While Gene was hard at work, moderating a dynamite panel session on payment reform, I had the pleasure of being able to just absorb the heart pounding two hour experience. Combined with some time just to network and mingle, I realized on my flight home, some of common themes at the conference and, recognized not only were they common, they were transcendent. Many themes that were officially spoken of, AND, many themes remained to lunch time discussions and vulnerable confessions behind closed doors.
5 Central Themes at #AscendEvent
Like it or not, payment reform happens. It has happened in the past and will continue to in the future. While “historians” may say that providers in healthcare created this beast for ourselves, it doesn’t change the fact that in order to be effective in this space, you must understand the payment game. However, understanding and doing something about it is different.
I want to credit Mike Connors, who beat the drum to NOT giving in to the pressures of bad contracts during the Payment Reform Panel.
Wait… don’t give into bad pay? THAT SOUNDS FAMILIAR! => #DPTCareerPrimer <=
Value. Value means everything. If we devalue ourselves, how much more will the insurance companies who hold the keys to their dollars as well as the general consumer who is actually out, and about, shopping out clinics?! For the first time in healthcare, we’ve seen shoppers en masse, coming by just to check out places they are considering to patronize as customers.
Sure. Payment reform, we need to know about it, keep up with it, and advocate for the best solutions. That’s a given. What is more, is that our participation in the healthcare market is value strong.
Bring value. Be value. Don’t accept anything that devalues.
Measure EVERYTHING. Why? Because, it has everything to do with where we go, moving forward. Value based pay and pay for performance is a thing. If you don’t measure now, you won’t have any data, any outcomes, or anything to show for how valuable you are and how well you perform.
Also, since no one really knows what CMS and insurance carriers are going to mark up as key metrics, it’s important that EVERY factor is taken into consideration, properly documented, and ready for data mining.
On the flip side, we’ve also created our own mess in the same veins in outcome measures. There are hundred and hundreds, close to a thousand rehab functional outcome measures. Most, which we could agree, couldn’t be best in class just by numbers alone… not to mention all the research validation (or, lack thereof).
What’s the solution?
As was said it’s all about unity. Payers have already stated what would get them to say, “Yes” and increase pay: merge. Of course, no one wants that. Then, we must collaborate. We must come together and form a consensus on what to use for metrics and what not to use. More importantly, we must unify in how we implement these measure when we present them as evidence of our value. Otherwise… all we’ll present is an unbound clutter of sticks, easily broken… blown away by the wind.
A single twig breaks, but the bundle of twigs is strong. – Tecumseh
The age of referral source is dead… and, most of us don’t even know it. It’s easy to continue in one’s set ways. It’s easy to buy donuts, provide lunch, and hope that physician offices will be friendly toward our practices. However, it was openly stated that this age is dead.
Instead, those in the lead are demonstrating that the opposite is true! It’s not about surgeons referring to PT practices. In fact, those practices who are TRULY growing are having surgeons come up to them, meekly asking about appropriate referrals! THIS. IS. HAPPENING!
Two of the session at Ascend spoke specifically on marketing. The Strive Lab guys are quoted for saying that “Marketers will save physical therapy.” And, I agree!
Physical Therapists are excellent providers. However, we are terrible marketers. We are abysmal at communicating the value of our services. We think only from our perspective, and not, from that of the healthcare consumers.
The businesses we watch grow fast and grow strong, do so because they do not rely upon other people to grow their model. They take control for themselves and include to their own, a team who knows how to do it right!
This was more or less an unspoken and mutually understood theme at the conference; be it referred to as human capital, human resources, or just… talent. Talent was spoken about in numerous sessions, including a smashing session with Dr. Larry Benz.
PEOPLE. Excellent people, are the key to long term growth and success.
Since APTA’s Private Practice Section conference in 2015, we have heard ENDLESS cries by business owners for help in attracting and retaining talent. For this reason, we went ahead to create the 2016 Talent Acquisition Report for PT.
During Ascend, talent, mentorship, and excellent human resources were identified as true strategic differentiators for success. How much interest was there? Well… our contest giveaway winner, DPT student Cruz Romero, was practically mobbed by practice owners and managers in the aftermath of the mentorship session — representing one of two students present at the business summit. What did they want of him? They wanted to know where to find students as engaged as he is. He told them…
“We’re everywhere. We’re all over Twitter. We WANT mentorship. You just need to make yourself known.”
A profession’s culture represents the core of who they are, why they do what they do, and HOW they go about doing it. *Sighs*… there weren’t very nice said about our culture. Things like..
Physical Therapists eat our own young.
And, what is worse: IT IS TRUE! We’ve got to stop this. And, we need to stop eating at each other. We need to stop denigrating the practice across the street for any one reason or another. It isn’t corporate vs. mom & pop vs. cash PT. It isn’t experience vs. new grad. It isn’t about competing or keeping our cards secret (shoutout to Paul Gaspar for saying it as it is). There is far too much internal fighting over a market that barely knows we exist. A market that would just lose their flipping minds to know there is a solution to musculoskeletal concerns OTHER THAN A PILL.
This is just the start.
Our culture need to purify things like the over billing or up-coding that we all know is going on. It includes needing to start penalizing mediocrity and rewarding reward, REGARDLESS of clinical experience, seniority, status, or credentials. It means we need to stop trying to differentiate ourselves and start unifying ourselves in the eyes of the public.
It means we need to take at core interest, our common values rather than distinctive traits. After all, at the base, all physical therapists want the same thing for our patients. We have far more we agree upon than disagree upon. We just have a unique manner in going about it. It’s not about setting, or sections, or private practice or hospital based outpatient. It’s about the fact we’re all in the same profession and NEED to start acting that way.
Stop being known for what you are against. Start being known for what you advocate for.
A culture shift also includes how we think about business. Several years ago, I recommended that the future of physical therapy lies in our interpretation of the dental business model. This year at Ascend, the very thought was once again expressed by panelists and speakers alike in following the dental model. It was also brought up that we need to stop working FOR… and, start OWNING our own profession. Thoughts such as: Why not employ a PA or an NP? Why not even employ a physiatrist or another type of physician, synergistic to PT? After all, there are already practices like this in Europe. Truly, we need to stop thinking about how we fit in the pecking order and simply step outside such paradigms to create our own. After all… it was said at the conference:
If you don’t define yourself, someone well will.
I feel some of the biggest takeaways from the event were the following:
- Physical Therapists own less than 8% of the musculoskeletal marketshare. The other 92% seek pain medication, substitutes, and other providers… mostly because they don’t know who we are or how we can make a difference.
- If we continue to fight for that 8% and only consider how much of a slice of 8% we get, we will ultimately lead to our own mutual extinction.
- HOWEVER, if we forge together in like-minded-purpose, we can move that needle at 8% to 10%… 15%… 30%… 50%… and, beyond. The HOW: Unity. That, is simple… not easy.
- Rehab Therapy needs to stop eating its young. We do this out of fear — fear that if we don’t eat our young, they will eat us first. We do this out of jealousy. We do this, because EVERYONE recognizes that 15 years of experience and commensurate annual raises is not an accurate reflection of skill set nor value contribution. We need to be honest with ourselves and begin valuing what our customers value; not, what we find attractive and interesting. It’s NOT ABOUT US. It’s about our customers.
- We need to change our mindset. Then, we need to change our culture. This culture of subservience, of dependence, of inferiority, of poverty, and of powerlessness. Physical Therapists and all our rehab therapy allies have the opportunity to truly transform society. We can do this at a local level, at a social health level, and at the billions-of-dollars-economic level. The biggest disservice we can do, is stay the same.
What will you do, to ascend to the next level?