All of the controversy surrounding Functional Limitation Reporting somehow reminded me of a charming 104 year old patient that I had the privilege of treating years ago. I saw her once a week because she was having shoulder pain. She had shoulder pain because she fell out of a cherry tree when she was a sprightly 94 year old, so she had some boney callus at the surgical neck of her humerus and some impingement.
Read More...Assigning Severity Modifiers The final July 1 deadline for reporting Functional Limitation Ratings is fast approaching. I have already expressed my opinion in prior blog articles about the flaws in this requirement, but that does not really matter much, since it is the law of the land. This past week, we released a set of features in Insight that make the process for including Functional Reporting Classifications and Severity Modifiers on your documentation and claims easy
Read More...As someone who is responsible for coming up with practical solutions to comply with complex requirements, I have been observing the online debate over the Medicare PQRS, Medicare MPPR, and Medicare Functional Limitation Reporting programs with a lot of interest. I have got to say, most of the interactions are not helpful and are usually a litany of indignant complaints along the lines of: How dare Medicare ask us for additional information
Read More...As I indicated in some prior posts linked at the bottom of this post, we have the attention of Medicare. Under the Microscope To review, the Medicare Payment Advisory Commission (MedPAC) has made it clear that therapy services are going to be under close scrutiny. Using physicians as gatekeepers and using an annual cap with an automatic exceptions process has not changed therapy utilization in any meaningful way. Put more simply, from MedPAC’s perspective, Medicare doesn’t
Read More...Medicare recently released proposed revisions in payment policy rules for 2013. If you would like to review the entire 1300 pages, here is a link: Proposed Rules. The information that is important to PT, OT and Speech providers begins on page 220. In my last post on “What is Medicare Thinking” someone alertly pointed out that Medicare is not a person, and an institution can’t really think. So, forgive me for giving Medicare human characteristics, but here is what
Read More...On October 5th, the Medicare Payment Advisory Commission (the independent agency that advises Congress on Medicare Policies) presented their recommendations on outpatient therapy services. I believe Slide 6 in this presentation is very telling. My interpretation is that MedPAC wants to know
Read More...My world has been turned upside down… my girlfriend/significant other/fiance/friend/sounding board* was diagnosed with Acute Myeloid Leukemia on July 19th. Since then, she has been through Round 1 of chemotherapy, in and out of intensive care, and suffered all of the indignities that come with hospitalization. We have shared a lot of laughs together during this whole journey so far, which seems odd, because I am normally pretty emotional: I am prone to crying at sad commercials, especially anything involving
Read More...Recapping a recent response to a great post from Tim Richardson on implementation of Clinical Decision Support Systems: There is good evidence to show that Clinical Decision Support can be beneficial, such as this study from the British Medical Journal The article points out that one of the more important features of a useful system is that it provide decision support as a normal part of the workflow. The primary problems with these systems seem to
Read More...I just had a surreal, bittersweet moment…. one of the most unforgettable characters I ever had the privilege of treating was mentioned in a best selling biography that I happen to be reading right now. My ex-patient, let’s call him “Bill”, died a few years ago, but I will always be in his debt. He was simultaneously inspiring, fun, delightful … and a giant pain in the ass. In Bill’s world, pretenses and politeness were dishonest. In his youth,
Read More...This is part 3 of my 3 part series on Outcomes in Physical Therapy. To read part 1 on “Meaningful Physical Therapy Outcomes”, click here. To read part 2 on “What are Outcomes?”, click here. Bang for the Buck I believe that useful, meaningful outcomes analysis will only occur when we can get to what I call the “bang for the buck number”, i.e.: How much money does it take to get a certain population of
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