Healthcare organizations bring in contract rehabilitation services to help meet a specialized need that often cannot be met by in-house staff. Sometimes, however, it can be difficult to know what to expect from rehab service providers, or how to integrate their services into the needs and culture of your organization.
Perhaps you don’t know the right questions to ask to ensure your patients are receiving the right care experience. Or, you may feel that, since your contract providers are the experts in this area, the processes and standards they have in place should meet your needs.
But best practices might vary among healthcare organizations, and ultimately: you know your organization best. It’s important to recognize that as a customer, you can set expectations and hold providers accountable for meeting them.
In my role, I collaborate closely with executives and nursing teams to guide them on ways they can manage the relationship between their organization and contract care providers.
By establishing clear expectations and enhancing communication channels, you can improve your organization’s operations, and more importantly, guarantee that the needs of your patients are met with the highest standards of care.
Questions to Evaluate Your Contract Rehab Provider
Are the lines of communication as open as they can be?
Patient status updates are ever-changing, so it requires an interdisciplinary, collaborative approach to care plans. The rehabilitation team is an integral member of the process. Oftentimes, the organizations I counsel have a daily meeting where an interdisciplinary team—including the rehab director—attends. However, since the COVID-19 pandemic, I’ve seen a shift where some providers are stepping back and saying they can no longer devote the time to be part of these.
You must continue finding ways to include your rehab director in regular meetings. Some staff, like nursing team members, may check in periodically to administer medications. But, if your resident is receiving an hour of therapy a day, that’s undivided time that allows for deeper discovery. Those observations and insights from your therapy providers are likely worth sharing with the team.
Additionally, what is the staffing and presence in your physical building? Some rehab providers offer five days a week, others seven days a week. Are your providers available later in the day to offer a range of hours? These are all important questions to consider when evaluating the partnership.
Are they assisting in program development?
Your rehab service provider is an important partner in helping to analyze what the needs in your organization are. Partnering with your therapy provider to examine your community population trends will assist in providing specialized interventions geared to your patient’s profile and the outcomes you wish to see.
The second layer of program development is knowing how to build the systems around that – does your therapy provider know how to build the program, document the process, and bill it correctly?
If a new service is launched, can they assist in communicating that to current and prospective patients? The provider’s specialty insights into these offerings are invaluable.
How are they measuring success and outcomes?
One of the biggest indicators that a therapy provider is keeping themselves accountable is that their regional support team is conducting regular visits. A collaborative partner will offer a Quarterly Business Review, a comprehensive review of outcomes, reimbursement, staffing, and more. This is an area that’s often forgotten or neglected and can make a difference over time.
A second indicator of accountability is that they are administering some type of customer satisfaction survey, and then looking critically at outcomes. These outcomes should also be communicated to your leadership teams to discern areas for improvement.
Are they optimizing reimbursements?
A rehab provider should be helping optimize their services for reimbursement. Regarding billing and documenting, it can be a costly mistake to assume that these processes are happening as they should. Compliance audits can help ensure the therapy team is billing and documenting appropriately. These safeguards will mitigate risks in claim reviews, or denials of nonpayment. It’s important that you have a contract provider that is making this process as easy as possible.
Ask the right questions, today.
Considering these points will help your healthcare organization work with contracted service providers successfully. Don’t let busy schedules stand in the way of quarterly meetings, reviewing quality surveys, and persisting in compliance committee schedules. Instead, work alongside your executive and nursing team to ensure you’re asking the right questions of your contract providers and not letting uncertainty or perceived limitations hold you back.
And, more importantly, remember that while your organization bears some responsibilities, selecting the right contract provider means they’ll have their own measures in place to ensure quality service delivery.
At the end of the day, it’s not just about therapy minutes; it’s about making a real difference in the health and well-being of the individuals receiving services.
Michelle Hediger
Michelle Hediger, M.S., OTR/L, has 25 years of experience in operations and clinical experience across the post-acute continuum. Her background focuses on long-term care, assisted and independent living rehabilitation. Her expertise includes contract and in-house therapy management, including compliance and clinical programming. In her current role, Michelle is a compliance specialist with Friends Services Alliance.
