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Tapping a Physical Therapy Provider Network that Values Both Quality and Quantity

No two physical therapy networks are the same. Quality should always be valued over quantity or price, but what differentiates a best-in-class network from a sufficient or merely adequate one is the ability to provide injured workers with timely access to both high quality providers and a wide selection from which to choose.

Let’s break down the key components needed for this winning combination.

What Defines a High Quality Physical Therapy Network?

1. Timely, Successful Access– It is critical that injured workers are promptly and accurately scheduled and able to access physical therapy following an injury. If you utilize a managed care company to coordinate these services, take some time to evaluate their ability to accomplish this. For example, we demonstrated the ability to achieve 97 percent scheduling success in 2019.1

Scheduling the appointment is part of the equation, albeit an important part. Initial and subsequent physical therapy appointments should occur as soon as possible to jumpstart recovery and quicken return-to-work timeframes. Our data shows that injured workers who start physical therapy within three days of injury require 38 percent fewer physical therapy visits to achieve successful outcomes.2

2. Specialties and Settings - The best physical therapy networks offer access to an array of providers across multiple specialties to ensure injured workers receive individualized care.

In addition, a broad selection of physical therapy settings means injured workers, regardless of their situation, are more likely to keep their recovery on track. Quality networks provide injured workers with access to traditional (brick & mortar) clinics, on-site workplace clinics, and telerehab for their physical therapy needs.  

3. Scoring - Accurate, frequent, data-driven, clinically-based network scoring ensures every network provider is delivering timely, patient-centric care. A thorough scoring process measures the network by critiquing the management of: injured worker engagement; injured worker and provider surveying; credentialing practices; utilization principals to ensure the right provider is selected for each injured worker; and the prompt, appropriate handling of all complaints.

It Takes Two – How Quantity Complements Quality

Quantity equals choice. The more providers to choose from, the more an injured worker will feel their best interest is in mind, thus building trust and improving the chance for overall success.

1. Adequacy – In order to achieve the type of quantity needed for a best-in-class network, the network should attain, and maintain, high adequacy. This is comprised of many factors including the time and distance it takes to get to physical therapy appointments; the ratio of providers to injured workers; and the total number of providers in the network.

2. Serving Rural Communities – While it is often easiest to find physical therapists in cities and suburbs, a best-in-class network will include providers in even the most rural areas of the country. Workplace injuries are not confined to large cities – network providers should not be either. There must be sufficient access throughout the U.S. This means evaluating the number of physical locations, not just therapists, in a physical therapy network.

This is where access to telerehab plays an important role. If getting to a physical location is inconvenient, injured workers with telerehab services built into their network can attend physical therapy appointments from anywhere so long as they have a smartphone and WiFi access.

Conclusion

Utilizing a physical therapy provider network focused on both quality and quantity, we get injured workers back to work sooner. Our injured worker therapy duration is 50 percent shorter than ODG duration. In addition, our network outperforms ODG visit and duration guidelines on 100 percent of the top ICD10 codes.3

As with other areas of healthcare, the same is true of workers’ compensation – the provider network can make all the difference between an injured worker’s success or a recovery path filled with roadblocks and detours. Regardless of your provider network of choice, keeping quality and quantity aspects top-of-mind will undoubtedly lead to the best possible outcomes for injured workers.

By Michelle Despres, PT, CEAS II, CETS, National Product Leader for Physical Therapy, One Call

This article was featured on WorkCompWire as part of their Leaders Speak series.

 


Notes:

1. One Call data for prospective cases scheduled in 2019 in employer directed states.

2. One Call national data. Reflects injured workers who completed physical therapy from Jan 2018-July 2019. Data excludes injured workers who received surgery prior to starting therapy.

3. One Call national data. Median duration and visit utilization for prospective, injured workers who completed therapy from Dec 2018-Nov 2019.

 

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