCM cycle, Wallace highlighted some simple errors that everyday therapists continue to make in 2024. The biggest surprise to me was in the realm of proper ICD-10 coding. We have been using ICD-10 for over eight years now, but many therapists are still using the coding structure akin to ICD-9. This has led to a rising number of claim denials post-pandemic. Wallace divulged that CMS has ramped up its auditing post-pandemic and the initial grace period. 

What’s the number one thing providers can do for their ICD-10 coding, you ask? Well, start coding specific to the diagnosis, and the concept of ‘less is more’ reigns supreme. In many instances, providers are assigning too many diagnosis codes (e.g., unnecessarily tacking on M25.561 for knee pain after a primary diagnosis of Z47.1, aftercare following surgery for joint replacement). Simple fixes like proper ICD-10 diagnosis coding or accurate evaluation complexity coding can go a long way to ensuring that your ship remains afloat for years to come.

To grow, we must stake a claim in the healthcare value arena.

If the PT profession is going to succeed and continue to grow in a tight healthcare space competing for insurance dollars, then we must be able to show our value. One area of our profession that has often been lacking in the value arena has been acute care. Tracking patient outcomes is quite difficult in this realm as lengths of stay are much shorter than outpatient PT, and PT touch points with these patients can be highly variable. However, the team at Cleveland Clinic created a value dashboard that provided clinicians real insight into their effect on patients’ lives and the value they brought to the healthcare system.     

Mary Stilphen, PT, DPT, and her colleagues created a value dashboard, which they covered in the presentation “Driving Value in Acute Care: Creating a Culture Focused on Value.” From their value dashboard, the team discussed how they use the “wheel of data” to generate and collect data—and use the available knowledge collected—to influence patient-centered care and drive value within their teams. What resulted from the initiative was actionable and easily understood data points to prove to administrators and insurance companies that PT had a place in acute care, and—more importantly—a place on the front lines of patient care.

As the team wrapped up their presentation to field questions, they touched on one important factor that I must mention. The value dashboard they created and the data they were able to aggregate were made possible through their technology platform. For PT practices to continue to collect data and easily disseminate it into hard, actionable evidence, they need a Practice Experience Management (PXM) solution that considers the whole patient episode—start to finish and beyond, at home and in the clinic.

Revitalizing the industry requires fortifying our pipeline.

Saturday is often a day met with hits and misses on the part of the conference schedule. Many attendees have left for the weekend, while others are looking for one last great presentation. Anyone in attendance in the Grand Ballroom in the Westin was not disappointed, as Heidi Jannenga, PT, DPT, ATC, Co-Founder and Chief Clinical Officer of WebPT, gave a packed-house presentation titled “Fortifying PT Talent: How to Retain PTs, Juggle Productivity Goals, and Reduce Burnout.”

In this brass-tacks discussion, Jannenga cut to the chase, describing where we were as a profession 16 years ago and where we are now. And right now, the profession is facing an unprecedented labor crisis. Aside from the ever-present issue of declining insurance reimbursements, the labor shortage is the biggest hurdle to our profession's growth and revitalization. 

To do that, Jannenga discussed how technology has been with therapists along the way, but it has evolved with the industry to meet the demands of present-day health care—her mantra for physical therapy in 2024 was to “work smarter, not harder.” Providers need solutions that eliminate redundant and mundane tasks to reduce administrative harm and boost provider satisfaction — which is where the ideals of PXM take center stage.

As the session examined ways for the profession to grow and revitalize, Jannenga’s discussion inevitably turned to artificial intelligence (AI). After all, it’s not a tech presentation in 2024 if AI doesn’t get a mention. But Jannenga went deeper to call out what an AI digital assistant can do for therapists. From compliance checks, coding boosts, documentation shortcuts—and more—AI in physical therapy is looking to eliminate administrative harm and return the focus to patient-centered care.

Revitalization takes more than a conference.

Even though the wind chill was single digits some days, CSM in Boston did not leave us frigid. Admittedly, I am biased, and the weather didn’t stop me from running the Charles River or past the ducks, Mrs. Mallard, Jack, Kack, Lack, Mack, Nack, Ouack, Pack, and Quack, in the Boston Public Garden. I love that CSM is in February and starts clinicians’ years off with fresh ideas and revitalized energy. Sure, we have some headwinds in the form of regulators and insurance companies, but we are stronger together, and I think the over 15,000 attendees can speak to that. 

But let’s not stop at a conference. In order for the sense of regeneration and gusto to continue through the year, we must put words into action. As I go forward into 2024, I plan to pay more attention to advocacy networks like APTA and APTQI. I also plan to spend more time with community members building the PT brand and fostering tomorrow’s clinicians. What will you do in 2024?  

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