I read with interest APTA’s testimony on CMS’ pay for performance initiative:

APTA Links Performance-Based Pay to Fixing Medicare Problems

APTA urged a congressional committee this week to repeal the therapy cap and fix payment problems that interfere with quality care incentives before adopting any pay-for-performance system for Medicare. In written testimony submitted to the House Ways and Means Health Subcommittee, the Association endorsed Chair Nancy Johnson’s (R-CT) Medicare Value-Based Purchasing for Physicians Services Act (HR 3617) but urged the subcommittee to specifically include physical therapists and other non-physician professionals in developing any system. To effectively implement pay-for-performance, APTA argued that Congress must repeal the Medicare therapy cap and replace the “sustainable growth rate” in the current Part B physician fee schedule, as well as standardize the physical therapy benefit in all outpatient settings and use APTA Connect and Optimal, the Association’s electronic patient medical record and assessment tools, in moving to a value-based payment system.

I cannot agree enough with the repeal on the cap-it impacts those seniors that tend to have greater needs that we can address in rehab but I am particularly confused over the marketing of the Connect and Optimal as a tool to move to value-based payment system.  Are any of you using it?

The other major point to permanently repeal the cap that makes the most sense is that the cap is not really lifted-it would only be in place for all NON HOSPITAL delivery systems (exempt for hospitals).  How would part B medicare patients in a nursing home get to a hospital?  Why would you want cost shifted to the highest cost delivery system (sorry for those that work in a hospital but it is the highest cost deliverer-statistically speaking) AND it would appear to violate some type of anti-trust in this regard as well.  If reimbursement for medicare continues to go lower (both in nominal and real terms and coupled with higer costs), it would make it a complete loss for hospitals to have so many patients shifted.  Thoughts?  Let’s all continue to be advocates to our representatives for the repeal.

Larry