As mentioned previously, a unique aspect of physical therapy is that we can treat people at all stages of their health. Last time, we looked at acute care, but more people are going to other facilities before going home. Rehabilitation is the focus for these patients, and we can have a huge impact on somebody’s life by being able to get them moving well enough to get discharged from the facility.
The inpatient rehabilitation setting... The people in the most need of intense physical therapy should have the opportunity to attend inpatient rehab, however the number of facilities is declining, and admissions to lower level rehab centers is increasing. Given that the inpatient rehabilitation setting was designed to promote the greatest amount of recovery in a short time, therapists would ideally be able to dictate what that plan of care would look like to achieve these gains. However, the length of stay dictated by insurance is decreasing, and therapists are trying to figure out how to show an improvement in a FIM score, provide education to the patients and their loved ones, and document everything in a way that justifies another day. This balancing act makes it difficult to implement the evidence-based practices that would promote a greater recovery. I feel your pain…
It is difficult to get out of a box that is closing in on you, however, I think it would behoove ALL physical therapists in all settings to recognize the importance of fighting for insurance to continue providing inpatient rehabilitation coverage to their members! The benefits of this level care are well supported in the literature, and the high cost is justified looking at the long-term recovery and medical care of the beneficiaries. More importantly, these patients often become lifelong customers, as well as proponents of physical therapy, and having them cheerlead for our services the best marketing our profession could ask for!
Did I convince you that everyone could benefit from physical therapy? I challenge you to make a shift in your business model, and let us know the approaches you have taken to expand your services!