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Therapy in 2022! A Three Part Q&A Series with Hilary Forman, Chief Clinical Strategies Officer (Part 1)

Hilary Forman, Chief Clinical Strategies Officer, weighs in on how therapy has changed since COVID.

Q: Before we address therapy in 2022, please share any thoughts from last week’s NIC meeting in D.C.; what are owners and operators talking about related to therapy services, etc.? 

Hilary: The Fall NIC meeting was terrific! The senior housing market is optimistic about the future. I had several conversations with management teams about teeing up new payer arrangements, addressing the middle market, and planning for the differences between current residents versus future residents. For example, operators want to assure the viability of the active adult model by fortifying wellness and lifestyle choices, but also acknowledge the continued shift towards an integrated medical model and how opportunity exists for senior living communities to be an important part of their care continuum. To that end, many of the operators we talked with are interested in ancillary care providers that offer more than ‘just therapy.’ After all, rehab companies that focus only on driving therapy utilization are likely not touching the lives of all residents on their campus. Specifically, wellness, occupancy support, strategy consulting, risk management and staffing support represent additional value, help offset costs, and support overall enterprise-wide success. When it comes to partnering with ancillary providers, owners and operators are asking, "What's in it for me?"

Q: Let's discuss therapy services in 2022. Can you offer an example of how therapists have changed since the pandemic? 

Hilary: The pandemic served to shine a light on skillset and resource gaps as well as a need to better manage the pressure of stressful care settings. For example, COVID conditions required therapists to quickly assess risk and emergent changes in patients’ acuity level. These changes have been a challenge for some therapists and may, indeed, explain why many have exited the field. The better news is today’s therapists have embraced new practice patterns that prioritize the need for efficient risk assessments and care delivery models. For example, HealthPRO Heritage therapists leverage technology (such as telehealth) and rely on evidence-based clinical care pathways. 

Q: Speaking of outcomes, have you observed changes in therapy outcomes since COVID?

Hilary: Interestingly, our clinical outcomes as a company have remained the same or improved compared to outcomes tracked and measured since before the pandemic. Our performance metrics (shared here) tell the story.

Q: That’s surprising! What do you attribute these net positive results?

Hilary: Our outcomes are a testament that we have remained consistent on delivering quality programming despite COVID-related challenges and PDPM.  Recall that PDPM took away any prescriptive guidance as to the amount of therapy patients receive.  Our approach may be very different than CMS’ therapy minute delivery reports that suggest some rehabilitation providers have dramatically reduced the amount of therapy minutes in favor of their own business interests.  Instead, we empower our therapists to 'work at the top of their license' to make clinical decisions on behalf of their patient's best interests.  We continue to leverage our therapists' individual strengths; encourage them to serve as truly integrated members of the IDT; and we provide access to limitless resources and education to assure their success.

 Q: How can therapists leverage tech innovation to make the provision of care better and more meaningful?

Hilary: Technology is here to stay! HealthPRO Heritage is an advocate for embracing tech solutions, and we help our clients by objectively evaluating which problems need to be addressed and determining a viable technology solution that assures efficient care delivery and/or positive outcomes. This process requires a willingness to be humble, admit where gaps exist, and to make changes. Specifically, tech must be able to:

·    Enhance care

·    Help to identify risk

·    Assure compliance and/or

·    Address staffing shortages.  

Consider the most obvious challenge related to investing in technology. The speed with which things change in healthcare is rapid! Resident and patient populations can significantly flux, and corporate initiatives and goals change, too. There’s an inherent risk in investing in technology that can become irrelevant, antiquated, or ineffective over time. We must be selective, objective, and realistic about committing to technology since our choices will continuously need to be revisited, evaluated, updated, advanced, or changed.

 Our company has been intentional about vetting and partnering with various tech solutions (rather than selectively embracing only one or two companies like other rehab companies have done) because every client and their needs are unique. Our approach has been to understand the landscape of possibilities and make recommendations based on client and resident needs, budgets, and desired outcomes.   

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To Be Continued!

Check back for Part Two of our Three-Part interview with Hilary in the weeks to come!