How one practice's EHR helped offset its declining Medicare reimbursements
Photo: Simon Hargus
First Settlement Physical Therapy is a family-owned and operated provider of orthopedic outpatient physical therapy services. Established in 1999 as a single clinic in Marietta, Georgia, it has grown to 37 clinics with roughly 200 employees, delivering a wide array of therapy and rehab services to patients in both suburban and rural communities across the Mid-Ohio Valley.
Physical therapy and rehabilitation practices rely on software to enable scheduling, billing and other critical business-related functions. When First Settlement went looking for IT tools, staff found the digital platforms on the market lacked the ability to scale as a practice adds patients, therapists and services.
“The inability to scale our business meant we might not be able to capitalize on the overall growth expected for the physical therapy industry,” said Simon Hargus, owner and CEO of First Settlement. “Fortune Business Insights predicts the U.S. occupational and physical therapy services market will grow to $73 billion in 2029 from $50 billion in 2022. This growth is being fueled by an aging population and increases in both chronic conditions and sports-related injuries.
“As an organization that delivers care to both suburban and rural communities, we needed a digital solution that would not only maintain our quality of care, but facilitate growth and further our opportunities for success,” he continued. “We had experienced exponential organic growth in recent years, and naturally along with it came growing pains.”
Addressing challenges in billing and revenue cycle management was one of the group’s first priorities. It needed software that could handle authorization processes. It had been losing money by not being able to manage its medical billing needs, and the entire process had become costly and inefficient.
“We also realized we needed to level up our marketing and patient engagement strategy,” Hargus noted. “Our marketing team needed more opportunities for outreach and engagement and required a software platform that could support a sales funnel. While there is third-party lead gen software that can do this, we wanted an all-in-one, comprehensive solution.”
There is a wide variety of electronic health record vendors on the market today, including Allscripts, athenahealth, Cerner, eClinicalWorks, Epic, Greenway Health, Medicomp Systems, Meditech, Medsphere Systems and NextGen Healthcare.
MEETING THE CHALLENGE
First Settlement implemented Raintree’s all-in-one electronic health record system. It includes a set of business intelligence tools that provides remote access capability – critical for a practice with so many clinic sites across a region.
“The EHR platform includes automated patient engagement tools that allow us to further market our clinics to medically underserved areas,” Hargus explained. “These tools help us to keep up with internal and external campaigning efforts. It is now easier for us to attract and retain new patients using lead tracking tools and the ability to monitor patient trends.
“Front-desk automation, such as scheduling technology, has given our office staff the opportunity to cover more responsibilities and save resources,” he continued. “On the billing side, an automated claims appeal system that ties certain codes to troublesome claims has translated directly into money and time saved.”
The EHR platform comes with artificial intelligence business intelligence tools that save therapists time by quickly analyzing a patient’s medical history, current symptoms and other relevant information to make an accurate diagnosis, he added. AI is used to monitor a patient’s progress, adjust treatment plans as needed, and even alert therapists to take preventive action against potential complications.
By streamlining and optimizing existing processes, First Settlement has been able to nurture organic growth.
“Automating complex workflows across medical billing, marketing efforts and regulatory reporting – such as Medicare’s Merit-based Incentive Payment System – enables us to refocus time and resources on delivering quality care to patients,” Hargus reported. “The resulting organic growth has more than offset declining reimbursements for Medicare beneficiaries.
“Not only can these technologies help alleviate pain faster, they also reduce the amount of time a patient needs to spend in physical therapy, allowing our therapists to see more patients without sacrificing the quality of treatment,” he added.
Another feature that has proven useful is the EHR’s ability to separate student metrics from employee metrics so staff can easily balance student opportunities with ongoing efforts to deliver quality care.
“Physical therapy and rehab practices like ours are under pressure to grow with the market or risk falling behind competitors, even as we struggle with staffing challenges and reductions in reimbursements,” Hargus said. “We rely on advanced technologies such as AI and automation to ensure we have the tools to scale our business while maintaining high levels of patient satisfaction and engagement.”
ADVICE FOR OTHERS
“Plan for growth by choosing a solution that is extremely scalable and easy to transition to, especially for your therapists,” Hargus concluded. “There is a learning curve, yes, but it should only take hours, not weeks.”
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