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Trends in rehab: What's around the corner

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Sarah Dalton Ortlieb
Sarah Dalton Ortlieb

It's way more than physical, occupational and speech therapy.

True, those are the predominant areas, but being able to offer measurably sustainable, successful (and more often than not, life-changing) rehabilitation services involves so much more. From assessing where we are and where we came from to continual education and industry monitoring, rehab is a force unto itself. 

Here are some of the top trends in rehabilitation services today.

1.         Reading the Healthcare Industry Tea Leaves

The signs are there, and they're in bold-faced print. Healthcare is constantly changing, a morphing industry with innumerable regulatory changes. If we don't keep up with those shifting sands, we will forever be behind the curve.

Knowing what's coming – reading the signs and watching for the changes before they occur – enables us to offer tangible solutions to a growing health care crisis. For example, at National Church Residences, we expanded our home and community centers so that we can provide services in any number of settings, not just inpatient care. Whether it's adult day centers, home health agencies, outpatient therapy or assisted living, expanding services to cover all post-acute settings provides exceptional care in the most appropriate location for the patient while offering the most cost-effective avenue to deliver that care.

2.    Outcome Equals Income

We're seeing it now, and we will continue to see an even greater connection between measurable, provable outcomes and reimbursement for services in the future. Payers increasingly want to see positive outcome evidence to ensure the patient, and by extension the payer, are getting what they paid for. Reimbursements will be based on using more objective tools and outcome measurements to assess patients and ensure they've improved.

 By building a solid, evidence-based practice and employing comprehensive outcome measures, rehabilitation service organizations can help ensure a sound and consistent level of high-quality care delivery while optimizing payment. 

3.         Efficient Quality

Not only do rehabilitation providers need to ensure outcomes, they must do this more efficiently than ever. Efficiency, both in their delivery of care—employing the right techniques and modalities to get the patient better sooner – and in their workforce. For example, previously a therapist's plan with a patient may have recommended 12 visits to reach their goals. Now they may be approved by a third party payer for half as many visits, but have the same or better expectation for outcome. Shrinking reimbursements also are compelling organizations to ask for more work from their therapists in less time. Finding the sweet spot between efficiency and quality will be key.

4.         Preventative Care

Along with the pay-for-performance trend and reimbursement changes comes another trend, a change that may well have a direct and positive impact on care delivery.

By targeting proactive and preventative care, costs could actually be driven down.

Say, for example, we could help prevent an aging adult from breaking a hip during a fall, or better yet, help prevent the fall altogether. How? By implementing screening and assessment strategies to identify those at risk then employing patient education and therapeutic techniques, we can reduce falls and prevent injuries. Treating a broken hip is vastly more expensive than taking a preventative approach, and more payers are identifying this is the way to go.

5.         Advanced Certifications and Education

Expertise – and lots of it – can set one rehab organization head and shoulders above another.  Dedication to continuing and advanced education is leading the trending wave.

While building new, well-equipped gyms and expanding various departments are important, too, it's really the education, expertise and experience of the clinicians that make the difference. Many people outside the industry are often surprised to find out that a rapidly and consistently growing number of therapists are not just licensed, but also have advanced degrees (often doctorates) in their field.

Watch for an increasing amount of specialization to fill out virtually all therapists' credentials.

6.         Contracted vs. Employed Therapists

Shifting from contract to in-house therapists was a short-lived trend in the late 90s/early 2000 because of Medicare changes. Today, however, we are starting to see a resurgence of employed rehabilitation departments.

Why? Recent tightening of the therapy workforce gives employers more potential and flexibility in retaining their own therapists, and ever-shrinking reimbursements demand they hold on to as much revenue as possible. Being employed directly with the provider is attractive to therapists, so organizations with strong leadership and emphasis on quality are able to draw the best therapists— and they, in turn, deliver excellent outcomes. It goes full-circle.  

Sarah Dalton Ortlieb, PT, is the vice president of rehabilitation services at National Church Residences.


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Guest Columns

Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.