ASHA News: Prove Your Services' Value to Thrive, Leaders Advise As health care service delivery shifts toward a value-based model, speakers at Health Care/Business Institute 2013 strategized on keeping pace. by Matthew Cutter A crowd of clinicians drifted from a session on looming changes in health care, and Caroline Ahmon lingered, hoping to ask presenter Ann Kummer a few questions. ... ASHA News
ASHA News  |   June 01, 2013
ASHA News: Prove Your Services' Value to Thrive, Leaders Advise
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ASHA News & Member Stories / ASHA News
ASHA News   |   June 01, 2013
ASHA News: Prove Your Services' Value to Thrive, Leaders Advise
The ASHA Leader, June 2013, Vol. 18, 60-61. doi:10.1044/leader.AN1.18062013.61
The ASHA Leader, June 2013, Vol. 18, 60-61. doi:10.1044/leader.AN1.18062013.61
As health care service delivery shifts toward a value-based model, speakers at Health Care/Business Institute 2013 strategized on keeping pace.
by Matthew Cutter
A crowd of clinicians drifted from a session on looming changes in health care, and Caroline Ahmon lingered, hoping to ask presenter Ann Kummer a few questions. But her question wasn't about the future because at the Weisman Children's Rehabilitation Hospital in Marleton, N.J., change has already arrived.
"We have been experiencing denials for treatment, based on our evaluation reports," Ahmon said. "Insurers are scrutinizing our progress evaluations for additional authorizations after the first sessions of therapy were approved. They're looking for marked progress—if not the achievement of the goals we set, then marked progress toward them." Ahmon and her colleagues are not alone.
More than 400 professionals gathered in Orlando, Fla., April 27–28 for ASHA's 2013 Health Care/Business Institute. The conference underlined—in addition to tracks focused on adult neurogenic disorders, swallowing and pediatric issues—speech-language pathologists' most pressing needs amid sweeping changes in service provision. Most pressing is the need to prove the value of speech-language services.
Speaker Paul Rao—vice president for clinical services, quality and compliance at the National Rehabilitation Hospital in Washington, D.C.—offered a solution. SLPs need to practice "at the top of the license"—providing services that require their specific skills and expertise—and allow treatment partners (family members or assistants, for example) to perform other tasks.
In her session, Kummer expanded on that idea by noting the importance of teaching new skills to families, rather than "practicing" with patients again and again. Repetition "needs to be done at home," she said. "That will reduce the cost per patient of treatment and allow us to be able to see even more patients, and provide more care."
Rao agreed, saying, "I think we need to use families. In the adult sphere, for example, we use peer mentorship—folks with aphasia who work with patients. I think that's a very important element. Partnership is the thing we need to stress."
And partnership isn't merely a way to show value; according to Kummer, it may also improve outcomes. "Speech therapy is like taking piano lessons," she explained. "If you just go for the therapy and you don't practice at home, you never develop the automaticity of those motor movements." Language treatment, she said, is no different. "You can be taught all about verb conjugation, but unless you actually use it and practice it every day, you never learn another language. The work at home is really important."
Dee Adams Nikjeh, co-chair of ASHA's Health Care Economics Committee, offered improved documentation as another way SLPs can demonstrate value. "Our documentation needs to be able to show functional improvement that matters to the patient—not to the clinician, but to the patient."
And Nikjeh was quick to point out that even if changes in health care provision haven't yet appeared, they are on the way. "Changes are coming, whether we like it or not, and we need to see these changes as opportunities to improve what we do, and how we do things, and to be accountable. It may trickle down—you may not feel it immediately—but eventually you're going to feel it in your paycheck. When you feel it in your paycheck, you're going to know a change is happening."
But despite the fact that change often involves pain, Kummer believes the gains will be worthwhile. "I think this a great opportunity for the field of speech-language pathology, because it will allow us to work to the level of our licensure and provide only skilled work," rather than repetition and practice that can be done outside the session, she said.
Nikjeh agreed, "I think the objective is good, the rationale behind what is being done to save health care dollars is good, and I think it has been thought out—to a point." But, she said, "there's always going to be a way to game the system, and that is what hurts all of us, in the end. I think it comes down to integrity among service providers.
"We can try to stay ahead of the game, and educate our members, so this does not come as a surprise," Nikjeh continued, "but rather as an opportunity to make changes—changes that we have control of."
Caroline Ahmon and Weisman Rehabilitation Hospital staff members are ready to meet the changes head on. "It's evolution," Ahmon said, "and we're trying to keep up with it and educate our families. That's been a challenge for us—to understand it and then relay it in a parent-friendly way to our families, how it affects their child's therapy. Before, we could just treat from womb to tomb."
Ruth Battiato, owner of Diverse Speech Therapy Solutions LLC in San Antonio, Texas, agreed that education is key. "That's why I came to this conference: to learn more about all the new changes coming about," she said. "Now I know what to look for, what to predict, and how to make changes within our own setting to accommodate the changes that are coming."
Find more Health Care 2013 coverage on ASHAsphere. For more information about upcoming ASHA conferences, visit our Events website.
Matthew Cutter is a writer and editor for The ASHA Leader.
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June 2013
Volume 18, Issue 6