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Raising the Bar in Rehab

Are We Affordable and Accessible?

Published May 23, 2013 6:16 PM by Lisa Mueller

Those are two powerful words in healthcare today -- "accessible" and "affordable." We (healthcare providers) need to be accessible and affordable to patients in order to provide care, period. Those two words don't even begin to address quality or evidence-based care, but simply allow patients the opportunity to receive care. This concept is more global than just a physical therapy clinic and is probably more of a public service barrier to care, but the idea intrigues me.

The biggest question I have (as always), is how do we measure if we're truly accessible and affordable? Accessibility is a little bit easier to analyze. This is one area where physical therapy has probably seen the most change in the past few years. With the rise in direct access for many physical therapy practices, patients can be seen without a referral, which minimizes the barrier of time to provide care.

Furthermore, I can look at my schedule and see when the next opening is for a patient to be seen. I can look at my messages and emails and see the time it takes to respond. I can look at the space of my clinic and observe the physical accessibility and possible barriers. If I wanted to determine the geographic accessibility of my clinic, I could ask each patient for his zip code or address and plot out the areas with the most demand. Finally, separate parties could be either a barrier or a facilitator for accessibility as various payers may have limitations or recommendations on where patients receive care.

For me, determining if a clinic is accessible is an easier factor to analyze than affordability. When I think of the cost of providing physical therapy to a patient -- including the cost of the facility, equipment and therapist's salary, those things are relatively consistent across all rehab sites. As I'm typing my thoughts out here, this is actually making more sense to me. The combined costs of providing care are paid somehow -- either by the patient's own finances or a third-party payer (insurance). Whether or not physical therapy is affordable isn't based on how payment is received -- but solely on keeping the costs low. That's the definition of affordability, right?

Are there industry standards for affordability and accessibility in physical therapy? I've heard other local clinics define accessibility as a patient being evaluated within 48 hours of calling to set up an appointment. Physical accessibility is fairly consistent with ramps and electric doors to accommodate patients with disabilities. What about affordability? Is it common practice for clinics to calculate their cost per visit? What about the average charges for an evaluation or treatment?

I think the reason these two components of healthcare are important is because they need to be established and somewhat consistent across all providers before we can compare other metrics. Is having better quality care important if the facility isn't affordable for patients? Can we trade excellent outcome measures for a patient waiting weeks for care, and the clinic lacking accessibility? What do you think?

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2 comments

PingBack from http://www.scoop.it/t/ethics-of-physical-therapists-and-athletic-trainers/p/4003149063/are-we-affordable-and-accessible

June 12, 2013 11:04 AM

Lisa, I'm thrilled to see another PT interested in access to care. That is one of the primary concerns of public health. I am reminded of one of my interviews for PT school, back in the 1980's, one Head of Department asked what I thought was the biggest issue in healthcare. I responded, "Accessibility". I suppose that was an omen!

Here is the page from HealthyPeople.Gov which defines accessibility and some of the issues around this topic.

http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=1

Thanks for bringing it up! Dean

Dean Metz May 25, 2013 1:19 PM

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