November 2014: What’s New At Therapy Partners?
(Note – the vertical axis cost scales are not the same for both graphs – work comp episodic costs are higher than commercial.)
Notice the similarity in the trends. When you couple this data with the conclusions drawn from LBP studies by Fritz at Intermountain Health and Gellhorn at the University of Washington; the cost results at Virginia Mason with their LBP care model; the knee study from Harvard – you bring a very compelling case to powerful decision-makers who seek to control costs and improve outcomes:
Well-timed physical therapy provided by skilled PTs reduces costs and can improve the functional well-being of their employees (businesses), enrollees (health plans), or members (ACOs).
One of the plans we have a close relationship with up here in the Midwest has invited us to work with them in 2015 to prepare for a value-based model to start in 2016. We are also in discussion with an ACO to create a collaborative partnership with well-defined care paths between primary care and independent physical therapists we represent. In another state, we are working with a vertically integrated health plan-ACO on a value-based model to reduce total cost of care for musculoskeletal pain.
Health plans have always borne financial risk, and with the ACA, their risk has increased. ACOs also bear financial risk and will be paid via various value-based models. ACOs have 2 primary responsibilities – provide quality care for their members and manage the cost of that care. Both health plans and ACOs are looking for providers who can deliver measurable quality care AND help them reduce total cost of care. What does that mean to independent physical therapy practices?
Here are some more specific ideas for you:
- Commit to change and delivering value, sharing risk.
- Get big enough to be relevant to the decision-makers. Size matters. Network, IPA, MSO.
- Organize and analyze your patient outcomes and cost data – prove your value.
- Determine your value proposition.
- Create a Value Vision that everyone on your team embraces and ‘buys into’.
- Organize your message including a value-based model you can propose to plans and ACOs.
- Set expectations aligned with your vision; share with your staff; lead your change.
- Reach out to health plans, ACOs, self-insured businesses – tell them you can reduce their costs, deliver measurable value, and share financial risk. Request a meeting.
- Make sure you are very well prepared. You may only get one shot.
- Confidently deliver your proposal for a value-based contract or pilot.
- Decisions are never made quickly. Be diligent. Keep meeting until you reach an agreement.
- Keep leading change back at your clinic.