Home Health & Hospice Week

Part B therapy providers should check out these recommended measurement systems.

If you're furnishing outpatient therapy under Part B, you'd better get friendly with some new patient outcome tools or fall behind the pack.

The Centers for Medicare & Medicaid Services recommended four therapy outcomes tools in Transmittal 63 released Dec. 29, 2006. CMS named the Activity Measure-Post Acute Care (AM-PAC) tool developed by the Boston University Health and Disability Research Institute, Focus on Therapeutic Outcomes Inc.'s FOTO Patient Inquiry, the American Speech-Language Hearing Association's National Outcomes Measurement System (NOMS), and the American Physical Therapy Association's Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL) as recommended ways to measure your patients' progress.

Important: CMS doesn't require you to use any of these tools, but you should check them out. They could turn out to be your best benchmarking friend--and you might need them down the road if CMS does decide to require them.

Here are the details on two of the four therapy outcome tools. (Look for information on the remaining two therapy outcome tools in next week's issue of Eli's Home Care Week.)

AM-PAC Has Home Health Slant

Who it's for: Home care providers may be most interested in AM-PAC, which is best suited for the post-acute care patient. That includes home health, outpatient therapy, inpatient rehabilitation and skilled nursing settings that treat post-acute patients, clarifies Alan Jette, director of the Boston University Health and Disability Research Institute.

How it works: AM-PAC includes a comprehensive list of 240 functional activities that examine daily tasks an average adult would encounter. The instrument then organizes the tasks into three scales: basic mobility, daily activity and applied cognition. "AM-PAC can be completed by the patient or the therapist, but it usually depends on the setting and the patient's cognitive status," Jette says. A facility may also choose between a paper-based AM-PAC and a freestanding Web-based Computer Adaptive Test (CAT).

Extra: CMS has mentioned AM-PAC in a report on the development of a Uniform Patient Assess-ment for Post-Acute Care and notes that companies such as Merck, HealthSouth, Kaiser Permanente of Northern California and SeniorMetrix use AM-PAC for its functional domains. For more information on AM-PAC, visit www.crecare.com/ampac.html.

Cost: Your facility can obtain a license for the paper-based form at $250, while the CAT version of AM-PAC is $600.

Get Benchmarking-Serious With FOTO

Who it's for: Mostly physical therapists turn to FOTO's Patient Inquiry because of its strong musculoskeletal focus, according to experts. But FOTO can also extend to occupational therapy and speech-language pathology because it addresses some neurological function, clarifies therapist Al Amato, president of Focus On Therapeutic Outcomes Inc. As far as rehab settings best suited for using FOTO, Amato says that users span the entire continuum of care, including outpatient and inpatient settings.

How it works: FOTO is a questionnaire the patient--not the therapist--completes via an intuitive software program whose questions change based on the patients' input to compute a classification score. The patient completes the questionnaire at admission and discharge or at other intervals if the therapist sees a need.

Extra: If you want to benchmark your outcomes, FOTO links and compares your patient data to other rehab facilities nationwide that use FOTO. That's a database more than 14 years old and approaching 2 million cases, Amato says.

"The FOTO data is great evidence for us as a company when we speak with insurance companies," says Mitchel Kaye, director of quality assurance for PTPN, an independent physical therapy network that uses FOTO. "And each practice can get reports specific to body part, condition, referral, insurance company or by therapist in their office," Kaye elaborates. PTPN also enjoys the option to add additional screens to the tool.

Cost: Your facility or practice would pay an annual $450 fee for FOTO and then pay a usage fee of $1.50 per patient billed monthly, Amato explains. You can find out more about FOTO at www.fotoinc.com.

Note: The transmittal with the recommendations is online at www.cms.hhs.gov/transmittals/downloads/R63BP.pdf.  For more information on outpatient Part B therapy, see Eli's Rehab Report at www.elihealthcare.com/spec_rehab_report.htm or by calling 1-800-874-9180.