Quite a bit has been on my mind recently. My specialty is working with older adults. My FOTO profile compares my patient demographics with FOTO's large database. My profile indicates my practice is quite different and is heavily weighted with a really high percentage of patients who are 65+. This was great to see because I have worked at ensuring I target those who are 65+ in my community and with local physicians.
As I was looking at my company's profile data, my gut dropped when I saw how many of the patients treated have a lot of co-morbidities. My initial gut response was a bit of worry. You see, I am categorized as an individual provider by a company called Evicore. Evicore has a contract with Blue Cross Blue Shield of Michigan to categorize the level of care I provide to patients. Evicore is also contracted to be a gatekeeper and provides authorization for physical therapy services based on a provider's category.
My initial gut response was because Evicore doesn't really base a provider's category on a strong risk adjustment process. If my patients take more time to achieve outcomes, how can I 1) show that my patients are different than the typical practice and 2) provide real outcomes of care for patients who have a specific payer?
Do you know how you can use FOTO to be your defender?