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  • 'Choosing Wisely' List Subject of Move Forward Radio Episode

    APTA's contribution to the national Choosing Wisely campaign,released earlier this week, is designed to encourage conversations between physical therapists (PTs) and patients to avoid waste and improve care. Move Forward radio is helping to get that conversation started.

    To help consumers understand the list and be better informed, Move Forward Radio dedicated an episode to the list of "5 Things That Physical Therapists and Patients Should Question." 'It's really important that patients be involved in decision making about their care, and that they're really comfortable asking questions about the care that's recommended for them,' APTA's senior director of clinical practice and research, Nancy White, PT, DPT, OCS, told Move Forward Radio.

    In the episode, Tara Jo Manal, PT, DPT, OCS, SCS, discusses each of the "5 Things" and explains terminology and concepts found in the list such as "passive physical agents," "under-dosed strength-training programs," and "continuous passive motion machines."

    Manal emphasizes that it isn't a list of 5 things that should always be forbidden.

    Manal says that other than the recommendation related to whirlpools for wound management, "which we have really moved past in current practice," the list is about setting the stage for informed conversations. "It's important that patients realize that this list … is not a list of things that are inherently dangerous," she says. "They really are things that should be discussed."

    "If a therapist is doing interventions that are on this list, I think it's a very reasonable conversation to say, 'Is this really adding to my rehabilitation?' Or, 'Might we be able to spend our time [together] in a more productive way?'"

    PTs are encouraged to use the resources at MoveForwardPT.com to share the Choosing Wisely information with their patients and clients.

    Move Forward Radio airs approximately twice a month. Episodes are featured and archived at MoveForwardPT.com, APTA's official consumer information website, and can be streamed online via Blog Talk Radio or downloaded as podcasts via iTunes.

    APTA members are encouraged to alert their patients and clients to the radio series and other MoveForwardPT.com resources to help educate the public about the benefits of treatment by a physical therapist. Ideas for future episodes and other feedback can be e-mailed to consumer@apta.org.

    Postacute Care Data Reform Legislation Passes Both Houses

    Legislation that would standardize data used across postacute care (PAC) settings has now passed in both houses of Congress and could soon become part of larger reforms. APTA has been working to influence this legislation.

    The Improving Medicare Post-Acute Care Transformation (IMPACT) Act now approved by both the House and Senate would instruct the US Department of Health and Human Services (HHS) to standardize patient assessment data, quality, and resource use measures for PAC providers including home health agencies (HHAs), skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term care hospitals (LTCHs).

    The House passed the legislation last week by voice vote. Late on September 18, the Senate did the same.

    APTA and other supporters of the legislation believe standardization would allow HHS to compare quality across PAC settings, improve hospital and PAC discharge planning, and use this standardized data to reform PAC payments in the future.

    The legislation will:

    • Require PAC providers to begin reporting standardized patient assessment data at times of admission and discharge by October 1, 2018, for SNFs, IRFs, and LTCHs and by January 1, 2019, for HHAs.
    • Require new quality measures on domains beginning October 1, 2016, through January 1, 2019, including functional status, skin integrity, medication reconciliation, incidence of major falls, and patient preference regarding treatment and discharge.
    • Require resource use measures by October 1, 2016, including Medicare spending per beneficiary, discharge to community, and hospitalization rates of potentially preventable readmissions.
    • Require the Secretary of HHS to provide confidential feedback reports to providers. The Secretary will make PAC performance available to the public in future years.
    • Require MedPAC and HHS to study alternative PAC payment models due to Congress in 2016 and 2021-2022, respectively.
    • Require the Secretary to develop processes using data to assist providers and beneficiaries with discharge planning from inpatient or PAC settings.

    The congressional committees have provided a summary (.pdf), including timelines.