Guest Columns

Listening instead of reacting

Tara Roberts
Tara Roberts

I've really taken one of the “7 Habits of Highly Effective People” to heart the last few months. I usually am compelled and passionate about getting “my point” across quickly.  So I've been pretty silent lately, not blogging, not reacting.

There has been plenty of “triggers” to have normally elicited quick responses from me, including the LTC-loving OIG. But I've learned that I can control my response and thus be more understanding and thoughtful.

In taking a step back I've removed myself from the onslaught of proposed rule commenting, convention cycle and just plain ol' survival mode. I wanted to remind myself of why we are all in this business.

September was National Rehab Week and October is National Physical Therapy month. I have enjoyed reflecting on why I decided to become a PT and healthcare professional 20 years ago. What was alarming to me is how much has changed related to my ability as a licensed professional to drive and deliver care in the best interest of my client, resident or beneficiary. The changes and challenges that exist right now competing for the “best” reimbursement model solution are superimposed against this panoramic view I have of the last 20 years in healthcare.   

Most frustrating is the arbitrary constraints put on rehab to optimally meet each client's needs effectively and efficiently. The root for these arbitrary constraints are 100% driven by savings opportunities. These are short-sighted savings opportunities of course. The value of a LTC therapist's ability to use concurrent and group therapy in the plan of care under their professional direction without being dictated to about what a “group” must be or whether concurrent “does or does not” have a clinical benefit to their client is significant in LTC.  

Reimbursement model changes should bring freedom back to the licensed professional. If payment was tied to outcomes and value, then let the path to this value and outcomes dictate by the professionals delivering the care. The results should be a reflection on the therapist's effectiveness.  Give the provider and rehab group or rehab professional, collaboratively, the ability to derive a rehabilitation philosophy and care model that meets their culture and client's needs.

Indicators show the popular reimbursement models will be with one entity controlling the dollars or the payment in a lump sum per episode. Rehabilitation in long-term care IS unique, and this must be recognized with proposed changes. This recognition will be critical in keeping LTC a viable step in the post-acute care continuum and maintaining and improving its ability to provide efficient care for the beneficiary. Take the handcuffs off our licensed professionals and give them back the control and all the tools in their tool belt to get each client back to optimal health and well-being. This will be a “win-win”.

Happy physical therapy month from a PT always and LTC advocate at heart!

Tara Roberts, PT, is the Vice President of Rehabilitation and Wound Care Services at Nexion Health.
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