The Robert Wood Johnson Foundation’s new series of animated educational videos aim to help patients and health care consumers understand how the new benefits and provisions of the Affordable Care Act (ACA) will affect them. The short videos tackle 5 common terms of ACA implementation. Share the videos with patients, friends, and family or post them to your Web site to help people gain a clearer understanding of what the law means for them.
Here’s my latest Taking Care of Business column published in the OT Advance:
Taking Care of Business
I applaud AOTA President Florence Clark’s 2011 Presidential address (see www.AOTA.com) in which she discussed competition as it related to the practice of occupational therapy. Clark stressed that it is to our credit that we are compassionate, kind, and honest, but added that these values do not have to preclude competition. “Competition is not mean. But we can’t continue to let others define occupational therapy. That’s not playing nice-it’s playing dead,” she said.
Clark compared OTs to sleeping giants who must stop letting others muscle in. We need to be worthy collaborators rather than support personnel. As she noted, “victories are sometimes won through teamwork but always through competition.” Clark pointed out that in its best form, we compete with, not against others; the stronger the occupational therapy team members are, the better the outcomes.
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Competition vs. Service Substitution
An old adage is “to compare is to despair.” That does not have to hold true. Good can come out of looking around at other practitioners. Heidi Grant Halvorson, author of Succeed: How We Can Reach Our Goals, writes that upward comparison can be punishing and make you feel terrible . but also states that you can look upward to learn.
Downward comparison may make you feel superior, may remind you of your good fortune, but could also help you avoid the challenge to do better. To be competitive in today’s environment, you first have to have a good handle on who your competition is and what it has to offer.
I have found from consulting with therapists that they may not realize how competition in health care has changed over the years, most notably in the last five. Traditional, or direct, competition is typically what we are used to. A pediatric OT practice is in competition with another one in town, a physical therapy practice specializing in ortho competes head to head with another. But that condition is not very stable. For many years, Pepsi and Coke were direct competitors for the cola market, and they loved it! Why? Because they each had a 50-percent share of the cola market, they knew and understood each other, and had made peace (and profits) with each having half the market. Then something happened to rock their world. Along came water. The consumer began drinking water instead of soda, and act that we would call service substitution. Pepsi and Coke were blindsided; they knew how to compete with each other, but not with another product. Sound familiar?
Therapists need to realize the extent to which there is service substitution encroaching in health care. Many consumers are looking to other services much like the consumer turned to water. There are personal trainers, athletic trainers, life and wellness coaches, behavioral therapists, even posture coaches to name a few.
Clark shared her confidence that this is OT’s time, based on the rising incidence of polytrauma and TBI; and I would add that the fact that baby boomers now survive and live with many diseases, including cancer, can give our field momentum to be acknowledged and embraced by consumers. She suggested promoting areas where OT is already well recognized, including hand therapy, autism and “wounded warriors.” We can take a competitive edge by sharing published studies emphasizing OT’s effectiveness, increasing grant proposals to NIH, using our experience in home health for falls prevention and energy conservation, and “owning” the appropriate words in documentation to reflect OT intervention.
As holistic as our frame of reference is, we need to look at the whole picture. Make sure you know with whom you are competing so you can better strategically position yourself for long term success and recognition in this increasingly crowded market place.
Pepsi and Coke found a way – they started bottling water. I know we can do better than that!
Over the last 10 years I have consulted with over 600 practices in 37 states – ranging from solo practitioners, to multimillion dollar therapy businesses. Nothing is more exciting than to see a therapy practice grow from scratch, so, with their permission, I am happy to showcase some of the practices I have the privilege of working with. First up, two practices just getting started; consults focused on options for legal set up, as well as developing a strategic marketing campaign and web site to get the ball rolling.
Here is an OT practice that started out providing services to school aged children in their home. This practice is continuing to grow, has already expanded to offer school based services as well as services in Connecticut, Westchester and NYC! And check out Angel in Motion’s new website! Job well done!
I have often said in my workshops that the HIPAA police force will one day be mobilized, and it looks like that day is getting closer. The Office of Civil Rights is the organization within the Federal Government that oversees HIPAA. They announced this week that they will be starting a pilot program for Privacy and Security Audits that will run from 11/1/11 through 12/31/12. A random number of covered entities will be contacted to participate; 150 audits in total are expected OCR plans on using the audits to assess HIPAA compliance over a wide range of covered entities.
If your practice is chosen, you will be notified in writing starting 11/1/11, and under the HIPAA Enforcement Rule, your full cooperation is expected.
Upon receipt of your written notice, you will have 10 business days to supply all requested documentation. Once the auditor receives your documentation, the auditor will make an onsite facility to observe and question key staff on your practices for HIPAA compliance. The estimate of time that the auditor will be onsite is 3 – 10 days, depending on the size of your practice. The auditor will then prepare a written draft final report for you to comment on and provide a Plan of Correction, if needed. You will have 10 business days to make your comments and Plan of Correction. After you submit your comments and, if needed your Plan of Correction, the auditor will create the final audit report and submit the Final report within 30 days to OCR. OCR can launch a full compliance review should the audit indicate a serious compliance issue.
If you have not addressed HIPAA in your practice, now is the time – In the words of JFK, the best time to put on a new roof is when the sun is shining. Contact Iris if you have questions about how to bring your practice up to speed!
For all practices that utilize an Advance Beneficiary Notice Form – there is a new one to use!
The approved ABN CMS-R-3-11 and instructions can be found on http://www.cms.gov/BNI/02_ABN.asp. in the downloads section at the bottom of the page.
Great article in the 10.24.2011 edition of Crain’s called The Century Club -detailing interviews with execs from companies who have been in business for 100 plus years. Read the full article, but here’s the summary of tips:
The Foundation for Physical Therapy now is accepting applications for the postprofessional 2012 Promotion of Doctoral Studies (PODS) Scholarship and the New Investigator Fellowship Training Initiative (NIFTI). with a 1.18.2012 deadline.
Apparently this year there have been many changes to the instructions and guidelines. For additional information, you can contact Rachael Crockett for more information via e-mail or phone at 800/875-1378, ext 3385.
Modeled after the multiple procedure payment reduction policy implemented by the Centers for Medicare and Medicaid Services, UnitedHealthcare (UHC) will implement a new multiple therapy reduction policy on physical medicine and rehabilitation services effective March 1, 2012. The October 2011 OptumHealthphysical health provider newsletter provides details on the multiple therapy reduction policy, which will apply to UHC claims only.
UHC’s intent is to use the code with the highest practice expense value as the primary procedure. OptumHealth is evaluating the policy and will notify its providers in a future newsletter if it will be implemented in OptumHealth systems. The policy does not apply to providers contracted at a flat rate per diem payment methodology.
OptumHealth’s physical health provider newsletter is available online for contracted providers through its member-protected Web site. The bulletin will be available online in November through UHC’s Web site and will be accessible to providers both in and out of network (OON). This will give OON providers advanced notice prior to implementation.
I have been talking about the revolution in healthcare advertising for the past few years, and now the NYTimes is writing about it, in a great article by Andrew Adam Newman entitled A Healing Touch from Hospitals. Check out the article, and then check out my new webinar New Perspectives on Marketing for Therapy Practices and learn how to adapt these ad campaigns to fit your practice.
Take the course, and see where it takes you!
If you missed this article in the NYTimes on 9.8.2011, make sure you check it out. It speaks clearly to the issues faced by the vast majority of practices facing increased overhead expenses but little to no control of fees charged. Concrete suggestions to implement including cross training staff etc. is discussed.
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