Dana Strauss (00:00) Welcome to episode 14 of Future Proof PT. I'm Dana Strauss and today my co-host Alex Bendersky and I are driving into something that could fundamentally change how you think about patient care and even your professional value. It's the therapy value quotient. Here's what you'll walk away with after listening to this episode. First, you'll understand why saying, I know it works isn't enough anymore.

We're going to break down why subjective clinical reasoning, while important, won't elevate our profession or secure our place in value-based care. Alex is going to explain how the therapy value quotient creates an objective framework that balances cold economic metrics with the warm therapeutic relationships we do value as clinicians.

Second, you'll learn a practical algorithm you can actually use. It's not theoretical. Alex is going to share a specific formula that factors in functional improvement, patient complexity, care intensity, and cost. You can plug these into a simple Google sheet and start measuring your clinical impact in ways that payers and administrators can understand and value. Third, we'll challenge you to think beyond discharge. We're going to push you on something that might be uncomfortable.

You have a responsibility to establish a clear therapy prognosis for every patient and think about your value over months, not just visits. That goes beyond the actual episode where you're seeing the patient in the clinic remotely or both. So we're going to explore how staying connected with patients post discharge, through follow-up calls, check-ins, and by being their go-to MSK or movement provider creates real value.

that you can sell to payers and at-risk providers. And finally, we all give you a reality check about the future. Nothing new, we try to do this a little bit in every episode. We're discussing how AI and improved data connectivity are already being used to identify overutilizers and measure provider quality. The days of endless three times a week for infinity treatment plans are numbered and we'll show you how to get ahead of this shift even as it's happening.

So why should you listen today? Because whether you're working in skilled nursing and outpatient or any other setting, you need objective measures to prove your value. If you can't measure it, you can't sell it. And if you can't sell it, your empathy and clinical skills won't matter when budget cuts come or when payers start making decisions about who gets to stay on preferred provider list or gets to join value-based contracts with payers and at-risk providers.

So we'd say this episode is for therapists who want to move from hoping they're providing value to knowing they are and being able to prove it. Let's get started.

Dana Strauss (02:53) Hi everybody, welcome to episode 14 of the Future Proof PT podcast. I'm here with my good friend Alex Bendersky, my co-host. And today we have a excellent topic to talk to you about. It's about the therapy value quotient.

Alex is going to define it. and where the therapy value quotient can be.

both looked at from the therapy-centric perspective and how that may play into the way we as therapists think about value-based care. So take it away, Alex.

Alex Bendersky (03:24) Excellent Dana and thank you again for allowing me to be a part of this process. It has been a fundamental positive, net positive in my life. So this has been great. right, going on 14, this is a good exploration of all these topics that have been swirling in the head for now a couple of decades. So it's a good way to put conceptual thinking into practical thinking. So yes.

Dana Strauss (03:33) Me too.

Alex Bendersky (03:48) value quotient or a therapy value quotient. I think the origin of it is identifying an empirical way of assessing value in terms of clinical productivity. And so there are a lot of productivity matrices that are available that are more based on productivity volume or productivity substance or availability of resources, but few look into that global and overarching

inclusive productivity matrix that looks into that what traditionally is a dichotomous thinking either system availability aka resource availability or patient resource allocation, patient value, patient alignment, patient centric values. So this is a way of really defining value in terms of economics but also in terms of productivity and resources. So this

concept and this algorithm comes from acute care process. this the value therapy value quotient TV Q is novelty to me because I just stumbled upon a 2018 Journal of acute care physical therapy which discussed this as a matrix of identifying resources for an acute care hospital.

and looking into clinical outcomes, clinical productivity, and having an algorithmic way of assessing and allocating resources towards inpatient hospital and seeing how these can be operationalized. So first, looking into that ever-present term of value. What is value, right? PT's need to define value, and we've discussed this extensively. Value is really a cost over outcome.

right? That's your, the easiest way of sampling value. How much does it cost and what is the guarantee that this is going to generate some kind of a not positive or negative clinical outcome. But there really is a mismatch between that very cold, stone cold economic term of value and this therapist driven quote of actually needing to be there for patients and not everything is reflective.

in patient reported outcomes. And so there's always an argument of, know it works, I've seen it work, or patients need me. And the counter argument is we don't have resources for this. And unless outcomes change in what would be a standardized factor of four visits, six visits, 20 visits, whatever the predicted factor is, what your threshold for change is, when you are able to show change through that threshold, you can continue care. If there is absence of change,

through that threshold of time, you have to discontinue care. So therapy value quotient is in a way of objectifying it and mirroring both of these cold calculating ways of assessing resources and more warm interpersonal, therapeutic alliance driven concepts. So with this, I'll pause and I think we can discuss this a little bit.

Dana Strauss (06:37) So never thinking of it as therapy value quotient, I think I can just bring to this an example of what I, when I was working with the transitions of care, with transitions of care therapists within and among care settings, a lot of the discussions I would have when I was working on making sure patients were having the right patient journey was talking to therapists about the way that they were justified.