Advocacy
What is the purpose of the APTA House of Delegates?
They are the policymaking bodies for APTA. They meet annually and make decisions on the issues for the profession of PT
What is the purpose of a Strategic Plan?
to determine where a company is, where a company wants to be, and how to get to that point.
What is the purpose of the operational plan?
provides a systematic way of dealing with organizational processes and functions to allow for day-to-day running of the program/business
What is the purpose of a budget?
- Projection/forecast of what you anticipate your money coming in/out is gonna be
- Allows you to prioritize costs and allocate resources
- Used for loan approvals
- Helps everyone (mangers, PTs, etc)
- Responsibility for all to follow the budget
- Helps plan for the unexpected
- Compare financial performance over time
What was the significance of the Tax Cut and Jobs Act that relates to the ACA?
Got rid of the individual mandate fine from ACA
What is the role of the APTA in policy development/advocacy?
Establish and maintain relationship with members of congress, Provide info on PT issues, and Develop network of PTs that will write letters or make phone calls to legislators
What are some examples of external factors that contribute to a SWOT analysis?
(external factors = opportunities and threats)
Demographics: what the population is
Economics: payment sources and their level of transportation
Political: Change of administration -- anticipate what that might mean for you as a business
Stakeholders: who has a role in your business
Competition: how many other competitors are in the area
Ecology: Are you in an old building, are you in a flood zone, do you work in an area that has lots of snow in the winter which would lead to more cancellations
What are some examples of operational systems in a business?
human resources in PT- actual providers of services and support staff
facilities- the structure or the clinic that you actually work in
equipment and supplies- everything from medical equipment to paper clips and pens
accounting and billing- insurance through EMR and can include scheduling
Describe the differences between:
labor and non labor costs
direct and indirect costs
fixed and variable costs
labor: costs associated with people
non labor: costs associated with supplies & equipment
Direct Expenses: directly impact the pt
Indirect expenses: things that are overhead; not going to have a direct impact on pt care but necessary
Fixed costs: Does not change no matter how many pts you see
Variable costs: Expense that would change if the volume of patients were to change
How do Human Resources maximize businesses performance?
analyzing metrics: business performance, individual therapist level (in financial terms), Productivity, and patient outcomes
Hiring people that are well rounded
What is the process of the APTA House of Delegates meetings?
Intro motions, amend bylaws, direct course of action, articulate and association attitude on PT needs
Motions are used to direct course of action or describe goals of association
What makes up a strategic plan?
Vision Statement
Mission Statement
Core Values
SWOT Analysis
Organizational Goals
Measurable Objectives/Outcomes
Annual Plans of Operation
Review/Revision of the Plan
Explain the differences between salary, hourly, and per diem
salaried: Set amount, no matter how many hours are worked; determined based on what expected full workload is (generally around 40 hrs)-- NO OVERTIME PAY, Eligible for benefits: HC, insurance, workers comp, retirement plans, PTO
hourly: Getting paid based on how much time you are working, Eligible for overtime, but not getting paid if leaving early, Typically hired with a guaranteed number of hours→ hired full time but hourly not salary, Eligible for benefits: HC, insurance, workers comp, retirement plans, PTO
Per diem: Paid for the time you work when needed → paid hourly, Under the companies contract, so they call you when they need you: Not guaranteed any amount of hours, Paid hourly, at a higher rate since they do not have benefits, Typically called in during holidays, vacations and sick time, Not eligible for benefits
How does an income statement relate to the budget variance report?
Income Statement (profits and loss statement)--> Actual revenue and expenses
Budget variance takes the income statement and compares it to the budget
What settings did the IMPACT act have an impact on and what was the intent behind the CARES tool?
SNF, LTACH, subacute, home health, inpatient rehab
Intent: with each discharge, the next HC provider could see where the pt was at. This helped with communication and seeing the pts function from each level on --> Primary goal was to compare the quality of care b/w subacutes, rehabs etc. to see if one facility is more effective for a lower cost
What is the Anti-Discrimination Motion Concept that is being considered at this year's House of Delegates?
APTA shall implement a ban on holding national conferences or events in a state with laws that discriminate against Sexual orientation, Gender expression, and Gender identity.
How does an organization goal compare to objectives and key indicators in a strategic plan?
the organization goal sets the priority for the business with a longer time frame (3-5 years)
vs.
Objectives are the measurable element to the goals and helps to determine resources and responsibilities and time frames
vs.
key indicators are processes that are put into place to hopefully prevent the negative outcome --> if these are met, the business should achieve the objectives
What is the difference in discipline specific and service line organizational structures?
Discipline specific: All people in the same discipline report in the same manner--> Ex.all nurses will report the same boss
Service line: all providers working with specific pt groups are organized around the pt--> Ex. all providers working with pts with cancer report to the same boss, who is likely not in the discipline the providers are in
Define what a startup/ Pro forma budget is, what an operating is, and what a capital budget is.
Startup/Pro Forma: What you do when you are starting a brand new business--> True forecasts and projections; What you anticipate is going to happen when open for the first few years; Does the bank need to give you a loan?
Operating: When a business is up and running → can only be used for existing companies!--> Looks like a startup budget but is a projection of revenue and expenses for existing company
Capital budget: Separate budget for big ticket items → more than a certain amount of money, Anticipating how profitable item will be, For certain specialty items more
What did the Bipartisan budget act do (specifically for PT)?
removed hard cap - medicare reimbursement
What is the Future of Specialization in the PT Profession that is being considered at this year’s House of Delegates?
Direct APTA to assemble a group of stakeholders to examine the history and future of clinical specialization, then propose how we might better integrate and expand concepts
How do you calculate projected volume?
1. Define target population
2. Estimate number of target customers; obtain demographic information to determine number of people in your market area that may require your services annually.
3. Identify number of competitors in market area
4. Divide number of total individuals who may require your services annually by total number of providers who provide these services
What are the steps in determining staffing levels?
1. determine the number of visits per year per discipline (ex: 1600 therapy visits per year)
2. determine the expected number of visits each worker would perform in the year (ex: each worker to perform 12 visits per day x 5 days x 52 weeks = 3120 visits per year)
3. divide the total number of visits per year by the number of visits one employee can do in a year (ex: 1600 visits / 3120 = 0.51 FTE)
4. account for sick time, paid time off, vacation, etc (this part we don't need to calculate for the exam)
Explain what each form of reimbursement type is and what their financial incentives are:
- fee schedule
- per diem/ per visit
- per case
- capitation
Fee schedule: fee for service (CPT codes and you get paid for those)--> Incentivized for more services
Per diem or per visit: contract w/ aetna and they pay you $70 for a visit: Can provide an hour ½ or 20 mins - doesn't matter SET RATE--> Incentivized for more visits and less services
Per case: contract w/ aetna and they pay you $1000 to care for X patient: 2 visits, 10 visits, 30 visits - doesn’t matter SET RATE--> Financially incentivized providing fewer services
Capitation: contract w/ insurance co that insures a group in your area - you provide PT for whoever is insured under the company & needs it for however long and you get paid $X-thousand dollars: PT services that a population insured by a specific company needs in a given year for a SET RATE--> Financially incentivized providing fewer services
Describe what each measure of financial performance is and what equations are associated with each:
- cost per visit
- payment per visit
- operating gain
- operating margin
Cost per Visit: how much we actually charge: =Direct and Indirect Cost/Number of Visits
Payment per Visit: how much you actually get paid: =Total payment/Number of Visits
Operating Gain: difference between revenue and expenses: =Total Revenue (-) Total Expenses
Operating Margin: What % of the revenue coming in do you actually keep; best measure of financial performance: =Operating Gain/Revenue