PTPN`s Outcomes Program is first to measure efficiency for true P4P.

Measuring REAL Provider Performance
PTPN’s Outcomes Program is First to Measure Efficiency for True P4P
If you were the judge at a cooking competition, who
would get the prize: the chef who did the best job
following the recipe, or the one who made the most
delicious meal?
With outcomes, as with cooking, the proof is in the
pudding. As a payer battling soaring medical costs,
you want the providers who are the most efficient at
getting patients better.
Yet, surprisingly, the first pay-for-performance
programs have focused on measuring how well
clinicians follow the steps that are supposed to produce
good outcomes. Medicare, for instance, pays healthcare
providers merely for reporting measures, not for the
actual achievement of quality outcomes.
Other programs have found that achieving processdriven quality measures does not necessarily reduce
costs. For example, seven plans in California paid
physician groups a total of $65 million, according to
the Integrated Healthcare Association (IHA).1 But
because those P4P programs haven’t saved any money
yet, the IHA is devising efficiency measures that
include resource use.2
Efficiency is the key performance measure
The lesson for payers is: Before you invest your scarce
resources in providers, make sure you have a reliable
yardstick to measure provider performance. The more
effective and efficient the provider, the lower your
overall costs will be.
First outcomes program for rehab measures
true results
Rehabilitation therapists are a critical group of
healthcare providers whose efficiency can significantly
impact both your members’ health and your bottom
line. These professionals help patients recover from the
three most costly healthcare ailments – heart conditions,
trauma disorders, and cancer – as well as such illnesses
and injuries as osteoporosis and back problems,
conditions that drive up costs and sap productivity.3
The PTPN Outcomes Program, powered by FOTO,4
now offers the first outcomes measurement system
for rehabilitation that lets you measure and recognize
the providers who are the most efficient in delivering
superior outcomes. This program:
• Predicts at initial evaluation the number of
expected visits needed for a patient with a
particular problem and particular medical history.
• Produces a provider efficiency score based
on the number of visits a patient had combined
with the improvement in function over the
course of treatment.
• Compares providers to their peers on a
national level.
• Measures patient satisfaction.
PTPN Outcomes
Program compares
providers
to national
benchmarks for:
• Effectiveness
• Efficiency
• Patient
satisfaction
Does actual
performance
significantly surpass
national norms?
YES
Therapist
receives incentive
NO
No incentive paid
With the PTPN Outcomes Program, you know
which therapists produce superior outcomes for your
members. You can use this data to identify and reward
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PTPN is the nation’s first
and largest network of
independent rehabilitation
practitioners. For more
insights, please visit
ptpn.com and click on
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In This Issue:
Measuring REAL Provider Performance
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From PTPN, the rehabilitation and
workforce productivity experts
the offices and the networks that actually deliver on
the promise of outstanding quality care.
Rewarding real success: How it works
Each quarter, the PTPN Outcomes Program compares
providers’ performance to national norms for treatment
effectiveness, efficiency and patient satisfaction.
If an office’s quarterly scores for a payer’s patients
is statistically better than the national norm (in other
words, significantly above average), the office receives
an incentive. If results are not significantly better than
the norm, no incentive would be paid.
PTPN’s program truly delivers on the promise of
outcomes measurement and pay-for-performance.
You will:
• Improve quality of patient care.
• Reduce your overall costs in the long run.
• Know that the therapists in your network are the
most efficient.
• Reward the best therapists.
To schedule a demo of the PTPN Outcomes Program
and learn how it can help your bottom line, contact Lisa
Burroughs at lburroughs@ptpn.com or 800-766-PTPN.
1 “California Health Plans Pay $65 Million to Improve Performance in Patient Care,” Integrated Health Care
Association (IHA), February 27, 2008
2 Terry, K., “Is P4P Getting Tougher?” Medical Economics, July 20, 2007.
3 “Big Money: Cost of 10 Most Expensive Health Conditions Near $500 Billion,” AHRQ News and
Numbers, Jan.23, 2008.
4 FOTO is the oldest and largest outcomes reporting service in the United States, with an active comparative
database of more than 2 million cases in just the last two years. Backed by the magnitude of its standardized
database, FOTO produces the most accurate and validated results.
This information is provided by PTPN, the nation’s first
and largest outpatient rehabilitation network. All PTPN
providers must be independent practitioners who own their
own practices. PTPN’s network includes more than 1,200
therapist offices throughout the United States. PTPN is the
first national therapy network to mandate an independent
outcomes measurement program.
WITH NETWORKS IN:
Arizona • California • Colorado • Florida • Georgia • Louisiana
Maine • Maryland • Massachusetts • Michigan • Mississippi • Missouri
New Hampshire • New Jersey • New York • Ohio • Oklahoma • Pennsylvania
Rhode Island • Tennessee • Texas • Vermont • West Virginia
COPYRIGHT © 2008 PTPN
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