Payment for Outcomes

Question 1

Outcome

Answer 1

Degree of health or recovery

Question 2

What is the gold standard in relation to PT outcomes?

Answer 2

Functional status

Question 3

What other categories are in PT outcomes?

Answer 3

Pain level
Ability to return to physical activities
Ability to return to work

Question 4

Value=

Answer 4

outcome/total cost

Question 5

Pay for reporting

Answer 5

portion of data must be reported or payment is at risk

Question 6

Pay for performance

Answer 6

part of payment is tied to performance

Question 7

IMPACT ACT of 2014

Answer 7

SNFs, IRFs, and LTCHs must begin reporting on quality measures

Question 8

Data set ffrom Impact must include:

Answer 8

Functional status and changes in function
Skin integrity and changes in skin integrity
Medication reconciliation
Incidence of major falls
Patient preferences

Question 9

IMPACT ACT GOAL

Answer 9

To advance PAC (post-acute care) reform

Payment should be based on patient needs, not site of service

Question 10

What did Post Acute Care sites (PACs) have to report on:

Answer 10

Medicare Spending Per Beneficiary (MSPB)
Discharge to community
Hospitalization rates of potentially preventable readmissions

Question 11

Global Function

Answer 11

Measures that quantify patient’s overall functional status

Includes mobility, ADLs, etc. (e.g., OPTIMAL, AMPAC, PROMIS, SF-36

Question 12

Condition/Body Region Specific

Answer 12

Measures that quantify functional status for a specific condition or body region
Activities for a condition or body region (e.g., Neck Disability Index, Oswestry, DASH, etc.)

Question 13

Performance Based

Answer 13

Measures that quantify function specific to a task or tasks

Specific activities patient is asked to perform (e.g., Tinetti, TUG, 6-Minute Walk Test, etc.)

Question 14

Quality assessment

Answer 14

refers to measurement of quality compared to some goal or standard

Question 15

Quality assurance

Answer 15

continuous quality improvement

Question 16

5 things that most affect customer satisfaction

Answer 16

Communication of treatment plan from patient’s perspective
Consistency of clinicians
Respect for patient autonomy & patient input
Time clinician spends with patient
Clinician understands patient’s history & condition

Question 17

4 steps of CQI:

Answer 17

Measure performance: where are we now?
Set goal for future performance: where do we want to be?
Implement process changes: how do we get there from here?
Measure: were we successful in getting there?

Question 18

Comparative effectiveness research

Answer 18

Comparison of one form of treatment versus another

Question 19

Who does G codes apply to?

Answer 19

All practice settings that provide outpatient PT, OT, and SLP services for Medicare Part B beneficiaries

Question 20

Functional limitation categories

Answer 20

Mobility
Changing and maintaining body position
Carrying, moving and handling objects
Self care
Other