In today’s episode Erin Gallardo, PT, DPT, NCS and Claire McLean, PT, DPT, NCS had the pleasure of interviewing APTA President Roger Herr and asking all of the burning questions about what it’s like to run a neuro practice with Medicare as it is and where we’re going. Roger shared his journey into physical therapy and his extensive experience in key roles that gave him a wide angle perspective of the profession he advocates for now.
Alternative Payment Models for PT Practices
- Herr emphasized the importance of finding local, regional payment models that best fit each practice's needs, whether that's working with employers, payers, or patient groups.
- He discussed strategies like opting out of Medicare, negotiating contracts, and exploring cash-based services to create sustainable business models.
Challenges for Micro Practices
- Smaller PT practices often struggle with billing, communicating with payers, and navigating the complexities of Medicare coverage.
- Could clearer guidelines around medical necessity and skilled care be a helpful short-term goal?
Advocacy Efforts for the PT Profession
- Herr highlighted the need to shift from volume-based to value-based care, and to advocate for recognizing the downstream costs and impact on patients.
- He discussed opportunities in Medicaid, annual wellness visits, and partnering with patient advocacy groups to drive change.
Modernizing Medicare Access
- Herr explained efforts to update Medicare legislation and allow beneficiaries to directly contract with physical therapists.
- This could provide more flexibility and options for patients, though the details around rules and limitations are still being worked out.
Leveraging Technology and AI
- Herr shared insights on how technology and AI can support population health management, documentation, and reducing administrative burdens for PT practices.
APTA Infographic of Prior Authorization
ChoosePT How Medicare Determines Payment HH and SNF
Download the APTA Advocacy App
ChoosePT Directory - Sign up by logging into APTA account, then go to Online Profile, then Find a PT
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