Hook ‘Em: Highlights from PPS 2023

Right off the heels of Ascend 2023, this year’s PPS saw rehab therapists convene once again to enjoy stimulating educational sessions, check out the latest and greatest in technology and services, and cut loose a little—this time in Austin, Texas. The city’s eclectic vibes added to what’s always an exciting event, with great lessons for clinic leaders to take with them on the flight home. With that in mind, here’s what I learned deep in the heart of Texas. 

Reimagining the Marketing Funnel

Friday’s keynote came from noted marketing expert Andrew Davis, who offered attendees an alternative to the tired marketing funnel: the Loyalty Loop. As Davis explained, the consumer decision-making process starts with a moment of inspiration—the instant in which they start asking the key questions that will guide their purchasing decision. 

That decision starts a process in which PTs—or other business owners—have the opportunity to set themselves apart from the competition and create a brand that inspires loyalty and generates referrals. How? By focusing on the experience and feelings, they can inspire patients with what they’re offering. Part of that effort requires building anticipation in each part of the care journey, harnessing the honeymoon period with a new patient, and leveraging satisfied customers to create more business than digital advertising ever could. 

Turning PTs into Their Own Best Advocates

In “How to Get Your Clinicians to Sell without Losing Sight of Patient Care,” Darryl Yardley, MScPT, MCISc(Manip), COO at Clinic Accelerator, laid out how clinic leaders can create a team of clinicians who are ready to sell their services and their expertise to patients. The process of establishing the value of PT starts with providers—if they’re not confident in themselves and the care they're providing, convincing patients to return past the initial eval is going to be next to impossible. 

Beyond just coaching clinical skills, clinic leaders need to educate providers on better communicating the value of PT in a language patients understand. That starts with establishing patients’ expectations and concerns, sharing in the decision-making process along the way, creating a home exercise plan that includes a few simple exercises, and most critically, understanding the “why” behind treatment. If you’re focused simply on “returning patients to normal,” you’re missing out on key emotional triggers that can drive better outcomes, like centering treatment around being able to do the activities a patient loves.    

How Digital MSK Can Tap Into the Direct-to-Employer Market 

During “Digital MSK—a Blockbuster Moment for PT or the Beginning of a New Era?” Scott Hebert, PT, DPT, CEO at Second Door Health, Ellen Morello, PT, DPT, COO at Second Door Health, and Zachary Walston, PT, DPT, OCS, National Director of Quality and Research at PT Solutions Physical Therapy, discussed how digital solutions for treating musculoskeletal (MSK) conditions are one solution to the ongoing professional challenges facing physical therapy, which include: 

• Declining payments and reimbursements from private payers and CMS,
• A lack of revenue diversification among many private practices, 
• Little leverage to force payers to improve rates for physical therapy services, and
• The struggle to provide the convenience patients seek at a cost they can afford.

This situation persists even though MSK remains the most common and most costly health condition. Digital MSK is one avenue for rehab therapists to escape a negative spiral of lost revenue and shrinking margins—particularly when you’re using digital MSK to move outside the dominant insurance-based model. 

More employers are adopting the self-insured model—which means that PTs have the opportunity to leverage digital MSK and hybrid care models to help them save money on their overall healthcare expenses. It’s not a perfect solution, or at least not yet; enrollment in digital MSK is stuck at around 3%, many patients still prefer in-person care, and finding a pricing model that satisfies both employers and providers can take some work. But, as Hebert notes, the important thing is that PTs take that first step rather than being intimidated by the work involved.  

Adopting AI to Solve Documentation Problems

For the session, “Using Data and AI to Develop Benchmarks for Running an Effective Practice,” panelists Ravi Atreya, MD, PhD, Co-Founder and Chief Clinical Officer at PredictionHealth, Chris Hoekstra, PT, DPT, PhD, OCS, FAAOMPT, Chief Clinical Transformation Officer at Therapeutic Associates, and Kelly Brown, PT, DPT, OCS, Director of Client Success at PredictionHealth,  discussed the application of machine learning in rehab therapy. Ultimately, attendees were able to walk away with three main takeaways:

A focus on functional activities can create happier patients and drive stronger outcomes. An analysis of the “big four” CPT codes found that the ideal mix for providers who were seeing the best returns on their billing included 60% of units across their patient population with 97530 (Therapeutic Activities) and 97112 (Neuromuscular Re-education) and 40% 97110 (Therapeutic Exercise) and 97140 (Manual Therapy). It’s not a matter of changing therapists’ behavior to choose higher-paying codes; it’s about being thoughtful about what they’re documenting and, crucially, harnessing the power of AI to identify instances where functional activity codes would be more appropriate based on the details provided in their notes.

Working smarter, not harder. One of the biggest pain points for therapists is trying to turn minutes into CPT codes, finding the right code, or documenting care in a way that justifies using that code. AI can help identify opportunities where they might be missing codes in their daily work and where there might be inefficiencies in their care—like doing 60-minute initial evals with patients but only billing at the same level as other providers for 30-minute evals. 

Having a process for reviewing and addressing notes. Maybe AI’s greatest strength is its ability to review every note for every provider rather than being limited to a periodic spot review. Documentation review done by AI also reduces the challenges presented by human review, which are the inherent biases of reviewers and what can be an unwillingness of providers to take feedback from a reviewer. The key to creating good processes for making positive changes from AI reviews is to use the data and have empathetic conversations that focus on helping providers achieve the results both of you want. 

Advocacy Efforts and Final Rule Changes

In the “Annual Conference Payer Update,” Janet Shelley, DPT, Chief Disruption Officer at Therapy Partner Solutions and Chair of the Private Practice Section Payment Policy Committee, and Robert T. Hall, JD/MPAff and Senior Consultant with the APTA, reviewed some of the big items physical therapists need to be aware of moving forward, including:

• The APTA’s new report, “The Economic Value of Physical Therapy in the United States,” and how it (and future reporting) can help PTs in their fight for better pay and a seat at the table with insurance companies;
• The creation of a direct-to-employer services directory to connect PPS members with self-insured employers looking to partner with PT practices for cost-effective care for their team;
• The State Payer Advocacy Resource Center (SPARC), which offers PTs information and resources to help them start or join advocacy efforts for better pay and less regulatory burden at the state level; 
• The wins PT advocacy organizations have enjoyed in the past year, including reversing prior authorization requirements, increasing pay rates in Pennsylvania, Iowa, and Wyoming, and more gold card programs that reduce prior authorizations; and
• The payment consortium PPS has formed in conjunction with the Academy of Orthopaedic Physical Therapy to continue the advocacy efforts for better pay and reduced prior authorizations. 

During the second part of the session, Rick Gawenda, PT, President of Gawenda Seminars, dove into the details of the 2024 final rule. Fortunately, we’ve got you covered on that front with this blog post recapping the final rule—although if you want to hear Rick’s expert insight on those policy updates and what we can expect from CMS moving forward, be sure to check out our final rule webinar on December 14. (Keep an eye on your email for details on how to register.)    

Nothing but a Good Time 

Of course, no conference is complete without the chance to cut loose, and this year’s event saw plenty of opportunities. WebPT’s fantastic Events team put together a pair of parties designed to give attendees the chance to let their hair down. Thursday night’s Member Happy Hour at Foxy’s Proper Pub had people packed in to enjoy a pint and pick up a free t-shirt, and Friday night’s disco rodeo featured drinks, dancing, and—no joke—armadillo racing. And if that weren’t enough, APTA’s 80s-themed party on Saturday night had rehab therapists rockin’ out to a live band playing all the big-hair hits of the decade. So credit where credit’s due—PTs are practicing what they preach when it comes to movement, whether that’s in the clinic or on the dance floor.  

The chance to learn—and party—alongside so many dedicated rehab professionals is always a privilege and always time well spent for those fortunate enough to break away from work long enough to enjoy some thought-provoking conversations. Personally, I’m looking forward to seeing some familiar faces at next year’s sessions in National Harbor, Maryland!