Digital Meets Physical (Therapy, That Is!)

Are you truly future-proofing your professional PT career? Or are you skating towards where the puck is right now, or where it was last season? Having a strategy and plan for your career is a non-negotiable. In episode 12 of the Future Proof PT podcast, Dana Strauss and Alex Bendersky explore a crucial topic affecting every physical therapist's future: Remote Therapeutic Monitoring (RTM) and how it intersects with the strategic vision of the Center for Medicare and Medicaid Innovation (CMMI).

This episode is a vital conversation about understanding the rapidly evolving healthcare landscape and positioning yourself at the forefront of healthcare delivery transformation. You need to look beyond the clinic and the day-to-day, paying attention to clear signals from influential stakeholders like policymakers and their advisors. Dana and Alex break down the latest developments in healthcare technology, payment models, and what these changes mean for your practice.

The conversation highlights how the PT profession, while pushing for autonomy through direct access, may have been distracted from other systemic problems like the fee-for-service payment structure. This structure has disincentivized comprehensive physician and APP engagement in the value of PT and has incentivized PTs to prioritize volume over individual patient needs, ultimately impacting professional autonomy and the perception of the profession by other providers and payers.

Crucially, you’ll learn about the CMS Innovation Center and its goals. Operating with significant flexibility outside the traditional rulemaking cycle, the CMMI is focused on moving Medicare dollars into downside risk models. In these models, providers are directly responsible for patient outcomes, which leads to changes in care delivery and offers more flexibility in payment mechanisms.

A major focus for this administration's CMMI is promoting evidence-based prevention and empowering patients, especially in the realm of chronic disease management, which accounts for a staggering 93% of Medicare spending. The potential of RTM, though still seeking true market fit, is discussed in detail.... When used well, it has the potential to align with CMMI's goals of accessing patients' needs at the right time and place and engaging them more effectively.

Alex shares his brilliant analogy of the train model for hybrid care delivery, perfectly illustrating how digital support systems like RTM can provide asynchronous, around-the-clock care and serve as a stopgap between episodic in-person encounters. However, navigating this future requires understanding the current challenges with healthcare data, particularly within therapy EMRs. The quality of data needs to be upleveled, as it's often structured for compliance and reimbursement rather than truly documenting the patient's condition and response to care.

You'll hear how issues with ICD-10 coding accuracy impact data analysis and how CMS and CMMI have the potential power to mandate better data collection, access via APIs, and even specific documentation styles in the future. With the increasing ability to analyze data on utilization and longitudinal outcomes, therapists must be cognizant of how RTM use impacts both patient results and overall downstream costs.

The inherent value proposition for CMS is that RTM should improve outcomes and reduce the need for more expensive downstream care. Dana and Alex also introduce tools like episode groupers, which have the potential to powerfully attribute healthcare spend to specific providers, paving the way for alternative payment structures that reward or penalize based on demonstrated value and evidence-based practice. While physical therapy represents a fraction of the spend compared to procedural care or diagnostic imaging, increasing patient access to musculoskeletal professionals as a first point of contact could be a key strategy to control overall system costs.

The takeaway is clear: mandatory participation in CMMI models is likely on the horizon. If you are unaware of these changes or unprepared to adapt, you risk being left behind. However, for those who are proactive and prepared, the "risk game" presents a significant opportunity. By betting on your ability to deliver high-value, appropriate care and prevent more costly interventions, you can potentially capture a larger share of the healthcare dollar. Listen as Dana highlights direct signals from CMS Innovation Center leadership, like the Deputy Administrator citing physical therapy as an example of high-value care that helps patients avoid orthopedics. These signals, along with growing interest from venture capital and larger organizations, indicate that change is not a maybe – it’s going to happen.

Tune in to episode 12 to gain crucial insights into these seismic shifts, understand how they will affect your practice, and learn how you can prepare now to benefit from the future of physical therapy. As a newsletter subscriber, remember you have access to valuable resources discussed in this episode, including the CMS Innovation Center strategy document and detailed guides on implementing RTM effectively. Listen now to position yourself for success and be part of the future-proof physical therapy profession!

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