Patient care is changing in many areas of medicine. Much discussion is taking place about volume vs. value based health care. What is the difference and how does that difference affect physical therapy?
Value based health care focuses on the patient’s needs in designing an appropriate rehabilitation program.
Not every patient will have the same needs or the same number of physical therapy sessions. Some will need less intense physical therapy while others will need more intense therapy. Often, patients need a graduated program that builds in intensity.
The number of sessions varies as do the length of each session and more often than not, can’t be planned at the outset of therapy as it is based on the patient’s progress. In value based care, patient outcomes are the priority.
Volume based care is more focused on what is called “productivity standards”.
The number of patient sessions per day with each session taking from 45 to 60 minutes. Volume based care also demands that each patient needs a certain number of therapy sessions, often 12 to 14. In some clinics, the time to complete attendant paperwork is not a consideration in the productivity standards.
Doing paperwork is considered time spent unproductively. In volume based care, numbers (productiveness) are the priority.
Physical therapy clinics do need to have good numbers in order to meet the financial needs of the facility but it should be balanced with high quality in patient care.
When value in the form of good patient outcomes is offered, the numbers will be there as doctors and hospitals are more likely to refer patients to physical therapy practices with high numbers of good outcomes.
Patients entering physical therapy want to have complete rehabilitation or as close to it as possible.
This is best achieved in value based health care environments that tailor therapy to the patient’s need rather than what a volume based care standard demands.
The majority of physical therapists also want to see good outcomes for patients and prefer to evaluate each patient based on that patient requires for the best outcome.
While a volume based care system might have a higher number of patients per day and more therapy sessions per patient, value based care systems likely have a higher volume of good outcomes. More patients achieving full or nearly full recoveries means more patients being referred as a direct result of the higher volume of positive outcomes.