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B. Bourcier1, T. Ruediger2
1Parkview Health, Physical Therapy, Fort Wayne, United States, 2Manchester University, Physical Therapy, Fort Wayne, United States
Background: As healthcare continues to move towards value-based and risk-based reimbursement, it is imperative that leaders in outpatient therapy settings understand and can quantify the value of the services that therapists provide.
Purpose: The purpose of this study is to report the steps towards developing a single number Value Metric that represents both the quality and cost of clinical care for outpatient therapy that can be used in real time.
Methods: To quantify value in outpatient therapy we considered a ratio of value to cost.
We reviewed 4000 charts in a six month lookback period. Of these 2400 had data required for inclusion in our research.
For value we used patient reported outcome measures (PROM) standardized by converting to a percentage to answer the question. "how did your do?". We used the Net Promoter Score (NPS) to answer the question, “how did we do?”. Multiplying the PROM and NPS gives us the value component of our Metric.
To quantify cost of care for the denominator we chose costs per hour worked (CPHW) for the therapist and chose to divide that by revenue per hour worked (RPHW) of the therapist to reflect cost as a percentage of revenue. We chose both cost and revenue per hour worked because we felt they were simple to calculate, meaningful, and understandable to the clinician. Cost per hour was calculated from the total therapist expenses divided by total clinical hours worked. Revenue per hour was calculated from units billed per hour multiplied by the average realized revenue per unit for that clinic.
The Value Metric was then validated through comparison of existing leader value rankings of those therapists.
We reviewed 4000 charts in a six month lookback period. Of these 2400 had data required for inclusion in our research.
For value we used patient reported outcome measures (PROM) standardized by converting to a percentage to answer the question. "how did your do?". We used the Net Promoter Score (NPS) to answer the question, “how did we do?”. Multiplying the PROM and NPS gives us the value component of our Metric.
To quantify cost of care for the denominator we chose costs per hour worked (CPHW) for the therapist and chose to divide that by revenue per hour worked (RPHW) of the therapist to reflect cost as a percentage of revenue. We chose both cost and revenue per hour worked because we felt they were simple to calculate, meaningful, and understandable to the clinician. Cost per hour was calculated from the total therapist expenses divided by total clinical hours worked. Revenue per hour was calculated from units billed per hour multiplied by the average realized revenue per unit for that clinic.
The Value Metric was then validated through comparison of existing leader value rankings of those therapists.
Results: The Value Metric, calculated using existing quality and cost data, was consistent with existing leader rankings on perceived therapist value. The equation demonstrated an adequate affirmation of our Value Metric concept to quantify value.
Conclusions: The proposed equation for quantifying value in outpatient therapy was effective and useful to reflect the quality and cost of clinical practice. We were confident moving from proof of concept to developing a system for real-time evaluation while continuing to evaluate utility of concept.
Implications: This equation can be utilized in outpatient therapies to shift metrics centered on cost to a metric focused on value.
Funding acknowledgements: No funding was received for this reseacrch
Keywords:
Value
Quality
Outpatient
Value
Quality
Outpatient
Topics:
Professional issues: business skills, leadership, advocacy & change management
Professional practice: other
Professional issues: business skills, leadership, advocacy & change management
Professional practice: other
Did this work require ethics approval? No
Reason: Exempt study
All authors, affiliations and abstracts have been published as submitted.
