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The Growing Role of Athletic Trainers in Orthopaedics
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Healthcare reform has forced orthopaedic surgeons to streamline office efficiency and search for new revenue streams. Adding certified athletic trainers is one option.
ORTHOPRENEUR spoke to Forrest Pecha, Director of Clinical Residency at St. Luke's Sports Medicine, on how orthopaedic practices might incorporate athletic trainers as mid-level providers.
“Athletic trainers can do everything from rooming a patient, entering data into electronic medical records, performing injury assessments, educating patients, drawing injections, prepping patients and assisting in procedures,” says Pecha. “It’s nearly all-encompassing, in that the athletic trainer can fulfill the roles of other more traditional health care professionals. Hiring an athletic trainer allows you to place a very versatile, multi-purpose professional in your practice, one with a deep background in musculoskeletal knowledge.”
A deeper discussion followed.
ORTHOPRENEUR: How do athletic trainers provide value to an orthopaedic practice?
Forrest Pecha: They increase patient throughput, improve clinic efficiency and flow and provide high patient satisfaction.
Athletic trainers have a very high musculoskeletal education level. It’s our foundation. When we’re working in an orthopaedic or sports medicine practice, we’re able to use our musculoskeletal knowledge to support injury assessments and diagnoses of our patients, presenting our findings to the physician. Following the patient's time with the physician, we can give the patient the necessary information about their injury and follow-up care. Taking these few steps for the physician allows his or her time with the patient to be spent more effectively. It allows the physician to focus on physician-necessary tasks – HPI, diagnosis and plan of care – and the remaining time to be spent developing patient relationships.
ORTHOPRENEUR: What revenue-generating value does an athletic trainer add to a practice?
Pecha: We see our services as both direct and indirect revenue changers. A number of U.S. studies indicate that athletic trainers are increasing patient throughput by 20% to 23% in any given physician practice setting. The increased patient throughput, increased billings and downstream revenue are quite significant when we’re increasing practice productivity on average 20%+. That is an indirect revenue share, and it’s important to remember that a 20% increase in office throughput should correlate to a 20% increase in other clinic ancillaries.
Athletic trainers can also bill directly, although success is variable across states, practices and insurance carriers. One direct revenue source can come from having athletic trainers perform services under the direction of the physician. Similar to cast techs, the physician is still billing for the application, but the athletic trainer may apply the cast. The same concept can be used to support home exercise programs, therapeutic exercise and crutch training. In those cases, the PM&R code is added to the physician E/M code. In some instances, a modifier may need to be applied to the E/M code.
In certain states, athletic trainers are working as first assists with surgeons in the OR and collecting first assist fees. For billing purposes, this may require a dual credential, such as Orthopaedic Technologist Certified (OTC) or Orthopaedic Physician Assistant (OPA-C).
A third source of revenue for the practice could be using the athletic trainer to develop a durable medical equipment business. In-housing your DME business may prove to be a profitable ancillary to the practice, and can be fully supported by an athletic trainer’s experience and training. They understand the bracing, prophylactic and durable medical equipment that will assist in the patient’s care.
ORTHOPRENEUR: How can hiring managers clarify varying state regulations regarding athletic trainers?