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GLEN MILLS, Pennsylvania (February 5, 2013) – U.S. Congressman Patrick Meehan (PA-07) will be meeting with constituents at Excel Physical Therapy at The Shoppes at Smithbridge, 331 Wilmington-West Chester Pike on Monday, February 11, 2013 at 10 a.m. While visiting Excel, he will take questions and discuss constituents’ concerns about current healthcare issues.

Meehan, who is serving his second term in Congress, co-sponsored the Physical Therapist Student Loan Repayment Eligibility Act of 2011 and also voted to repeal a provision in the 2010 health care law that would impose a tax on the sale of medical devices. He serves on the Oversight and Government Reform, Homeland Security, Transportation and Infrastructure, and House Ethics Committees.

Excel Physical Therapy in Glen Mills is one of 18 E & A Therapy clinics, committed to providing access to quality rehabilitative services and the information patients need to maintain healthy lifestyles. A Montgomery County-based company, owned and operated by physical therapists, E & A brings passion, integrity, excellence and accountability to its role as a health care provider. Our physical therapists participate in 40 hours of continuing education each year – well beyond what is recommended by the American Physical Therapy Association. As a result, they are some of the most knowledgeable physical therapists in the region.

The public is invited to stop by the Excel clinic to meet Congressman Meehan. While there, they can also meet the Excel physical therapy staff to discuss how physical therapy can help them maintain the quality of life they deserve.

Physicians tasked with discussing financial implications of referrals with patients.

Physical therapy co-payments of $30, $40, $50 per visit or more are becoming more common. High co-payments provide a financial barrier for patients to get the treatment they need. An insurance plan with a high co-payment is really no benefit at all. In many cases, the patient’s co-pay responsibility is nearly the entire amount of the allowable fee.

The Pennsylvania Physical Therapy Association is working to address this issue at the state level. Recently, a bill was introduced in the Pennsylvania Senate that would cap co-payments at the lesser of $30 per visit or the insurer’s primary care co-payment amount. Similar laws have recently passed in Kentucky, North Dakota and New Jersey.

We have learned that because of high co-payments, physicians are often in the uncomfortable situation of having to discuss the financial implications of a physical therapy referral with patients. Hopefully, this legislation will pass and allow the focus to remain on the best course of treatment for the patient rather than money.

- Contributed by: Jeffrey Ostrowski, PT, Partner, E & A Physical Therapy

Excel's own CEO Jeff Ostrowski, PT, discusses the biz, the healthcare system, today's private practice strengths/obstacles and all things physical therapy on this PT Talker Podcast.

Are You Running Your Physical Therapy Practice as a Business?

A passion for helping individuals overcome limitations and regain function is often the motivation behind starting a physical therapy clinic. Yet, many physical therapy clinic owners don039#t always think of their practice as a business. Today039#s expert makes a case for running a physical therapy clinic as a business.  Jeff Ostrowski, PT, and CEO of Excel Physical Therapy Services and Excel Consulting Crew shares tips for providing outstanding patient care while focusing on your bottom line.

Despite the trend of lower payments for physical therapy services, Ostrowski is cautiously optimistic about the future of physical therapy. He believes physical therapy businesses need to learn how to do more with less, maximize the productivity of every physical therapist on staff and utilize marketing and branding to set their clinic apart. He shares details about innovative approaches like incentive plans designed to reward productive and efficient physical therapists and reasons why the best physical therapists are often the busiest. Listen now to find out more.

Get informed and listen at PT Talker Podcast !

Having just read this article Next Medicare “Doc Fix” May Be Punted to Early 2011, I got to thinking about how we got into this mess.

Let039#s say you could go back and hit the undo button on health care, what would you do?

For me, this first thing I039#d do is stop using the term “health care“.  Health care is a personal matter.  It includes such things as exercise, eating properly and avoiding known risky behaviors (smoking or driving without a seat belt for example) that could cause a medical problem.  Medical care is different.  It encompasses what is done when someone gets injured or sick.  There is a difference and the semantics matter.  Health care requires personal responsibility and knowledge.  Medical care requires someone else to help you.

The next thing I039#d do is require that we as patients or consumers have more skin in the game.  Here039#s why.  Our current system is fraught with twisted incentives.

The patient, who has been paying insurance premiums (or the employer has) for a long time expects to get Grade A medical care, regardless of cost.  Do your patients complain about high co-pays?  Of course they do.  It all used to be “free”!

The provider, whether hospital or physician or PT, doesn039#t have great concern for cost either.  They want to provide the best available service so the patient gets well.  If it means ordering one more test or procedure to be sure, then so be it.

The insurance company hopes the patient doesn039#t need care at all and tries to pay the provider as little as possible.

If there ever was a recipe for disaster, this is it!

Let039#s face it…changing the system now would be nearly impossible.  But maybe we could nudge it in a more beneficial direction.  Consider this option.  Require patients to pay cash for routine medical care like office visits, x-rays, certain classes of medications, physical therapy, chiropractic care, and other basic procedures.  Then, patients or employers would purchase insurance for catastrophic care, surgeries, hospitalizations and more complex procedures.

A system like what I039#ve described above would place more financial incentive on patients to practice good “health care”.  It would probably drive down the costs of some of the more routine services.  It would allow insurance to focus on the big ticket items.  The cost of insurance would do down if it didn039#t have to cover all the routine procedures.  More people would be able to afford it.  Think of your car insurance.  You don039#t use car insurance for an oil change, you use it for an accident.

Specifically regarding Medicare, those recipients would receive vouchers to purchase commercial insurance policies.  We would needs test those in Medicare and provide subsidies for those who could not afford the out of pocket costs described above.

That039#s my idea.  I039#d like to hear what you think.

- Contributed by: Jeff Ostrowski, PT- Owner/CEO

“To realize the full benefits of the Affordable Care Act, physicians will need to embrace rather than resist change. The economic forces put in motion by the Act are likely to lead to vertical organization of providers and accelerate physician employment by hospitals and aggregation into larger physician groups.”

The above quote is an excerpt from an article that appeared in a recent edition of the Annals of Internal Medicine, which is the professional journal of the American College of Physicians.  The article is titled “The Affordable Care Act and the Future of Clinical Medicine: porThe Opportunities and Challenges“. You can read the article here. There is a bullet point summary of the purported benefits of the Affordable Care Act. They sound good.

Wait a minute.  Go back a reread the quote above.  I am reminded of something I heard someone say recently.  “If you are not at the table, you are on the menu.“  If you are in private practice like me, you have to be a bit concerned about what “vertical organization”, “employment” and “aggregation” mean to you.  Will we be marginalized if we stay in private practice?  What does this foretell about the professional autonomy that many of us in private practice seek?

Alas, I don039#t have any answers to these questions.  And therein lays the trouble.  The uncertainty is troubling.  In the meantime, the best we can do is do what we are doing everyday…. treat our patients well and look for efficiencies and opportunities to improve our practices.  I wish you the best of success.

On a final note, take a read through the responses to the article for a general flavor from the readership about the content.  It appears that not everyone is signed on to embrace.

- Contributed by: Jeff Ostrowski, Owner/CEO

President Obama recently appointed Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS). This appointment was done over a Congressional recess, thus avoiding hearings.  This has drawn criticism from some quarters ostensibly because of the still open wounds from the recent health care reform legislation and the fact that CMS has the largest budget in the federal government – even larger than the military.

Dr. Berwick has impressive academic and professional credentials.  Depending on your views of the role of government in health care, you may or may not like Dr. Berwick039#s philosophy, which you can read about in this recent editorial in the Wall Street Journal.

For an entrepreneurially-minded provider like Excel Physical Therapy and Fitness, one quote from Dr. Berwick caught my attention: “For-profit, entrepreneurial providers of medical imaging, renal dialysis, and outpatient surgery, for example, may find their business opportunities constrained.”

“Constrained” is a pretty subjective term.  My first thought was it was a euphemism for “cut, slashed, whacked” or other even more off-color terms.  One might be inclined to shrug it off as just more noise coming from Washington DC.  Let039#s face it, we039#re all pretty tired of and perhaps numb to the goings-on inside the beltway.  But please read on.

Also recently, CMS issued its proposed rule on the Medicare Physician Fee Schedule for the 2011 calendar year. This rule outlines a bleak and potentially devastating forecast for payment to physical therapists, physicians, and other health care professionals. Without Congressional action, the fee schedule will cut payments 23.5% on December 1, 2010, and reduce payments an additional 6.1% on January 1, 2011.

In addition to this cut, CMS proposes a detrimental additional physical therapy payment policy. The multiple procedural payment reduction (MPPR) would make full payment for the therapy service or unit with the highest practice expense value and reduce payment to 50% of the practice expense component for the second and subsequent procedures or units of the service furnished during the same day for the same patient.

Let me translate.  All-in, the worst case scenario for physical therapy providers as best we can figure means that come January 1, 2011, Medicare payments could be cut approximately 35-50% from current per visit payments.

In a competitive health care marketplace like the Philadelphia region, providers understand that you039#ve got to deliver quality care and get results to stay in practice.  If you do that and run a good business model too, then maybe financial success results.  But there is no guarantee.

With these drastic payment cuts perhaps on the short-term horizon, tough decisions are going to have to be made about salaries, benefits, personnel and even whether it is worthwhile to see these Medicare patients.  These are potentially sad consequences of being “constrained”.  Let039#s hope we can muster enough legislative muscle to defeat these proposed fee cuts.

By: Jeff Ostrowski, PT, CEO