Still Keeping Up with Change

Bridget Morehouse

By Bridget Morehouse, MPT, MBA

After the revaluing of our Current Procedural Terminology (CPT) codes in July, everyone is aware that the world of payment is always changing. The Payment Committee has worked hard to stay ahead of the curve and offer resources and training to members of the Private Practice Section (PPS), so they are prepared and positioned to maximize opportunity. This year the committee has several work groups focused on relevant reimbursement topics. These work groups have defined objectives and expected outcomes to drive results for PPS members. There is a work group addressing each of the following areas: telehealth, payer contracting, administrative simplification, member education, and vertical integration and joint venture partnerships. In addition, the committee is planning its annual Preconference Payment workshop for the Annual Conference. This year’s workshop will be held on Wednesday from 12 p.m. to 4 p.m. for a minimal fee. The topics that will be addressed in the workshop include Medicare updates, telehealth, payer contracting, and administrative simplification.

The committee has had several accomplishments this year. First, we worked with Hall Render, a health care law firm, to develop model language for payer contracts. We also drafted a document describing “pro-provider” versus “pro-payer” language, which is now available for members. This document can be used when negotiating language for a payer contract and offers numerous practical suggestions. The committee is providing a webinar featuring the document with practical strategies for payer negotiations. This webinar and resource document will be available on the PPS website.

A membership survey was conducted to assess member involvement in vertical integration and joint venture partnerships. The outcome of the survey and testimonials from the members participating in partnerships with health systems will be summarized in an article for Impact in the coming months. Several members who are having success with hospital partnerships are willing to share their success stories. The committee hopes this will inspire other members in overcoming the challenges of health systems.

A new focus of the committee this year is telehealth. The group is focusing on producing resources and training for members on how to operationalize telehealth within their practices and assure that telehealth services are provided legally and reimbursed. The work group is cosponsoring a webinar with PPS’s Health Policy Administration Section. The webinar will be available on the PPS website. In addition, there will be a moderated networking session on telehealth at Annual Conference.

The Payment Policy Committee is welcoming three new members and will have a new chairperson, Janet Shelley, in November. The committee will continue to work hard to keep PPS members abreast of the constant changes in the payment world.

Bridget Morehouse, PT, MPT, MBA chairs the PPS Payment Policy Committee and is senior vice president of contracts and
pricing at ATI Physical Therapy. She holds an adjunct faculty position with the physical therapy program at Marquette University and has taught doctoral physical therapy candidates for more than 10 years.