Outcomes and Incentives: Will Your Practice Make the Cut?

Fortunately—or unfortunately, depending on how you look at it—the days of receiving payment for your services, regardless of how well those services actually perform, are numbered. That’s because with each passing day, we’re moving closer to a completely value-based (a.k.a. pay-for-performance) healthcare paradigm—one in which payers will financially incentivize providers based on their patients’ outcomes, not just the volume of services provided to those patients. That means that implementing evidence-based, data-driven clinical best practices is becoming increasingly important—as is developing across-the-board standards of care to which therapists can hold themselves accountable. Soon, it will no longer be possible to provide subpar therapy and still turn a profit. In fact, it’ll be difficult to make any money at all without providing valuable treatment and collecting objective data that backs up the effectiveness of that treatment. And once the data’s in, we’re all going to know who’s performing at the top of his or her game—and who isn’t. So, how do you ensure you—and your practice—make the cut? You start tracking outcomes data, and you start right now.

Forethought and Initiative

You see, the rehab therapy industry has a unique opportunity to get ahead of this large-scale, Triple Aim-influenced movement—to beat the payers to the punch, so to speak—and all it’s going to take is a little forethought and initiative. After all, doesn’t it sound a lot better to establish your own standards and hold yourselves and your peers accountable now, so you set yourselves up for success—and payments—later? Because the alternative is waiting for the standards to be set for you—and there’s nothing more disempowering than that. Plus, who knows your industry, your patients, and your services—as well as their effects—better than you and your colleagues do? Who knows what’s reasonable—what good therapeutic services can achieve, and what they can’t? Who knows what data points are truly accurate measures of patients’ functional improvement and satisfaction? Third-party payers certainly don’t—nor do physicians or lobbyists. Leaving it up to them feels a lot like entering into a game of Russian roulette. Sure, things could work out in your favor—but there’s a really good chance that they won’t. And is that a gamble you really want to take?

Consistency and Practice

During a recent discussion with WebPT co-founder and Chief Clinical Officer Heidi Jannenga, she points out that there’s a lot of variation in rehab therapy practice, and as a result, patients’ experiences are all over the board—everything from a deep, genuine appreciation for their therapists and the functional improvement they achieved over the course of their treatment to flashbacks of pain, tears, and disappointment. While Jannenga acknowledges that no practitioner will ever be able to make every patient happy every single time, she explains that extreme differences in the quality of care bring up “an interesting issue, considering that [therapists] have earned a reputation as staunch advocates of evidence-based practice.” Jannenga goes on to note that historically, “we’ve been pretty laissez-faire when it comes to standardizing [our] practice. We’ve failed to establish any sort of objective quality guidelines, let alone develop universal tools for measuring and monitoring adherence to such guidelines across the profession. The result: there is no consistency in care administration and quality from one provider to the next. (And we wonder why we struggle so much to define who we are and what we do.)”

In Jannenga’s opinion, the problem starts with huge variations in academic curriculum and graduation requirements from one therapy school or program to the next (in some cases, differences amount to thousands of hours of required education). The issue then amplifies during clinical rotations, where students learn to repeat the sometimes bad habits of their predecessors. As Jannenga states, without any set standards of care, there’s no way to know what’s being perpetuated in class after class of new therapists: “...unless we implement some type of universal framework to eliminate the inconsistencies plaguing our profession, history will continue to repeat itself.”

Data and Tools

Now, there’s no sense dwelling on the past when there’s a clear opportunity for improvement in the present—and that’s because, for the first time ever, therapists have access to outcomes tracking tools that both align with the care they provide as well as produce data that all members of the healthcare community can understand, apply, and appreciate. That’s why all of us here at WebPT are betting on outcomes. In her February Founder Letter, Jannenga writes, “I’m 100% confident that if we, as rehab therapists, play our cards right, outcomes data will elevate our profession to heights we’ve never even dreamed possible. And if we don’t—we leave ourselves vulnerable to a loss that even the hottest of hot streaks couldn’t remedy.”

Now is the time to use outcomes data to advance your own clinic as well as the entire industry—and that means more than collecting information in silos. In order to reach these new heights of which Jannenga speaks, PTs, OTs, and SLPs everywhere must embrace this new payment era with the right (read: positive) attitude and commit to:

• using standardized tools to collect outcomes data,
• selecting measurements recognized outside of the rehab therapy realm,
• pushing to make findings more widely available outside of individual clinics, and
• acting on the data with the intent of improving the quality of patient care.

That’s because therapists who fail to deliver value risk the very real possibility of not making the cut.

What do you think about tracking outcomes data? Is it the catapult that’ll allow the rehab therapy profession to soar to new heights—or just another hoop to jump through in order to get paid? Tell us your thoughts in the comment section below.