If you weren’t at the FOTO Conference last week, you missed one of the best conferences of the year. About 150 new and experienced FOTO users were in Knoxville – a great place to be in spring where the temps were in the mid to upper 70’s with bright sunshine and tree blossoms everywhere. The presentation line up was fantastic with leading experts talking about FOTO implementation, clinical research, policy analysis, clinical pathway models, and pay for performance programs. The scope of topics and quality of the presenters is absolutely right for this time of health care reform. FOTO continues to invest in its outcome system, keeping it relevant and meaningful for clinicians, patients, and payers. Here are some of my key take home points.
FOTO is continuing to strive for standardization of process to improve the accuracy of the captured outcome. This is an area of concern for all FOTO users, as well as FOTO. We have found the optimal process to capture FOTO outcomes increases not only accuracy, but also increases the level of effectiveness and utilization on the scorecard.
Clinical Pathway continues to be a hot topic in outpatient rehab. Dr. Fritz presented on “Care Pathways for Low Back Pain”. Provider entry point is a big determinant of the type of care and the clinical pathway. Research supports the reality of “who you see is what you get”. Now not only there research supporting early access to PT, there is measurement of process duration. Traditional physician focused care averages 52 days, while going directly to PT averages 22 days. This is inefficient care, which employers are very sensitive to and will want to streamline to more efficient care pathways.
Dr. Gozalo presented the results of a study on the validity of the CMS G-code with 7-level modifier in relation to the FOTO FS scores. CMS G-codes are not as sensitive as FOTO FS scores at capturing patient functional change. When analyzing the data for sensitivity to use in benchmarking clinics, the G-codes are not nearly as sensitive as providers would accept. Profiling clinics based on G-codes would not penalize almost 1/3 of lower performers and would not reward almost 1/3 of higher performers. Let’s expect and work towards some refinement here!
Two models of pay for performance were presented. Seth Kaplan of Baton Rouge PT-Lake and Dan Fleury of Pinnacle Rehab Network have used FOTO to get a payer to use FOTO in a P4P program and the other used FOTO to leverage a relationship with an ACO. These are two great examples of taking steps forward toward demonstrating better management of care and getting better payment for better care management.
Mark Werneke always brings enlightenment to the clinician with his presentations. It is all about using data to better manage the patient and achieve a positive outcome. Two case studies were presented, and unless you are doing serial status surveys, you would have missed the mark with one of his patients. The power of prediction is key in FOTO, and rates favorably to other systematic reviews. Werneke studied a model that included intake prediction variables and treating clinician and presented the power of prediction increased. Meaning, clinicians using a classification system along with FOTO are likely to achieve the predicted outcome.
What does all this sift down to as pearls of wisdom for the clinician using FOTO? The standardization of the FOTO process coupled with the skills of the therapist that has a strong therapeutic alliance with the patient creates the opportunity to connect with payers and the powerful provider organizations to demonstrate the value of therapy. We are advancing the profession through the use of robust outcome data that is more meaningful every day. Meaningful data that demonstrates we can deliver better care, better outcomes, and smarter spending.
To learn more about using FOTO data to leverage better payment, send me an email.
What I Learned At The FOTO Conference 2016
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