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Traditional Values. Innovative Care.

Finding Value in Medically Oriented Gyms

Posted: 5/25/16
RehabVisions

Value has always been a core metric at RehabVisions. As the therapy industry moves from pushing volume to proving value, we continue to feel confident in our suggestions of programs that both add value to a practice and prove value to patient populations.

Steve Finn, PT and rehab director in Iowa is a proponent for the medically oriented gym (MOG), saying “When you think about future medical payment models, the MOG fits in well with what is coming down the pipeline.” Services provided in an MOG program are typically reimbursed by Medicare and other third-party payors.  Specialized treatment plans can help patients with chronic conditions, diabetes, balance and many other diagnoses.

Nearly one-third of the patients that are referred to physical therapy at his facility qualify for the MOG, making it a valuable add-on program. “We’ve recently treated several pre-diabetic patients, who have either gained weight or become less active,” says Steve. “Their physicians are concerned they will become diabetic and so they refer those patients to therapy. We do the initial physical therapy with them and then transition them to the MOG where they will exercise three times a week, and hopefully then for the rest of their life.”

MOG programs are fit to prove value and an easy way to include functional outcome measures tests with your patients. Steve will do the same outcome measures tests with a patient during their initial therapy, when they transfer to the MOG, and then typically a 30-day follow-up after starting the MOG and again after the 90-day program, before final discharge to measure improvement. The following functional outcomes measures tests are used:

  • Six-minute walk test
  • Number of times patient can go from sit-to-stand in 30 seconds
  • Determine self-selected walking speed using 10-meter surface
  • Curls per minute using 5 lb weight for women and 7 lb weight for men

After 90 days, the goal is for the patient to continue using the MOG as a wellness center or to continue exercising at home.

Other indicators are also important to track, according to Steve. “We track attendance rate and membership, which is an indicator of success. We have a 45 percent success ratewhich is the number of people who join the wellness center after going through the MOG program. The national average is around 30 percent.”

Continued use and enrollment into the MOG will hopefully decrease hospitalization rate and the amount of healthcare expenses participants require on a yearly basis.

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Comments

  1. Hi. So as PTs we can bill insurance for the visit and perform some sessions before transitioning? Ins are paying for codes like DM , HTN etc?
    Thank you

  2. RehabVisions

    While we can’t offer you specific billing/reimbursement advice, physical therapy service is billable when the treatment provided is skilled and medically necessary. There must also be underlying functional deficits or therapy-specific impairments that justify the skilled service beyond generalized diagnosis codes of diabetes mellitus or hypertension. For example, a patient may present with gait abnormality, muscle wasting/atrophy, weakness, lack of coordination/balance impairments, etc. that are appropriate to code along with additional underlying medical conditions.

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