Dramatic Revitalization for Southeast Orthopaedic Group
A 20+ surgeon orthopaedic group located in the Southeast had been experiencing a steady decline in its outpatient physical and hand therapy referrals and income. This group had started offering PT/HT services more than ten years previously, but over the past several years, the group’s physicians had come to believe that other therapy practices offered more skilled care and consequently sent a large number of their patients to other PT/HT providers. This group contacted Ancillary Care Solutions (ACS) to find out how its PT/HT program compared to other orthopaedic group programs. After reviewing PT/HT referrals, visits, charges, payments and other information, ACS concluded that internal referral rates, provider productivity and provider skills were significantly lower than at other physician-based PT/HT programs.
In addition to benchmarking the group’s PT/HT program against similar programs, we made a series of recommendations aimed at improving provider clinical and communication skills and productivity, regaining physician confidence and increasing net income. The group retained ACS to coordinate all PT/HT turnaround tasks. We were confident in the group’s ability to rebuild a successful PT/HT program and consequently based our fees on increasing PT/HT productivity and income.
Initially, our turnaround efforts focused on improving clinical skills, patient flow, documentation and coding. We provided productivity benchmarks and the training and follow-up reinforcement necessary to improve provider and support staff productivity. The process changes that were required to increase productivity and profitability included clinical education to enhance skill levels and coding education to help ensure the capture of appropriate charges. ACS also designed and helped implement an incentive compensation plan based on measurable productivity gains.
Some of the primary issues that we focused on involved physician and patient satisfaction. We found that the therapy providers were not spending enough time with patients to allow for optimum outcomes and patient satisfaction. The therapy providers needed to supplement their clinical skills and also needed to rework their patient schedules to allow for an appropriate amount of treatment time with each patient. We showed them how they could spend more time with each patient and increase appropriate daily charges in spite of decreasing their total daily visits. This change helped improve outcomes and increase patient satisfaction while also enhancing staff satisfaction by allowing therapists to spend more time with each patient and less time documenting treatment.
In addition, ACS helped this group replace its therapy director and a number of staff therapists, successfully open its first satellite location, expand its work hardening program, improve documentation, streamline its scheduling process and improve communication between physicians and therapists. The successful implementation of these changes has led to a therapy program that is not only better at meeting the needs of patients and physicians, but that is also generating a substantial amount of income.
More specifically, during the three years following our initial engagement, ACS was able to help this group increase its PT/HT revenue 79% from $1,476,000 in the year immediately prior to ACS engagement to $2,641,000 in year 3 and net income 227% from $242,000 to $793,000. In addition, as the group’s physicians regained confidence in their PT/HT program, referrals increased by 49% and total visits increased by 67%.
In summary, this group was not only able to more than triple its PT/HT net income, but also increased clinical and patient communication skills so that physicians regained confidence in their therapy providers and program.