This event will be held in person at The Whitney and Elizabeth MacMillan Community and Education Center (Allina Health) and live via Microsoft Teams.

Directions and Parking

Schedule

9:00am - 12:00pm Payer Panel Session (2.5 CEUs) *in person only

1:00pm - 3:30pm Education (2.5 CEUs) *In person and online

5.0 CEUs

The morning payer panel includes representatives from our commercial payers including BCBS-MN, Medica, and HealthPartners, with afternoon educational sessions provided by knowledgeable experts on current topics of physical therapy practice.

Event Description

Our experience as providers in the current health delivery system can cloud the vision of the future for physical therapist services in healthcare. The healthcare system is turning towards value-based payment models and it is important to recognize that physical therapy is an integral part of the healthcare ecosystem. We must find a way to succeed with these changes. What is our role in improving the healthcare system and ensuring we are part of the solution? How can we demonstrate our value to patients, payers, other providers, and members of society as the tide is turning? This course brings together representatives from the payer community in Minnesota for a morning payer panel followed by an afternoon educational session.

In the morning session, the payers will share their perspectives on these topics through prepared remarks and a Q&A format. This three-hour session will allow payers to present their material and leave time for questions from attendees. The afternoon education session is designed to discuss key topics impacting quality and payment for physical therapy services. The topics include:

•  Future Payment Models for Physical Therapist Services
•  Future of Technology Use in Physical Therapist Services 
•  The Future of Administrative Burden on Physical Therapist Services 

The afternoon will consist of presentations and interactive discussion, sharing a common theme of showing how proper practice, coding, documentation, and use of virtual care demonstrates the value of physical therapy, currently and in a value-based care environment. The goal is to gain an understanding of the importance of addressing these topics and how they fit together to better manage care delivery and decrease the burden of receiving payment.  

Effective Coding:

•  Selection and documentation of CPT codes to optimally charge for skilled services 
•  “New” CPT codes and codes that seem problematic from a payment perspective
•  Considerations for emerging interventions that don’t have CPT codes

Be Prepared for Documentation Audits:

•  Critical elements:
•  Past medical Hx and impairment and functional limitations to establish baseline information and rationale for physical therapy intervention 
•  Treatment goals and functional outcomes pertinent to the patient’s needs
•  Treatment Plan 
•  Rationale for skilled interventions provided and benefits or lack of benefits from treatment
•  Criteria for discharge 
•  Examples of documentation that meets/falls short of critical elements
•  Peer Review is a proactive resource to PTs- Audits- for objective, no-risk review of documentation

Virtual Care using Remote Therapeutic Monitoring (RTM):

•  Why virtual care and what are the patient benefits
•  A description of and proper documentation for compliance using RTM codes
•  What to expect for cost and revenue from an efficient and effective virtual care platform

The afternoon presentations are an educational follow-up to the morning payer panel session. The afternoon session will help practices, departments, and providers perform compliant documentation and code selection, prepare for audits, and provide virtual care that leverages technology to drive positive patient outcomes. Compliance with payer policy and best practices demonstrates the high standards of the profession, and leads to better patient outcomes, enhancing the physical therapy value proposition.

Learning Objectives

•  Understand code selection with supporting documentation that describes the services provided and demonstrates the rationale and quality of skilled care.
•  Learn about potential payment issues with new and existing codes.
•  Know the critical elements of documentation that demonstrate rationale, treatment and discharge criteria, and quality of care needed to prepare or pass a documentation audit. 
•  Understand why and how virtual care benefits the patient.
•  Understand the use and compliant process for billing RTM codes.

Pricing

In-Person Full Day  9:00 am -3:30 pm (5.0 CEUs) *Includes lunch and ramp parking

Full Day Registration Deadline: Sunday, October 22, 2023 *Registration on or after October 23, 2023, adds $20 to your registration fee.

Virtual Option 1:00 pm - 3:30 pm (2.50 CEUs)

Virtual Option Registration Deadline: Wednesday, Oct 25, 2023

Speaker Biographies

 Craig Johnson, PT, MBA
 Craig Johnson is a Physical Therapist and Healthcare Consultant focusing on value-based care and contracting. He has over 40 years of   experience in clinical care, practice ownership, and management in independent therapy practices. His professional degrees include a   Physical Therapy degree from the University of Minnesota, in 1979, and an MBA from the University of St. Thomas, 2000. Recently, he was   the Chief Operating Officer of Therapy Partners, a network of PT owned practices in Minnesota and western Wisconsin. Craig has led pilots   by other networks of independent PT practices across the country in the capture and utilization of patient outcomes as a foundation for   value-based contracts. He previously served as APTA-Minnesota President 2010-2016 and is a member of the APTA-MN Payment Committee. Craig also served on the APTA-Private Practice Board from 2016-2022 and led the workgroup that engaged and guided Millman & Associates. in producing a white paper on “The Impact of Physical Therapist Services on Low Back Pain”, and also led the initiative on Direct to Employer services. He currently serves on the Board of the American Physical Therapy Association. 

Lori Froehling, PT, MS
Lori is the Director of Therapy Operations at Courage Kenny Rehabilitation Institute, Part of Allina Health. In this role, she supports the clinical, operational, and strategic functions for over 50 multidisciplinary therapy departments in Minnesota and western Wisconsin providing acute care, inpatient rehabilitation units, and outpatient services. Accountabilities include oversight of quality, regulatory, compliance, and outcome measures as a function of value as well as the impact to payer contracts and reimbursement. She received her physical therapy degree from the Mayo School of Health Related Science in 1987 and her Master's degree in Human Performance and biomechanics from the University of Wisconsin-LaCrosse in 1995. Her clinical areas of specialty include spine, pelvic health, and cancer rehabilitation. Lori has been a member of APTA since 1985 and currently serves as the co-chair of the APTA MN Payment Committee and represents APTA MN on the SecureCare Clinical Review Committee. She is also a member of AMRPA IPRU and OP Committees.

 Jenny Wiltse
 Medica
 Jenny is currently the Director of Provider Network Contracting at Medica and has been in the Network Management department since   2017. Jenny has 30+ years of health care experience including payor and provider involvement.  In addition to working for Medica, Jenny   has worked for HealthPartners and Optum on the payor side and on the provider side, Jenny spent 10 years with Fairview working in   Accounting and Revenue Management and started her healthcare career as an office manager in a dental office. Jenny enjoys camping and   fishing (both open water and ice), craft shows, football and any time spent with family.  When she can’t get outside, she enjoys watching true crime shows and playing with her two new kittens.    

 Neil Wahlstrom, MBA, FACHE, PT 
 Medica
 Neil joined Medica in 2019 and serves as the Director for Clinical Strategic Initiatives. Neil has been a licensed physical therapist for 26   years, having practiced in multiple settings including hospital, OP, group private practice, and acute care—primarily focused on orthopedics.   Beyond working as a clinician, Neil has been a leader for multi-specialty physician practices and the post-acute care continuum. As an   internal consultant for Providence Health on the west coast, he guided revenue expansion, cost containment, and process improvement in   medical centers and out-patient services. Before joining Medica, he was the Executive Director for Home Health Services for Providence in   Eastern Washington. His background as a clinician combined with financial acumen and Lean Six Sigma drive a desire for the right care, at the right time, in the right place, at the right price. Neil enjoys being active, from fishing to barefoot water skiing, biking to weight lifting. He is a Fellow in the American College of Healthcare Executives, active in his church and enjoys time with family.  He likes all things Big 10 and NFC North and is easily distracted by Minnesota High School hockey. 

 Rebecca Harden 
 Blue Cross Blue Shield of Minnesota
 Rebecca Harden is a Provider Relations Business and Vendor Manager at Blue Cross and Blue Shield of Minnesota. She joined the   organization in 2000 and is responsible for the oversight of network vendor relationships and vendor impact on provider relations. In her   role, she participates in the development of strategy and innovative network solutions that impact Provider Relations and applicable     market/business segments. This includes developing and maintaining effective relationships with vendors for ongoing oversight and   management of their contractual requirements.

 Shaun Frost, MD, MHM, FACP
 Health Partners
 Dr. Frost is currently the Associate Medical Director for Care Delivery Systems at HealthPartners Health Plan in Minneapolis, Minnesota. In   this role he works on designing, deploying, and managing innovative payment methodologies and provider network configurations focused   on improving population health, patient experience, and care affordability. He is also a Clinical Associate Professor of Medicine at the   University of Minnesota Medical School, and he cares for patients as a hospitalist at Regions Hospital in St Paul, Minnesota. Dr. Frost has   previous health care delivery leadership experience, having served as the President of the Society of Hospital Medicine, Northeast Region Chief Medical Officer for Cogent Healthcare (now Sound Physicians), and Director of Non-teaching Inpatient Services at the Cleveland Clinic Foundation. In 2021 he was recognized by the Society of Hospital Medicine as a “Master of Hospital Medicine”, one of only 33 hospitalists to have been bestowed this designation since it was first awarded in 2010.

 Tasha Nembhard
 HealthPartners
 Tasha Nembhard is a Contract Manager in Provider Relation & Network Management with HealthPartners in Minneapolis, Minnesota. She   has worked with HealthPartners for over 12 years; starting in Member Services, helping members on understanding their benefits, network,   and claims.  During her time in Provider Relation & Network Management, Tasha manages the Physical Therapy, Occupational Therapy &   Speech Therapy network along with other specialties like Allergy and Pain Medicine, as well as local and regional Care Systems in   Minnesota and surrounding states. Tasha values doing work that support our communities; she helps support different quality initiatives and gender affirming care providers for the organization.
 
 Kathleen Picard PT, DPT
 Dr. Picard is the APTA-appointed advisor to the AMA’s CPT Editorial process and serves in policy advisory roles to Medicare, MN Medicaid,   and other commercial payers. Her long career in clinical practice includes over 25 years of practice management experience in an   independently owned multi-site physical therapist practice. Kathleen is the founder and owner of a health policy and practice management   consulting firm and is an associated faculty member in the division of Physical Therapy at the University of Minnesota. She currently co-c   chairs APTA MN’s State Government Affairs Committee.

 Jeff Vrudny, PT, MBA
 Jeff Vrudny is a Director of Rehabilitation with M Health Fairview Rehabilitation Services. He is currently responsible for the management of   7 clinic locations that provide physical therapy and hand therapy services. Jeff previously was a Director of Rehabilitation with the Institute   for Athletic Medicine. In that role, he had responsibility for regulatory compliance, coding, and billing, preauthorization, scheduling and   registration, medical records and had partial responsibility for the electronic medical record. Jeff has over 25 years of experience in   healthcare delivery working as a clinician and in management. Jeff obtained his MBA in 2011 and obtained his Master of Physical Therapy   degree in 1998 from the College of St Catherine. Jeff has participated in the Payer Advocacy Workgroup with APTA MN since 2019.

 David A Thoreson BS, PT
 Dave received his bachelor of science degree in physical therapy from the University of Minnesota in 1975. He is now semi-retired, but   stays involved in Physical Therapy, serving as APTA Minnesota Peer Review Quality of Practice Coordinator overseeing and providing peer   review services. He has served as a peer reviewer for APTA Minnesota since 1986, overseeing and completed hundreds of documentation   audits and consulting with many physical therapists and payers regarding documentation. in addition, he offers consultation services in   injury prevention and treatment, and medical legal.Dave has been a long standing-member of the American Physical Therapy Association.   His involvement in the Minnesota Chapter included: President, Treasurer, Board of Directors; Program Committee,   Reimbursement/Payment Committee, Governmental Affairs, and Public Relations. He has also served as the liaison to the Minnesota State   Workers Compensation Medical Services Review Board and Reimbursement Committee for the Private Practice Section. Dave enjoys spending time with his wife of 52 years, two children and five grandchildren. Hobbies include entertaining or being entertained by grandchildren, bicycling, spectator sports, hiking, home projects, yard work, and vacationing on the North Shore.

 Steven Coen
 CEO/Cofounder, SaRA Health
 Steven, driven by personal injury and opioid dependence experiences, is the CEO/Co Founder of SaRA Health which he started because   while he loved the amazing care he received in the clinic he was frustrated by the lack of continuity between visits. Previous Founder   (MyRiBiT.com), built self-insured employer offering at Medtronic Diabetes, Analyst to Manager at Deloitte Consulting (built Smart Factory @   Wichita and D-ICE business), and Startup Builder at High Alpha Innovation. Education in Finance and Entrepreneurship at Kansas State for undergrad and MBA at UCLA Anderson.