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FOTO Rehab Outcomes Blog

The Baker's Dozen #APTACSM Picks

 As you begin thinking about the Combined Sections Meeting of the American Physical Therapy Association, it can be overwhelming to go through all the programming. As I was preparing, I reviewed the programming for sessions focused on outcomes, value-based payment models, quality initiatives and developing a quality focused team. One of the most exciting aspects about this meeting is hearing different perspectives than myself. This conference is a great opportunity to learn from others, challenge one's beliefs and to grow.

As I share the Baker's dozen, these sessions will be in the order of their appearance.  I have taken liberties and snagged images from presentations to help provide a single snap shot of what will be discussed during the presentation. Although I did not ask for permission, I hope the speakers approve of the sharing of their session.

Thursday 8-10 am  Designing Models of Care for Value-Based Payment: Opportunities and Challenges (Chris Hoekstra, Peter Rigby, Sean Rundell)


Besides the title of this session, what is intriguing to me is the mention of private practices. Often times, value-based payment options and models are focused on integrated health care systems. This session should be interesting by discussing private practice. As a small private practice owner, I truly hope the future doesn't change to such a degree that private practice is squeezed out of the picture.

Thursday 3-5 pm  Creating Value-Based Systems of Care: Opportunities for Health Services Research (Anthony Delitto, Alan Jette, Linda Resnik, Joel Stevans)

This session intrigues me because I read tweets from the Center for Health Services Training and Research Summer Summit.  The beauty of an integrated health care system resides in the amount of data that can be analyzed to better understand a full continuum of care.  

Friday 8-10 am  Assessment to Inform DPT Program Outcomes: Accreditation to Program Excellence (Peter Altenburger, Amy Heath, Diane Jette, Denise Schilling, Kimberly Topp, Barbara Tschoepe)

Assessment_inform_dpt-programsAs I was reviewing the handout for this session, I was introduced to the various categories in which a DPT program could be assessed. One aspect that seemed missing was assessing the ability for students to deliver a defined level of patient outcomes during clinical care.  I am curious if there are entry level expectations as to what results a recently licensed physical therapist is to achieve.

Friday 11 am-1 pm  Emerging Issues in Medicare: Quality Programs and Alternative Payment Models (Kara Gainer, Heather Smith)

Medicare has had quite a few payment models in the past few years. This session may provide some insight into future alternative payment models for physical therapists. Hopefully the functional limitation G-code and severity modifiers are not a component for an alternative payment model.  

Friday 11 am-1pm  Linking Informatics, EMRs, and Quality Improvement: Preparing for the Future (Rhea Cohn, Kelly Daley, Kenneth Harwood)

linking_informaticsThe intriguing aspect of this session is the importance of having information at one's fingertips. Although this session focuses on students in a DPT class, there is value to understand the importance of data to help drive clinical decisions.  

Friday 11 am-1pm  A Roadmap Towards QI: Using Best Evidence to Improve Clinical Outcomes  (Hilary Greenberger, Sandra Kaplan, Amy Miller, Julie Tilson)

Evidence based practice and knowledge translation seem like buzzwords to me. What I liked about what I saw for this session are actual steps to really incorporate evidence. The first step in quality improvement is to actually know clinical outcomes.  What may be missing in the diagram is self-reflection. It seems that self-reflection would be necessary to determine if evidence is being used to attain the measured clinical outcomes.

Friday 3-5 pm  Aquatic Therapy: Objective Screening Components and Outcome Measures (Paula R. Geigle, Charlotte O. Norton)

This session was included in the Baker's dozen because the title mentioned outcome measures. One area that seemed to be missing patient reported outcome measures in the handout was in the musculoskeletal area. In my opinion, aquatic therapy can affect the musculoskeletal system. Patient reported outcome measures are able to capture a patient's perception of change. 

Friday 3-5 pm  AM-PAC: Not Just for G-Coding (Michael Friedman, Joshua Johnson, Robin Marcus, Mary Stilphen)

I appreciate the work being done with AM-PAC.  This session demonstrates ways to actually use a patient reported outcome measure to truly drive clinical decisions within an interdisciplinary environment. Immediately being able to target patients who are ready for increased mobility to improve underutilization of services and patient outcomes is exciting. Being able to more accurately determine a discharge setting and have the whole team on the same page with the same perspective due to the data available has to help create a cohesive team.

Saturday 8-10 am  Know Your Data: Are You an Outlier? Why Should You Care? (Ellen Strunk, Jaclyn Warshauer)


This session is timely since legislation has passed eliminating the $2,010 therapy cap. From my understanding, manual medical review is no longer mandatory, but reserved for targeted clinicians. In my opinion, legislation opens up a lot of gray area due to the ambiguity of the description for targeted clinicians.  The speakers should shed light on the type of data you will need about yourself to help you determine for yourself whether you are an outlier.

Saturday 8-10 am  Strategies for Implementing Performance Measures in Value-Based Payment Models  (Stephen Hunter, Bridget Morehouse, Heather Smith, Charles Thigpen)

When reviewing the information about this session, I'm not sure if the focus will be on patient reported outcome measures or performance measures. Sometimes these two terms are used interchangeably. The value-based payment models that I am familiar either focus on regulatory reporting of codes or on patient reported outcome measures. As mentioned in the description, a favorable value-based payment model will require a risk adjustment process for fair comparison between providers.

Saturday 11 am-1pm   Patient-Reported Outcomes: State of the Science 2018  (Katherine Bevans, Carole Tucker)

The focus in this session is on patient reported outcome measures for the pediatric population. I had no idea computer adaptive testing was available for this population. I wonder what age groups will be discussed because pediatric rehabilitation can be from birth to young adult.  For birth and toddler age groups, I assume proxy testing is required. Interesting to hear about a hybrid generic, condition specific combination measure. 

Saturday 11 am-1pm  High-Impact People Development: Preparing Your Workforce for Value-Based Care (Michael Billings, Derek Fenwick)


In the many conversations that I have heard, the focus on value based care resides on quality and outcomes.  This session intrigues me because quality is dependent upon more than just the expertise of clinicians. Consistently achieving high outcomes is due to a culture of excellence. Excellence is dependent upon far more than just delivering care. The speakers will discuss how clinical, management and leadership all contribute to an organizational culture focused on achieving high outcomes.

Saturday 3-5 pm  The Role of Quality Improvement in the Advancement of Physical Therapy Practice  (John Corcoran, Jodi Herbsman)

quality-improvementWhat I really liked about this session is the concept of control limits. Quality improvement inherently requires a definition of acceptable levels of outcomes. As alternative payment models begin to dominate for reimbursement, it will be imperative for organizations to have quality improvement strategies in place.

In case you were wondering about FOTO team, rest assured the team will be in attendance at the conference. You can find the team at booth 1225. As you are walking through the exhibit hall, take a few minutes to stop by and visit with the team.

Until next time,


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