Rehabilitation providers prepare for payment changes

Medicare payment changes are likely to affect how rehabilitation providers serve patients.

Those changes are forcing providers to become more efficient, said Stephen Hunter, president of the National Association of Rehabilitation Providers and Agencies, and a physical therapy administrator at Intermountain Healthcare in Salt Lake City. The industry's payment model is going through reform, and the way physical therapists bill for services is changing, he said.

Physical therapists currently are paid based on the time spent working with a patient, regardless of the complexity of care. That payment model does not incentivize optimal care, Hunter said.

For example, a 20-minute evaluation with a high school athlete suffering from a sprained ankle receives the same billing code as a 90-minute evaluation with an 80-year-old stroke patient.

But that's starting to change. A Current Procedural Terminology panel has approved a three-level coding system that's based on the complexity of the patient's care, Hunter said. Because of the time required to update the codes, and the fact that the CMS also must approve the change, the billing codes might not be updated until 2018, he said. But the new billing system will better align rehabilitation providers with the rest of the healthcare industry, he said.

Overall, the payment rate squeeze is forcing providers to take a close look at the quality and efficiency of the care they deliver, said John Kristel, CEO of Good Shepherd Rehabilitation Network, based in Allentown, Pa.

Good Shepherd has invested heavily in employee training and technology, he said. Staff members take part in quarterly training sessions, which cover patient-centeredness and leadership skills. In addition, Good Shepherd has invested in four Ekso Bionics exoskeletons. Those are bionic suits that help patients who have suffered a stroke or spinal cord injury reach a standing position to learn to walk again.