A Winning Combination


Celebrating individual successes is key to organizational success.

By C. Jason Richardson, DPT, OCS, COMT

As a practice grows, one of the hardest things to maintain is a culture that celebrates the wins. Adding therapists, support staff, and billing personnel makes it infinitely harder as a practice owner or manager to remain in tune to everyone’s impact on their areas of responsibility. This growth also increases the degrees of separation, which further dilutes our abilities to recognize staff for excellent work that fuels a private practice’s successes.

With growth, it is imperative for organizations to understand the psychology of praising staff for their great work and creating an employee recognition program. Making a conscious effort to foster a culture of recognition and create an infrastructure that celebrates the wins and publically acknowledges those who go above and beyond for our patients and teammates will yield massive value on investment.

Be Everywhere


Use client-focused marketing to increase leads.

By Jena H. Castro-Casbon, MS, CCC-SLP

Where You Are vs. Where You Want to Be
Inevitably, every December and January there is much talk of New Year’s resolutions. Whether they motivate you or make you cringe, starting each year by analyzing where you are and where you want to be in your private practice is very important. Chances are, no matter how successful your private practice is, you still have goals to increase income, productivity, and overall success.

If your main goals surround increasing income, you are going to have to tap into additional referral sources to grow your caseload. Although finding new clients is not easy, I urge you to dedicate your 2015 marketing efforts to being everywhere. Before we learn how to have a “be everywhere” mentality, we need to make sure that your future clients know why they should hire you.

During MLB Playoffs, Networks Encourage Fans to Watch Their Competitors

By Associated Press | Reviewed by Sturdy McKee, PT

Who is your Competition? According to Inc. Magazine, some networks do not see other networks as competitors during the Major League Baseball (MLB) playoffs. They, instead, hope that promoting the sport and the playoffs will help to build interest in the league and that will, in turn, benefit all of the networks that broadcast that sport. They emphasize that the audience is highly targeted and not loyal to a network but rather loyal to the sport and the league.

Major League Baseball has contracts with Fox Sports and TBS. During the American League Championship Series and National League Championship Series each was promoting the other to enhance the appeal and viewership of MLB in general.

Letter to the Editor

Dear Editor:

I am writing comment on the article titled “The Best You Can Be,” which appeared in the January, 2015 edition of Impact.

The article is written by a Private Practice Section (PPS) board director and highlights his experience in receiving physical therapy treatment for a herniated disc. I have to say, I cannot recall a single article evoking so many different emotions in me.

The first question that came to mind is where is there any consideration for evidence-based practice? First, the author states they had a “herniated disc” in the low back. Now I do not know if they had any imaging studies, but given the diagnosis I assume so. If that is the case, why not self-refer to physical therapy first? Assuming imaging was done, it did nothing more than increase the cost for his episode of care as there is in fact evidence showing limited benefit in performing imaging studies routinely; unless of course there are severe, progressing neurologic deficits that were not mentioned. My other thoughts about evidence-based practice relate to the comments the author made that he went daily, each session lasted at a minimum of two hours and the longest three hours and that he “walked, stretched, suffered, strengthened, trained, laughed, was poked, pushed, and manipulated (physically, mentally, and emotionally), heated, iced, lasered and stimmed.” Wow, what happened to the kitchen sink, did they just forget to throw it in the mix? Where is the evidence to support all this time and stuff the author had done to him? I am glad he got better, but how long did it take? What really helped him and where is the evidence?

That is not what I am most disheartened about in this column, however. What concerned me, and upset me the most, is the authors comment that he wanted to remind us all of the incredible impact that more appointments and more interventions provided by a large team of providers can have on outcomes. We do not know what helped him get better, but because he got better he is advocating that more is the reason and advocating for us to take that approach. Do we really want that to be our message? It is for exactly this reason that our profession is where it is at today with all of the utilization management companies scrutinizing us. This is why we now have the Care Core’s, Orthonet’s and OptumHealth’s of the world limiting what we can do. Our profession and association have put in a tremendous amount of resources to provide us with evidence and to overcome this perception of physical therapy just wanting to do more and more. I fear this article has the potential to set us back decades.

The final concern I will address about the article is that it appears in a section called “Board Member Report.” So now the perception will not only be that this is what private practitioners’ are advocating, but it is what the section and PPS Board of Directors are advocating as well.


Tom DiAngelis, PT, DPT


Keep your money in your pocket—avoid fines for noncompliance

Reenie Kavalar, PT

Welcome to Health Insurance Portability and Accountability Act of 1996 (HIPAA) 101. Since then a number of new HIPAA regulations have been instituted. This is a set of rules that has to be followed by doctors, hospitals, and health care providers to help ensure that all medical records, medical billing, and patient accounts meet certain standards with regard to documentation, handling, and privacy. This set of rules has changed the practice standards for physical therapists and will continue to do so as we enter 2015. HIPAA rules are broken down into Privacy, Security, Transactions, Identifiers, and Enforcement Rules.

I will focus on the Enforcement Rules, as outlined in the Health Information Technology for Economic and Clinical Health Act (HITECH Act) of Jan 2009, as they will directly affect us. The most recent modification to HIPAA and HITECH both went into effect in early March 2013 (HIPAA Omnibus Rule) with all changes required to be in place by September 2013. It can be argued that the HIPAA Omnibus Rule is neither a tweak nor sweeping reform. Far too much law is included in the HIPAA Omnibus Rule for it to be characterized as the former. It also cannot be characterized as the latter. However, the HITECH Act was sweeping and, for the most part, the Omnibus Rule is simply HITECH-izing the HIPPA rules. In order to give you information that can be condensed into a usable format, I will highlight a few points:

  1. HI-TECH Act mandated changes are now codified in final rules.
  2. Most recent HIPAA provisions directly apply to Business Associates (BA’s) of recent Covered Entities (CEs).
  3. Business Associate was re-defined.
  4. The Breach Notification method for conducting a breach analysis was revised.
  5. Consumer-oriented rights impact CEs, such as the right to electronic copy of medical record, sale, marketing, and fundraising restrictions, and the right to restrict disclosures.

With the United States Department of Health and Human Services (HHS) Office for Civil Rights expected to begin random audits in 2015, covered entities should take another look at the expanded penalties for privacy and security violations under the updated HIPAA Omnibus Rule. Of particular concern is the issue of audited or investigated organizations having done little or nothing to become HIPAA compliant, such as failing to be able to produce policies and procedures that govern a compliance program or not being aware of the need for compliance. The increased fines under the Omnibus Rule cover four areas of neglect: did not know ($100 to $50,000), reasonable cause ($1,000 to $50,000), willful neglect corrected ($10,000 to $50,000), and willful neglect not corrected ($50,000). However, fines can be assessed for multiple violations under any of these categories with a maximum fine of up to $1.5 million per violation per year.

In a presentation given by Gartner Security and Risk Management with Wes Rishel and Paul Proctor, a focus was placed on educating individuals on the broad nature of the regulation and how enterprises have wiggle room. Gartner reported that practices should not use HIPAA as a checklist but use this regulation as a starting point to determine what they can and cannot do. Once organizations understand how little HIPAA actually requires, they can do a better job of assessing what data really needs to be protected and go about protecting it.

According to Proctor, organizations should focus their efforts on performing a thorough HIPAA Risk Assessment, which clearly shows how security controls that have been put in place reduce the threat of scenarios deemed most likely to occur. Above all else, organizations need to provide details that demonstrate that thought and care have gone into their security programs in order to protect HIPAA related data. “Documenting your decisions is in the [HITECH final] rule,” he says. “You can not just make it up on the fly.” For our practice to comply with recent rules and regulations and keep our money in our pocket, make sure you are staying up to date with changes affecting your bottom line. For more information, you can access www.apta.org/hipaa.

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