The key topics he touched on include:
1. Bundled payment initiatives
2. Benchmarking for private orthopedic practices
3. The role of midlevel providers
4. Owning physical therapy services
5. Gainsharing opportunities
6. Reimbursement–locally and the sustainable growth rate
7. Home health services
The growing workforce for allied healthcare providers also worries Mr. Hillert, as there may not be enough business for the growing number of providers in the future. In Texas, the number of physical therapists as grown immensely, and across the country there is an aggressive push to expand the scope of practice for allied professionals.
“It has increased in several states where orthopedic surgeons have been unable to fight against it,” he said. “There is increased scope of practice for NPs, PTs, podiatrists and anesthesiologists.”
Another big issue is patient-reported outcomes. There are some states with statewide initiatives for reporting outcomes and data registries. In other states, physician groups collect their data to use during payer negotiations and outcomes studies. The data is also beginning to include price transparency.
“Price transparency is a huge issue,” said Mr. Hillert. “Maine is pushing price transparency. It’s one of the only issues where all the major players in the market oppose it.”
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