PTPN, the country’s premier private practice therapy network, has developed marketing tools to help practice owners participate in Medicare’s new Comprehensive Care for Joint Replacement (CCJR) bundled payment program.
The PTPN CCJR Marketing Toolkit is designed to help therapists secure preferred outpatient therapy provider status in the CCJR model. “Outpatient therapy is going to be the key to success for Medicare’s new initiative,” said PTPN President Michael Weinper, PT, DPT, MPH. “Experts across the healthcare industry are saying that high-quality, efficient, innovative post-discharge care is essential to making bundled payment schemes work — for providers, for patients, and for payers.”
For example, a January 2016 American Hospital Association Issue Brief on bundled payments states, “The most significant opportunities for reducing spending and improving quality generally occur after patients are discharged from the hospital.”
PTPN Vice President Nancy Rothenberg added that the Center for Medicare and Medicaid Services (CMS) agrees: “CMS has set low expectations for savings to occur in the inpatient portion of a CCJR episode of care,” Rothenberg said. “On the other hand, they expect ‘significant efficiencies’ when it comes to the ways in which post-surgical therapy can reduce readmission risks, decrease the use of more cost-intensive medical services, and speed patients’ recovery.”
However, according to Dr. Weinper, many hospitals and physician groups may not be aligned with the right outpatient therapy providers to maximize cost savings and patient outcomes. “Some hospitals and physicians are in the habit of steering surgical patients to outpatient therapists in the hospital facility or doctor’s office, so private practice owners need to spread the word about the advantages of independent therapists in community-based settings,” he said. “PTPN’s new marketing tools help them do just that, so they can become the preferred providers for these bundled payment models.”
The PTPN toolkit include templates for letters, flyers, presentations, and videos, one version of each for hospital executives, and another for physician group executives. The templates are designed to be customized by each practice owner to reflect a practice’s specific strengths, service offerings and outcomes measurement scores. While the templates are designed for the Medicare CCJR model, they can be easily adapted for the many other types of alternative payment methodologies that are proliferating in the commercial insurance marketplace.
The templates describe the advantages of using independent private practice therapists for outpatient therapy in bundled payment settings, including:
Lower costs in community-based settings. One study published by the National Institute for Health Care Reform found that hospital outpatient departments charge on average 50% more than freestanding clinics for physical therapy services.
Innovation in care pathways. Independent practice owners have the kind of entrepreneurial and innovative experience that stimulates new ways of thinking about the coordination and sequence of post-surgical care — which will be required for hospitals to meet the bundled payment spending targets.
Outcomes measurement. Experts are predicting that hospitals’ success or failure in the CCJR initiative will depend largely on quality care and outcomes. PTPN member practices participate in the PTPN Outcomes Program, a data-driven third-party system that measures the quality and efficiency of therapy care against national benchmarks.
The new marketing tools are available to therapists who are members of PTPN and can be downloaded from the password-protected, members-only area of ptpn.com.
For more information, watch a brief video about the tools.
About CCJR: The CMS CCJR model launched on April 1, 2016, in 67 geographic areas across the country. The goals of the initiative are to support better and more efficient care for Medicare beneficiaries undergoing the most common inpatient surgeries: hip and knee replacements (also called lower extremity joint replacements or LEJR). This model tests bundled payment and quality measurement to encourage hospitals, physicians and post-acute care providers to work together to improve the quality and coordination of care from the initial hospitalization through recovery. The model holds participant hospitals financially accountable for the quality and cost of an episode of care. At the end of a model performance year, actual spending for the episode is compared to the Medicare target episode price for the responsible hospital. Depending on the participant hospital’s quality and episode spending performance, the hospital may receive an additional payment from Medicare or be required to repay Medicare for a portion of the episode spending.
About PTPN: PTPN is the nation’s premier specialty network of rehabilitation therapists in independent practice. It has led the rehabilitation industry since 1985, pioneering innovative payer contracting, quality assurance, outcomes measurement and pay-for-outcomes (P4O) programs. The network comprises hundreds of therapy office locations and thousands of physical, occupational and speech therapists across the country. PTPN contracts with most major managed care organizations in the nation including insurers, workers’ compensation companies, PPOs, HMOs, medical groups, and IPAs. All members of PTPN must be independent practitioners who own their own practices. For more information on PTPN, contact Stephen Moore at 818-737-0246 or firstname.lastname@example.org, or visit ptpn.com.