Improving Performance

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Can value-based purchasing in health care live up to the promise?

By Jerome Connolly, PT, CAE

On March 4, 2014, the RAND Corporation released a new report concluding that after a decade of experimentation with reforms that give health providers financial incentives to improve performance—so-called value-based purchasing—relatively little is known about how to best execute such strategies or to judge their success.

The report—authored by Cheryl L. Damberg, Melony E. Sorbero, Susan L. Lovejoy, Grant Martsolf, Laura Raaen, and Daniel Mandel—which was designed to assess the state of knowledge about value-based purchasing programs in health care, found that evidence thus far is mixed about whether using such payment schemes can help improve quality and lower costs.1

Good Things Happen to Good Clinics

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As reimbursement becomes a challenge and profits are tight, the decision to support community efforts often becomes one of the first budget cuts.

Bob Worden, PTA, ATC, MS, MBA, CAGS

Looking back on our first decade as a clinic, Pinnacle Physical Therapy (a member of the Pinnacle Rehabilitation Network), we can say, “Good things happen to good clinics.” Surviving the infiltration of hospital- and physician-owned clinics in our community has been challenging. Maintaining our patient volume with a volatile physician-referral base has required a steadfast commitment to our guiding principles.

Secret to Success

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Lessons learned during the first year of private practice.

By Jeanette M. De Witt, PT, MPT, LAT, ATC

From July 1998 through January 2012, I practiced in a wonderful hospital system in Ohio that allowed me to gain experience, attend educational seminars, and advance my career from a staff physical therapist to a supervisor. Although I was content with my position, I always held high hopes that I would own my own clinic “one day.” After a family vacation to Wisconsin and falling in love with the state, my family decided to move, and I returned to a staff physical therapist position. However, after seven months, I found myself missing the supervisory responsibilities I had once enjoyed at the hospital. I elected to give private practice a whirl and reached out to a company that assists therapists in opening their own clinics and decided to pursue my dream. After a month of interviews, I joined the company’s network and embarked on my first year as a clinic director. This was a large leap of faith from which I have greatly benefitted. My practice was truly built from the ground up as at the time of signing, the clinic location was not even confirmed yet!

How to Transition from Visionary to Leader

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By Eric Paley
Reviewed by Jean Darling, PT, LAT

Many of us in the private practice physical therapy world have been visionaries at some point. This ability has helped propel us to where we are today in our practices and in life. However, leading others down your path involves more than just having good ideas. As Eric Paley writes, “Vision is the license to play the startup game and the base ingredient for being a leader. The challenge you face now isn’t easy—you have to lead.”

Benefit Design and Compliance

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Nancy J. Beckley, MS, MBA, CHC
Q:  What is an insurance plan benefit design and what does it mean for therapy providers?
A:  An insurance benefit design specifies services that are covered under the health insurance plan, whether government-funded, employer-funded, or a personal plan (available to individuals and families via insurance brokers). The benefit design includes deductibles, various co-payments for physician and emergency room visits and hospital stays (including inpatient rehab and skilled nursing) as well as prescription drugs, laboratory, radiology, and additional benefits such as physical therapy.

Copyright © 2017, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.