On November 28-December 1, APTA's Board of Directors (Board) met to fulfill a very important yearly function—adopting the association's Strategic Plan. During the 4-day meeting, the Board looked to the newly adopted plan to help guide its discussion and actions on various association initiatives.

The Board adopted the APTA Strategic Plan after a rich discussion on the 4 goals of the plan—effectiveness of care, patient- and client-centered care across the lifespan, professional growth and development, and value and accountability. Objectives under each goal—17 in all—were prioritized earlier this year by the Board. Resources toward the objectives in the plan are determined based on the priorities, so higher-level priorities receive more resources.

The objectives that were given the highest priority by the Board included the development of the outcomes registry and the advancement of a more appropriate payment system.

Action toward such a payment system for outpatient physical therapy services—called the Physical Therapy Classification and Payment System (previously known as the Alternative Payment System)—is under way.  The Board received a report from the task force working on the new payment system. As APTA finalizes its draft of the proposed payment system, a comprehensive communication, public relations, education, and professional development plan will be developed to maximize the opportunity for a successful transition. An outline of the proposed plan will be presented to the Board in January 2013. A final plan will go to the Board in June 2013. The final draft of the proposed payment system  is expected to go through several AMA groups and committees for vetting and valuation in 2013 and 2014. At this time, APTA is on target for a 2015 implementation of a new payment system.    

Other important priorities contained in the strategic plan include increasing the number and use of best practice guidelines to reduce unwarranted variation in care, in support of the goal toward effectiveness of care; exploring innovative learning opportunities, in support of the goal toward professional growth and development; and advocating for health policies that embrace value, safety, access, and integrity, in support of the goal toward value and accountability. Activities in progress or planned for 2013 to help achieve these objectives include continuing to expand the content in PTNow, APTA's online clinician's portal to evidence-based practice; adding a virtual attendance component to onsite APTA learning venues; and monitoring and influencing health care reform regulation.

Strategies and metrics for all 17 objectives have been developed and will enable APTA's Board to track their progress throughout 2013. Progress on the plan will be communicated to the members throughout the year.

In adopting the Strategic Plan, the Board recognized that it is a "bridge between Vision 2020 and a new vision to be considered in 2013." A proposal for that new vision also was discussed at the meeting, with the Board reviewing a report by the Vision Task Force. As the ultimate decision-maker on the vision of the association, the House of Delegates will consider the proposal in June 2013.

In other meeting activity, the Board approved a 2013 operating budget with revenue of $42,398,480, expenses of $42,398,480, and zero net revenue. It was noted that almost 24% of total expenses directly fund Strategic Plan goals.

Nine public policy objectives and strategies were adopted during the meeting, representing the critical public policy issues the association anticipates will advance physical therapist practice, education, and research in 2013-2014. The objectives and strategies include advancing a payment model(s) that promotes the value of physical therapists (see Physical Therapy Classification and Payment System above), eliminating physician referral for profit in physical therapy, and improving access to physical therapy services in integrated service delivery systems, such as accountable care organizations. The 2013-2014 priorities, developed with input from members and the Public Policy and Advocacy Committee, will be available to association members shortly. In keeping with the Board's focus on public policy priorities, a generative discussion was held on the determination of scope of practice issues. Board and staff members discussed possible mechanisms that could be used to review and analyze existing, new, and emerging fields of physical therapy practice to determine if APTA should endorse, recognize, or exclude the areas as part of the professional scope of practice. 

The Board also took action on several new initiatives related to policy and advocacy:

• Noting the need to effectively advocate for the inclusion and integration of physical therapy in emerging payment models, the Board voted to identify or establish and promote criteria/decision support tool(s) to ensure that patients and clients have meaningful access to appropriate physical therapy in all integrated payment models, such as a bundled payment system.
• The Board approved the development of a pilot program that would make select grassroots and advocacy resources available for nonmember audiences, such as physical therapists and physical therapist assistants, legislative staff, other health care providers, and patient advocates. Opening up access to selected resources would allow enhanced collaborative opportunities in regulatory and legislative priorities.
• With the formation of state exchanges and the recent release of the essential health benefits proposed rule, and in response to members seeking assistance with language for use in negotiations with legislators, payers, and policy makers, the Board adopted Essential Health Benefits Recommendations as a Board policy. This new policy provides definitions of "rehabilitation" and "habilitation" and guiding principles for these definitions.   

In the coming months, the Board will begin to consider the future relationship between APTA and the Commission on Accreditation in Physical Therapy Education (CAPTE). US Department of Education (USDE) regulations, new Council for Higher Education Accreditation (CHEA) criteria, and a perceived conflict of interest between APTA and CAPTE, have prompted discussion about and initial exploration into whether CAPTE should become partially or fully independent of the association. As such, APTA will gather financial data, confirm the various USDE and CHEA requirements impacting CAPTE, collect information on the 2 proposed models, and consult with the Academic Council, the Education Section, and other interested parties so that the Board can make a recommendation that would best serve the interests of education programs, the association, and CAPTE.           

To promote governance processes and structures that optimize policy development, the Board voted to develop motions for the 2013 House that will allow necessary Board discussion and action on the House of Delegates governance proposal. Data gathered by the Governance Proposal Board Work Group to inform its work as well as the report submitted to the Board have been posted to the Governance Review Community. The materials can be found in the Governance Review Community Reference Materials folder with document titles that begin with the words 'House Governance Proposals.'

For the first time, the Board meeting was livestreamed. APTA members can watch the video archive of the meeting until December 15 (refer to the agenda posted on the livestream webpage to narrow down the date and time of the discussions summarized above). The language for motions voted upon during this meeting is not considered final until the minutes of this meeting are approved by the Board. Final motion language will be reflected in the minutes of the November 2012 Board of Directors meeting, which will be approved and posted online in December.