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RE: WRCI stats: average number of visits
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RE: WRCI stats: average number of visits - March 27, 2008 10:57:46 AM
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JSPT
Posts: 282
Joined: April 19, 2005
From: Michigan
Status: offline
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I totally agree, Tom. I think that therapists in private practice have more of an incentive to maximize patient outcomes and satisfaction; we're sunk if we don't. A hospital system seems to provide more insulation for these factors, but, of course, they remain important.
SJ-No, I don't plan to attend the meeting. That's great that you've talked to someone involved in the decision-making process. So have I, unfortunately:
A guy came to me for secondary shoulder impingement. We talked about why/what he needed to strengthen, and how he could improve his general health. He was a 300+ pound 60 y/o, high stress/no physical activity gentleman. After a few sessions, the majority of which focused on exercise, he disappeared.
I called him a month after his last visit to check on his progress. He had been to a "neuromuscular therapist" in the GR area who did some "nerve massage" to his axilla, which completely alleviated his symptoms.
I spoke with him about 6 months after the phone call, and he was right back to where he started. His solution was to return to the NMT for another round of massage.
The kicker (and my point):
He was a BCBS executive who was in charge of deciding what kind of benefits they will pay for, and how much they will pay for various services.
I still don't know what a neuromuscular therapist is, and the patient is looking for an orthopod who will agree to perform a RC repair on him in the next few months.
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RE: WRCI stats: average number of visits - March 27, 2008 1:06:16 PM
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SJBird55
Posts: 2432
Joined: May 10, 2004
From: Michigan
Status: online
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You'd think that private practitioners would provide a higher level of service, but that isn't always the case.... There are a few private practices in this area that I wouldn't send my dog to. LOL How they stay in business beats me - "nice" people and the general public has no perception of quality service.
Well, the delegate wasn't too open to my suggestions. "BCBSM is difficult to work with. Only certain MPTA individuals are allowed to communicate with BCBSM. We're working on building their "trust." " I told her that how is it that BCBSM can only "allow" certain individuals to work with them... and trust? How's that working? LOL We've got the same guys on the MPTA banging their heads with BCBSM - and they aren't doing a good job. Things need to change... THe MPTA didn't help in any way shape or form with the BCBSM take backs from last year... they have nothing on their agenda for addressing improved reimbursement. The MPTA folks are complacent. I don't believe they do a darn thing with our membership dues... nothing that assists us as physical therapists in the business world. Nurses are getting what I'd call "direct" access with BCBSM and paving their way, I'm surprised that MPTA isn't looking into what the nurses are doing to push us along in the direction we would like to be. Whatever... just keep banging against the brick wall for legislative direct access instead of thinking outside the box to get what we want...
JSPT, sounds like you should have a heart to heart with that BCBSM executive. He's just as lazy as the rest of society and wants a simple fix... simple fixes don't always solve the issue in the long run either financially or functionally.
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RE: WRCI stats: average number of visits - March 28, 2008 6:32:53 PM
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SJBird55
Posts: 2432
Joined: May 10, 2004
From: Michigan
Status: online
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You know, you're probably more right with your suggestion. LOL
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RE: WRCI stats: average number of visits - March 28, 2008 7:09:12 PM
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jlharris
Posts: 476
Joined: April 12, 2006
From: Nebraska
Status: offline
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quote:
ORIGINAL: Tom Reeves DPT ATC
You would think that the payors would find it in their best interest to satisfy their clients by finding the best practicioners and recommending them to their clients....
LOL, you would think, but most payors know nothing of PT but price. Therefore - in thier eyes - lower price practioner (forced or not) is the way to go.
_____________________________
Jason L. Harris, PT, DPT
My PT Blog
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RE: WRCI stats: average number of visits - 
