Physical Therapist Referrals: 4 Metrics to Consider

One of the most exciting things about health reform is the transformation of fragmented provider silos into a connected care continuum.

Whether in accountable care organizations or other coordinated health networks, the most impactful health reform initiatives cut unnecessary costs by coordinating care amongst providers along the continuum.

Amidst this renewed effort to end fragmented care, one type of provider has become particularly indispensable: the physical therapist.

Physical therapists provide crucial alternatives to more expensive interventions. They are experts in prevention-minded and non-invasive treatment. And they are responsible for a bulk of post-acute care services for many orthopedic conditions. They also help avert unnecessary readmissions - a hallmark of value-based purchasing.

Despite knowing the value of physical therapy, many physicians report that referring patients to physical therapy feels like entering a black hole. They say they are sometimes uncertain if their referred patient is on track, despite the fact they will be held accountable for negative therapy outcomes.

Clinical technique is not the only thing that helps patients get better in physical therapy. Patient management is also critical. Therapists must effectively manage patients until the completion of treatment. This requires them to sell the value of treatment and prevent patient drop out.

How can you tell if the therapist to whom you refer has good patient management skills?

Here are four overlooked quantitative clues revealing how effective a physical therapist is in delivering quality care. Before you make a referral, ask the physical therapist to show you these numbers:

1. Their conversion rate

This is a measurement of how good a physical therapist is at getting referrals scheduled for a patient's first visit. Many factors determine why referrals fail to convert, from the patient’s impression of the first interaction with a physical therapist practice to the patient's copay amount. It’s important to refer to a practice that knows how to handle common objections and convince patients about the value of physical therapy. A good benchmark is to have 90 percent of referrals converted to first appointments within one week.

2. Their average scheduled frequency

One thing I’ve learned is that the best physical therapists schedule ahead. They are the ones selling the value of regular attendance and finding out why patients drop out of therapy. These practice owners and therapists connect patient experience with the completion of therapy treatment.

3. Their cancellation/no-show percentage

Similar to how well physical therapists schedule ahead, their no shows and cancellation metrics indicate their ability to effectively deliver a quality care experience. This is a measure of how good a physical therapist is at getting patients to show up for their visits. A very health practice will average less than 10 percent no shows and cancellations.

4.  Their average visits per discharged case

This is a rearview measure that tracks every referral until the course of care is completed. This measure is important because it lets you know how long that physical therapist takes to achieve a positive outcome and at what cost. The average number of visits per discharged case is eight visits to 10 visits, but depends heavily on the classification of the patient.

Not every physical therapist is the same and should not be treated as such. There is no guarantee that the physical therapist you refer to will be a perfect fit.

However, by asking the right questions, you can maximize the chances of referring your patient into a positive therapy outcome. And as the stakes get higher in a bundled-payment environment, successful physical therapy referrals are more important than ever.

Jerry Hendersonhas been a physical therapist for over 25 years. He is currently the chief therapist advising Clinicient, and was President of PhysioCare Corp., which provides management and financial services for independent physical therapy clinics. Prior to PhysioCare, Jerry founded Physical Therapy Clinics, Inc. (PTCI), a multi-clinic physical therapy operation. In 1995, he cofounded PT Link Corporation, which developed physical therapy documentation software. PT Link was acquired by The Pathways Group. In 1993, Jerry cofounded the Independent Private Practice Physical Therapy Association, a nonprofit corporation to organize independent physical therapists for local legislative action. Jerry has a BS in Physical Therapy from the University of Utah.