CoHSTAR Year 2 Update

CoHSTAR Year 2 Update View largeDownload slide View largeDownload slide Not long ago, we announced our commitment to advancing health services and health policy research in physical therapy. Thanks to all of you, CoHSTAR was established and has since generated an enthusiastic following as physical therapists come to learn the value of health services research. Two years in, CoHSTAR is making great strides. We are thrilled by the growth and reach CoHSTAR has made and would like to share with you some of its successes. Thank you for making all this possible. Barbara Malm, MBA CEO, Foundation for Physical Therapy CoHSTAR Summer Institute Recap The 2017 Summer Institute was held in conjunction with the NEXT Conference & Exposition with the goal of bringing together practice leaders and health services researchers to seek practical solutions to reduce variation in care and demonstrate value across the continuum of care. The Summer Institute was offered as a preconference workshop with over 100 attendees, 27 poster presentations, and 13 participants in its Intensive Workshop with CoHSTAR faculty members. Attendees discussed the shift from fee-for-service to bundled payments and other models that emphasize value and outcomes. Summer Institute attendees also examined how lessons learned from the joint replacement bundled payment initiative can inform physical therapist practice as integrated care models are developed and implemented. To view a complete list of speakers and accepted posters, visit bu.edu/cohstar/training/summerinstitute/ Education Session at CSM 2018 CoHSTAR will hold an education session at APTA’s Combined Sections Meeting in New Orleans next year titled: Creating Value-based Systems of Care: Opportunities for Health Services Research. This education session will present highlights from the 2017 CoHSTAR Summer Institute to discuss a critical role health services research can play to inform physical therapist practice within future integrated systems of care. To receive updates on CoHSTAR events at CSM/NEXT and its upcoming 2018 Summer Institute, email info@Foundation4pt.org to be added to our listserv. CoHSTAR Year 2 Pilot Studies Amit Kumar, PT, MPH, PhD Brown University Impact of Hospital-Based Physical Therapy Services on Hospital Readmission: Implications for Bundled Payment View largeDownload slide View largeDownload slide This research will generate evidence on the effectiveness of hospital based physical therapy. The findings will inform clinical guidelines on the appropriate dose of physical therapy service in the acute hospitals. The overall objective is to develop a new method of quantifying physical therapy utilization using Medicare data, use that method to explore the variation in hospital-based physical therapy services, and its association with unplanned hospital readmissions. This study will develop an innovative approach to quantifying physical therapy utilization in Medicare claims data that can be replicated in additional studies that explore associations between therapy utilization and patient-centered outcomes. This work has the potential to lead to improvements in clinical practice, reduce unwarranted variation, and minimize hospital readmissions. Ultimately, the study findings may improve health and outcomes of patients with stroke. Deborah Ellen Thorpe, PT, PhD University of North Carolina, Chapel Hill Health Care Utilization for Musculoskeletal Disorders (MSK) in Adults with Cerebral Palsy: An Analysis of Medicare Data View largeDownload slide View largeDownload slide The overall goal of this project is to gain a better understanding of health care use for MSK disorders among adults with cerebral palsy (CP) and the extent to which they use rehabilitation care for these disorders as compared to peers without CP. The proposed exploratory project will capitalize on Medicare claims data. This study will provide resources to analyze existing data on health care utilization which will help in understanding the health care needs of this population. The results of this study will lay the foundation for a program of research that will assess the quality and value of rehabilitation care for this population, with the ultimate objective of improving the health and quality of life of adults with CP. Sean Rundell, PT, DPT, PhD University of Washington Developing a Prognostic Model for Risk Adjustment in Patients with Back Pain View largeDownload slide View largeDownload slide The goal of this research is to advance risk adjustment methods for outpatient rehabilitation settings using a promising alternative to traditional comorbidity indices to further minimize bias when making comparisons for policy or research purposes. This will be done using a cohort of older adults with back pain that has both self-reported functional status and complete electronic health record data to examine the ability of an ICD9-based Functional Comorbidity Index (FCI) to predict function, health-related quality-of-life, and overall health care use. This study will test the validity of an ICD9-based FCI using outcomes that are important for risk adjustment and health services research in outpatient rehabilitation settings: function, health related quality-of-life, and total health care use. It is anticipated that completion of these aims will support the validity of the FCI for risk adjustment in older adults with back pain and tell us what other commonly available covariates should be included in a preferred risk adjustment model, with the hope that results from this study will inform future grant applications to continue improving risk adjustment methods suitable for physical therapy settings. CoHSTAR Year 2 Visiting Scientist Janet Freburger, PT, PhD, joined CoHSTAR in late 2016 bringing the number of Visiting Scientists to 3, with Katherine Berg, PT, PhD, and Kristin Archer, PT, DPT, PhD. View largeDownload slide View largeDownload slide Dr. Freburger is using the Visiting Scientist experience to extend her work in the area of postacute care by:apitalizing on faculty expertise and Medicare data available at Brown University in the hope that increased understanding of effective patterns of postacute rehabilitation care will inform practice in the areas of care coordination, care transitions, and team-based care. This work will ultimately translate to improved patient outcomes. Understanding effective patterns of postacute rehabilitation care episodes is also vital as payment for health care shifts to episode- and value-based models. CoHSTAR Year 2 Fellows In Year 2, CoHSTAR recruited 3 new faculty fellows and 1 postdoctoral fellow. CoHSTAR extended Adam Goode's PT, DPT, PhD, faculty fellowship through October of this year. Faculty Fellows Daniel Pinto, PT, DPT, PhD Comparative effectiveness of rehabilitation for total knee arthmplasty: A systematic review View largeDownload slide View largeDownload slide Dr Pinto has been assessing the comparative effectiveness of rehabilitation approaches peri-operative to total knee arthroplasty in patients with knee osteo-arthritis. This will lay the groundwork for a decision-analytic mode that will quantify the relative benefit and costs of the active ingredients in rehabilitation. Meghan Warren, PT, MPH, PhD Rehabilitation after total knee arthroplasty View largeDownload slide View largeDownload slide Dr Warren has focused on analysis of Medicare claims data for beneficiaries receiving community-based rehabilitation care after total knee arthroplasty. This work will help to identify the benefits of physical therapist managed rehabilitation and examine risk of adverse events. Daniel Young, PT, DPT, PhD Physical therapy in the acute care setting View largeDownload slide View largeDownload slide Dr Young is developing tools that measure patient activity and using those tools to help care providers and administrators identify the impact of rehabilitation services, identify patients that would benefit from rehabilitation services, and identify patients that are at risk for harms without rehabilitation services. Postdoctoral Fellows Catherine Schmidt, PT, DPT, PhD Brown University Physical therapy utilization for patients with lumbar spinal stenosis View largeDownload slide View largeDownload slide Findings have the potential to lead to recommendations to improve access to physical therapy care, ultimately leading to better functional outcomes and preventing the use of more costly interventions that carry higher health risks. Over the past 2 years, CoHSTAR has: published 29 articles, submitted 26 abstracts for a scientific presentation at conferences participated in over 22 speaking engagements/meetings. © 2018 American Physical Therapy Association http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Physical Therapy Oxford University Press

CoHSTAR Year 2 Update

Physical Therapy , Volume 98 (2) – Feb 1, 2018

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Publisher
American Physical Therapy Association
Copyright
© 2018 American Physical Therapy Association
ISSN
0031-9023
eISSN
1538-6724
D.O.I.
10.1093/ptj/pzx115
Publisher site
See Article on Publisher Site

Abstract

View largeDownload slide View largeDownload slide Not long ago, we announced our commitment to advancing health services and health policy research in physical therapy. Thanks to all of you, CoHSTAR was established and has since generated an enthusiastic following as physical therapists come to learn the value of health services research. Two years in, CoHSTAR is making great strides. We are thrilled by the growth and reach CoHSTAR has made and would like to share with you some of its successes. Thank you for making all this possible. Barbara Malm, MBA CEO, Foundation for Physical Therapy CoHSTAR Summer Institute Recap The 2017 Summer Institute was held in conjunction with the NEXT Conference & Exposition with the goal of bringing together practice leaders and health services researchers to seek practical solutions to reduce variation in care and demonstrate value across the continuum of care. The Summer Institute was offered as a preconference workshop with over 100 attendees, 27 poster presentations, and 13 participants in its Intensive Workshop with CoHSTAR faculty members. Attendees discussed the shift from fee-for-service to bundled payments and other models that emphasize value and outcomes. Summer Institute attendees also examined how lessons learned from the joint replacement bundled payment initiative can inform physical therapist practice as integrated care models are developed and implemented. To view a complete list of speakers and accepted posters, visit bu.edu/cohstar/training/summerinstitute/ Education Session at CSM 2018 CoHSTAR will hold an education session at APTA’s Combined Sections Meeting in New Orleans next year titled: Creating Value-based Systems of Care: Opportunities for Health Services Research. This education session will present highlights from the 2017 CoHSTAR Summer Institute to discuss a critical role health services research can play to inform physical therapist practice within future integrated systems of care. To receive updates on CoHSTAR events at CSM/NEXT and its upcoming 2018 Summer Institute, email info@Foundation4pt.org to be added to our listserv. CoHSTAR Year 2 Pilot Studies Amit Kumar, PT, MPH, PhD Brown University Impact of Hospital-Based Physical Therapy Services on Hospital Readmission: Implications for Bundled Payment View largeDownload slide View largeDownload slide This research will generate evidence on the effectiveness of hospital based physical therapy. The findings will inform clinical guidelines on the appropriate dose of physical therapy service in the acute hospitals. The overall objective is to develop a new method of quantifying physical therapy utilization using Medicare data, use that method to explore the variation in hospital-based physical therapy services, and its association with unplanned hospital readmissions. This study will develop an innovative approach to quantifying physical therapy utilization in Medicare claims data that can be replicated in additional studies that explore associations between therapy utilization and patient-centered outcomes. This work has the potential to lead to improvements in clinical practice, reduce unwarranted variation, and minimize hospital readmissions. Ultimately, the study findings may improve health and outcomes of patients with stroke. Deborah Ellen Thorpe, PT, PhD University of North Carolina, Chapel Hill Health Care Utilization for Musculoskeletal Disorders (MSK) in Adults with Cerebral Palsy: An Analysis of Medicare Data View largeDownload slide View largeDownload slide The overall goal of this project is to gain a better understanding of health care use for MSK disorders among adults with cerebral palsy (CP) and the extent to which they use rehabilitation care for these disorders as compared to peers without CP. The proposed exploratory project will capitalize on Medicare claims data. This study will provide resources to analyze existing data on health care utilization which will help in understanding the health care needs of this population. The results of this study will lay the foundation for a program of research that will assess the quality and value of rehabilitation care for this population, with the ultimate objective of improving the health and quality of life of adults with CP. Sean Rundell, PT, DPT, PhD University of Washington Developing a Prognostic Model for Risk Adjustment in Patients with Back Pain View largeDownload slide View largeDownload slide The goal of this research is to advance risk adjustment methods for outpatient rehabilitation settings using a promising alternative to traditional comorbidity indices to further minimize bias when making comparisons for policy or research purposes. This will be done using a cohort of older adults with back pain that has both self-reported functional status and complete electronic health record data to examine the ability of an ICD9-based Functional Comorbidity Index (FCI) to predict function, health-related quality-of-life, and overall health care use. This study will test the validity of an ICD9-based FCI using outcomes that are important for risk adjustment and health services research in outpatient rehabilitation settings: function, health related quality-of-life, and total health care use. It is anticipated that completion of these aims will support the validity of the FCI for risk adjustment in older adults with back pain and tell us what other commonly available covariates should be included in a preferred risk adjustment model, with the hope that results from this study will inform future grant applications to continue improving risk adjustment methods suitable for physical therapy settings. CoHSTAR Year 2 Visiting Scientist Janet Freburger, PT, PhD, joined CoHSTAR in late 2016 bringing the number of Visiting Scientists to 3, with Katherine Berg, PT, PhD, and Kristin Archer, PT, DPT, PhD. View largeDownload slide View largeDownload slide Dr. Freburger is using the Visiting Scientist experience to extend her work in the area of postacute care by:apitalizing on faculty expertise and Medicare data available at Brown University in the hope that increased understanding of effective patterns of postacute rehabilitation care will inform practice in the areas of care coordination, care transitions, and team-based care. This work will ultimately translate to improved patient outcomes. Understanding effective patterns of postacute rehabilitation care episodes is also vital as payment for health care shifts to episode- and value-based models. CoHSTAR Year 2 Fellows In Year 2, CoHSTAR recruited 3 new faculty fellows and 1 postdoctoral fellow. CoHSTAR extended Adam Goode's PT, DPT, PhD, faculty fellowship through October of this year. Faculty Fellows Daniel Pinto, PT, DPT, PhD Comparative effectiveness of rehabilitation for total knee arthmplasty: A systematic review View largeDownload slide View largeDownload slide Dr Pinto has been assessing the comparative effectiveness of rehabilitation approaches peri-operative to total knee arthroplasty in patients with knee osteo-arthritis. This will lay the groundwork for a decision-analytic mode that will quantify the relative benefit and costs of the active ingredients in rehabilitation. Meghan Warren, PT, MPH, PhD Rehabilitation after total knee arthroplasty View largeDownload slide View largeDownload slide Dr Warren has focused on analysis of Medicare claims data for beneficiaries receiving community-based rehabilitation care after total knee arthroplasty. This work will help to identify the benefits of physical therapist managed rehabilitation and examine risk of adverse events. Daniel Young, PT, DPT, PhD Physical therapy in the acute care setting View largeDownload slide View largeDownload slide Dr Young is developing tools that measure patient activity and using those tools to help care providers and administrators identify the impact of rehabilitation services, identify patients that would benefit from rehabilitation services, and identify patients that are at risk for harms without rehabilitation services. Postdoctoral Fellows Catherine Schmidt, PT, DPT, PhD Brown University Physical therapy utilization for patients with lumbar spinal stenosis View largeDownload slide View largeDownload slide Findings have the potential to lead to recommendations to improve access to physical therapy care, ultimately leading to better functional outcomes and preventing the use of more costly interventions that carry higher health risks. Over the past 2 years, CoHSTAR has: published 29 articles, submitted 26 abstracts for a scientific presentation at conferences participated in over 22 speaking engagements/meetings. © 2018 American Physical Therapy Association

Journal

Physical TherapyOxford University Press

Published: Feb 1, 2018

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