Outcome for rehabilitation providers is a strategy: more than just a scorecard

Honestly, “result” is not a new word in healthcare. We've been talking about them for decades. But what changed is that we are finally in a moment where results are not only aspirations. They are required. How they judge, fund and increasingly choose the way care is taken.

That's not a bad thing. It's a challenge, but it's also a challenge for those who do the work from all angles: clinical care, operations, technology and policy. And now, as CMS makes the U.S. healthy weight again through its new framework, we have the motivation, clarity and guidance we need for a long time.

Not only is this a new federal talk point, it also provides the healthcare industry with an ongoing and even more emphasis on the information to sit down at the table to prove your worth.

Prevention is key, but it must be measurable

In the recent update of CMS strategy, they once again keep the U.S. healthy, they said it focuses on three main pillars:

• Promote evidence-based prevention
• Empower people to achieve healthy goals
• Promote people's choices and competition

Among these three pillars, CMS highlights that evidence-based prevention is probably the most natural prevention for treatment providers we have been in the prevention business, whether it is to reduce risks, grow functional liquidity, stabilize chronic diseases, or help people avoid surgery altogether. This is the core of our work.

But for a long time, this work has lived in the patient’s story and clinician’s instincts, not highlighted in data analytics, dashboards, or as a key driver in therapeutic business models. This has to change. Calculate only when captured and counted.

There are many tools: Promis, Foto, QuickDash, Lefs (select your abbreviation). Most importantly, we start using these tools consistently, not just because the CMS wants us to do it, not because payment needs (e.g., MIPS), but because they help us understand and improve what we actually do. I've seen first-hand how this data unlocks funds, builds trust with payers, and strengthens the care model from the inside out.

More importantly, I have seen that this can actually help make better clinical care decisions that will in turn help thousands of patients get better care, faster and better than ever before.

Why results should drive your strategy

One of the most common mistakes I see providers make is to treat the results as compliance tasks. Yes, CMS wants data. Yes, there are performance thresholds. However, reducing the result to the checkbox completely ignores this.

When used correctly, the outcome data can help identify high-performance clinicians, improve care plans, reduce unnecessary utilization and improve patient engagement. It can also help leaders make smarter decisions about staffing, business investment, clinical training needs, technology adoption and even scaling strategies.

If you are doing business in the healthcare sector, rather than mining result data to guide operational decisions, you will leave real value on the table.

The ability to empower patients begins with transparency

Patients are no longer passive nursing recipients. They are consumers, partners, and more and more decision makers. They want to see evidence and actual results.

If we don’t share data with them, we will not be able to empower patients. I don't just mean emission notes or functional improvement scores that reside in EHR records. I mean meaningful, easy to understand and personalized information that can connect what patients do, how they progress and what they mean for their future functions and quality of life.

We have a real opportunity here: to educate, motivate and activate patients using the same outcome data we collect for CMS. This is not more work. Better make use of the work we are already doing.

Operationally, we must expect from ourselves

This moment involves not only CMS compliance on a long and arduous road to following the latest regulations. This is about clinical maturity. If our organizations take quality care seriously, then the measurement must be non-negotiable, not only at the organizational level, but also to individual providers.

I don’t just say it’s someone who works in nursing services and then ends up in management and operations. When we don’t invest in this goal, I’ve seen what happens to our industry in general. We are plateau, satisfied with the work we consider to be based on our own biases. Ultimately, this can lead to rehabilitation professionals falling behind and losing the value of continuity of care – especially since the gains achieved are not immediate (rather than medications that may have direct effects, but may also have long-term unknown consequences). Both the payer and the patient want to work with providers who can demonstrate effectiveness. That's just reality. But the reality is also true, we need to continue to expect more and continue to move towards better and more efficient care. Continue to heal in unprecedented ways.

Good news? Everything gets better when the results are captured correctly and action is taken meaningfully: clinician confidence, patient engagement, financial performance and most importantly in clinical outcomes.

Bottom line

We have crossed the line from “should” to “must”. Outcomes are no longer good or post-fact reasons for providing care. In the system, they move to accountability faster than ever.

This is the time to recalibrate. Because if we can combine patient-centered clinical insights, operational knowledge, and patient-centered focus with strong realistic outcome data, we will not only prove our value. We will reshape how value is defined.

Image source: Olga Strelnikova, Getty Images

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