If you thought alternative payment models—and the quality data-tracking demands that go with them—were just a passing fad, think again.
With its recent announcement of yet another mandatory bundled payment program—this time, one structured around heart attacks and bypass surgeries—CMS has made clear that value-based payment systems aren't going out of style anytime soon. And that puts even more pressure on providers across the healthcare continuum to implement systems for quality-data collection, analysis, and utilization. Otherwise, they'll risk not only being out of date, but also going out of business.
The new proposed cardiac bundling program links financial and performance accountability to payment for certain types of care episodes, thereby rewarding the quality of care delivered rather than the volume of services performed. A stark departure from traditional fee-for-service reimbursement models, this proposed bundling program is just one component of a larger CMS bundling effort known as the Bundled Payments for Care Improvement (BPCI) initiative.
The BPCI initiative has two primary goals:
1. Reduce Medicare, Medicaid, and Children's Health Insurance Program (CHIP) spending.
2. Enhance the quality of care for beneficiaries.
Ultimately, though, this initiative boils up to the overarching push to put patients back at the center of the healthcare delivery process. To that end, it'll also incentivize providers—including hospitals, post-acute care specialists, physicians, rehab therapists, and other practitioners—across the entire healthcare space to collaborate with a goal of ensuring patients receive best possible care and achieve the best possible outcomes.
Getting on the data train
Of course, it's tough to know which route of care is most likely to produce the optimal outcome for a particular patient without any data that speaks to similar care episodes. Furthermore, it's impossible for health systems to prove that they actually met—or ideally, exceeded—the established standard for any given episode if they didn't track the data to back up that conjecture. This is why, as alternative payment models become increasingly prevalent—and thus, impact more and more providers—outcomes tracking will become increasingly crucial for all caregivers. This is especially true for specialty providers who are more vulnerable to being overlooked as valuable members of patient care teams.
For many of those providers, however, data collection still carries a decidedly negative connotation. And understandably so: traditionally, the effort required to implement any type of quality data collection program didn't yield a high enough return. In the age of healthcare reform, though, specialty providers—including physical therapists—can no longer afford not to collect and track outcomes data. It is essential to not only keep up with ever-rising standards for patient care, but also safeguard the future of their practices by proving their value to patients, payers, and referring practitioners.
Luckily, collecting—and actually making use of—outcomes data is now easier than ever thanks to the advent of technology that integrates patient data collection into the normal documentation process as well as analyzes and presents it in highly visual, easy-to-digest reports. Furthermore, top-notch outcomes tracking software systems feature risk-adjusted national outcome comparison reports, and evidence-based, industry-accepted tests that are relevant—and more importantly, meaningful—to the healthcare community at large. And that's exactly what specialty providers need to stay ahead of the curve.
Establishing best practices
Of course, the success of any outcomes tracking program is heavily dependent on the manner in which it is implemented. So, how can specialty providers successfully introduce outcomes tracking into their practices? Here are a few pre-outcomes program must-dos that'll help streamline the implementation process and ensure that providers get the most bang (i.e., value) for their outcomes-tracking buck.
1. Get collective buy-in. Educate your team—everyone from administrative and billing staff to assistants and therapists—about the impending changes and urgency around outcomes data collection. Talk to them about the ancillary benefits of outcomes data, such as increasing quality of care, fostering operational efficiency, and demonstrating value.
2. Involve everyone in planning and implementation. Get everyone in the clinic involved from the beginning. That way, they're all learning the tool at the same time, you can address and resolve questions and confusion early in the process, and the entire team becomes better equipped to answer questions down the road.
3. Establish roles and responsibilities. Identify the individuals within the practice who are responsible for each outcomes tracking step—and hold them accountable. This includes everyone from the front desk person who supplies the questionnaires to patients to the assistant or therapist who tracks the progress being made along the way. This will help ensure seamless integration of data collection into the practice's clinical workflow.
4. Educate patients. For patient-reported outcomes data to be meaningful, it's imperative that patients complete the tests honestly, accurately, and completely. Educating patients on on how to fill out their questionnaires, how their responses will be used, and how their participation benefits them will help make this process easier and more successful. Furthermore, to help patients see the value in data collection—and ultimately, the treatment itself—practitioners can use the data to show the patient how he or she is progressing. This often increases patient satisfaction, as the patient becomes more engaged with—and invested in—his or her care.
5. Establish a process for administering patient surveys. Patients completing a patient-reported outcome measure (PROM) for the first time should do so in the clinic immediately following check-in. To facilitate this order of events, send the test to the patient—via either email or direct mail—and request that he or she complete it prior to his or her next visit. And be sure to encourage patients to fill in their responses independently (i.e., free of external influence) to preserve the integrity of the test and the accuracy of the results.
Fashion is fickle: some trends come and go in the blink of an eye, while others have true staying power. In the healthcare arena, value-based care delivery—and thus, outcomes tracking—certainly fall into the latter bucket. So, while you may continue to resist getting on the fashion train, you certainly can't avoid getting on the data-tracking train for much longer. Pay-for-performance—and bundled payment models—is here to stay. And that means outcomes tracking is, too.
Dr. Heidi Jannenga is president and co-founder of Phoenix-based software company WebPT, the leading software solution for physical therapists, occupational therapists, and speech-language pathologists. The company has more than 56,000 members and 8,600 clinics as customers as well as 99.2% customer retention rate. Learn more at webpt.com.
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