Contrary to wishful business thinking, you can’t grow an #outpatient #physicaltherapy clinic without the right balance between humans and #technology systems that manage care. For growth-oriented physical therapy clinics, that means a balance between the providers, their patients and the documentation technologies that support plans of care and payment for that care.
Underlying successful growth-oriented clinics is this understanding, and pursuit:
You get growth and good outcomes when patient and provider relationships are seamlessly linked by technology that supports interactions and the financial exchange for services.
In the dynamic world of outpatient #physicaltherapy, every minute counts. The business objective is always unparalleled patient care while ensuring the sustainability of the #MSK practice. However, there's an often-overlooked aspect that significantly impacts this objective: Documentation. It is the linchpin between a clinic working, and it not. It must balance the needs of providers using it, patients receiving information and service through it, and its ability to effectively and easily communicate to payers the reasons and progress in plan of care for payment.
In 2022 American Physical Therapy Association (APTA) conducted a survey of members yielding 773 respondents, 93% who give direct patient care, 26% were clinic owners/partners, 53% holding a management role, and 74% were in outpatient PT settings.
Here are some shocking highlights applied to a typical outpatient physical therapy clinic business case:
Amid declining reimbursements, 81% of respondents have added non-clinical staff to support the administrative burden.
86% of provider respondents agreed or strongly agreed that administrative burden contributes to burnout.
Claim denials kill growth from errors in documentation. Here is what it looks like when applying the results to a typical business case (with ~$106 avg reimbursement rate):
If a single clinic has $1.08m out to payers for care that already took place, 10.6% of the claims are denied, or $114,480
Of this amount, 4% or $43k will be LOST, net overturned and clinic costs (30 min per appealed claim!).
At the end of the day, for every 25 claims appealed, only 12 are overturned/paid.
52% of respondents say, “Standardization of documentation requirements across all stakeholders” would address documentation and administrative burdens (like denials!)
The remaining 48% is split almost in equal proportion ~32% between these potential solutions: eliminating POC signature & recertification requirements by CMS, standardizing coverage policies, standardizing pre-authorization, unrestricted direct access per provider.
The fact is clinicians are spending a disproportionate amount of time on documentation & admin tasks that CAN BE SOLVED with new technology today. In outpatient physical therapy specifically, the failure to have patients and providers both interacting with technology seamlessly, including the financial transaction for services, detracts from provider’s ability to focus on quality and quantity of patient care.
This imbalance not only affects patient satisfaction and outcomes but also limits the capacity of an outpatient practice, well-being of providers, and reduces potential revenue and growth opportunities.
Evaluating and optimizing how clinics allocate time is crucial (see our other post about time and maximizing profitability). By implementing efficient documentation technology strategies, clinics can reclaim value for patient care. Without it, the business of outpatient physical therapy clinical care doesn’t work.
