Rocky Mountain Rehab Alliance
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Introducing

Rocky Mountain Rehab Alliance

(RoMoRA)

The high-performance subsidiary of CPTN

We’re tired of waiting for someone else to find the solution.

You can’t enjoy the miracles of change……

….Unless you change something

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What We Are Doing

Rocky Mountain Rehab Alliance is a network of physical therapy practices that is redefining relationships with both payors and patients.

Dedicated to technology, innovative workflows and an unrelenting emphasis on quality, RoMoRA is a group of rehab practice owners who have partnered with payors to change the paradigm.

RoMoRA therapists spend dramatically more time treating patients. Not surprisingly, patient satisfaction and progression eclipse practices that put volume ahead of quality.

RoMoRA practice owners and payors work together with treatment and reimbursement models that deliver higher profitability for everyone.

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How We Are Doing It

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Quality Partners

With our EMR/billing partner, Heno,  RoMoRA has access to an efficient documentation and billing program for a much more affordable rate than an individual practice can negotiate. Heno allows therapists to document and with the push of a button, we can track patient progression by therapist, by body region and be compared to the national average. Every patient is a quest to improve quality.

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Commitment to Patients

With streamlining medical documentation therapists spend more time treating, the patients appreciate the superior physical therapy and they recover more quickly.

This is the way physical therapy is supposed to be: We put patients first.

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Innovation with Payors

Instead of working with payors as adversaries – we will work with them as if they were partners. This will require trust, communication and collaboration.

Who We Are

RoMoRA was formed by a group of clinicians

  • Who choose to practice with exceptional ethics and integrity.
  • Who have invested in mechanisms to ensure that they are all practicing with the highest level of standards.

They intend to show that they can have quantitative results that show that they are providing effective and efficient care that lowers the episode of care for musculoskeletal services, while providing an excellent patient experience, and delivering superior rehabilitation outcomes.

RoMoRA is comprised of clinics that will be billing under one Tax ID, thus reducing the administrative costs to payors – in providing payment to one entity as opposed to multiple entities.

The members of RoMoRA strongly believe that the way to lower the rising cost of musculoskeletal conditions is by adopting mandatory measures that are evidence-based and lead to real, measurable results.

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BOARD MEMBERS

  • Michael House PT ScD
  • Greg McCall PT, DPT
  • Bradley Schoonveld
  • Vincent Carmellini

FOUNDING MEMBERS
All Pro Physical Therapy, Back to Motion Physical Therapy, Colorado Orthopedic Rehabilitation Specialists, and Metropolitan Physical Therapy

The RoMoRA model attempts to address cost issues in a way that is unique in our local and regional markets, while also maintaining high standards of care/outcomes and customer service.

Here is an overview:

  1. A single Tax ID makes it more cost efficient for the health plan to pay and member clinics to be paid, thus providing economies of scale to our healthplan partners.
  2. There is transparency between practices in business arrangements.
  3. RoMoRA has a commitment to delivering high quality physical therapy service with the goal of reducing the total cost of orthopedic musculoskeletal care, particularly in reducing the downstream costs of such care. As a group, we are attempting to have measurable quality that we can sell to insurance companies that wish to contract with us, with cost savings to health insurance companies in imaging, medications, and surgeries.
  4. All clinics will have a singular EMR and outcomes collection system, which make the administration of physical therapy service more cost-effective for us and the payers.
  5. This model allows for more cost sharing opportunities that have not been explored.

For Practice Owners

  • The MSO will require a change in how you think about your practice. Collaboration and unification are key to maintaining the standards of practice and clinical care, as well as using the power of numbers to improve bargaining power.
  • This is not a passive organization. We require you to be actively involved in the process and training your staff to meet the clinical and customer service standards.
  • This will require providers to change your thinking from technique centric care to outcome driven care. The MSO doesn’t really care what treatment approach you use, but the approach needs to have successful clinical outcomes. If you’re not having good outcomes with your current treatment approach, you will be required to change to approaches that give you good outcomes to maintain membership in the MSO.
  • You will need to be flexible to the needs and direction of the MSO. The model is new, and at this point, is ever-changing based on the challenges that we come up against as we advocate to improve the reimbursement of member clinics.
  • Monthly fee costs may change over time, either an increase or a decrease, based on the needs of the MSO. For example, investing in a consultant or actuary group may require an additional investment in all members, including the founders.
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  • We anticipate that you will be contacted directly by insurance companies and offered a lucrative contract to go independent. We want to be clear: we do not want any owner or practice who will consider such an offer in RoMoRA. The purpose of this is to break the MSO of all negotiating power and sow distrust and disunity. This only works if we are all working together.
  • Cutting side deals with vendors, undercutting MSO rate, or trying to negotiate outside of the MSO without full transparency will lead to immediate termination and all fees will not be returned. This behavior will undermine the trust and effectiveness of the MSO.

Frequently Asked Questions

What is a Management Service Organization and what are the advantages of this structure?

MSO is a legal structure that allows independently owned practices to join in a way that they can use the power of numbers to negotiate and secure insurance contracts with improved reimbursement rates. It allows member owners to discuss and contract with insurances as a large clinic group, rather than a small practice, in a way that does not violate anti-trust laws or collusion laws.

We can also purchase services with vendors and use multiple clinic locations and volume to get better rates, including continuing education, IT services, healthcare plans for employees, retirement accounts, marketing, business insurance, professional liability, and web services.

The target here is to grow the MSO both in terms of numbers of clinics and geographical spread. The bigger we are, the more negotiating leverage the MSO will have. So, your small PT clinics of a few providers can have the advantages of a large multi-clinic hospital system when it comes to contract negotiations.

There is also a push, if possible, to use clinic outcomes to incentivize reimbursement. A good physical therapist will save an insurance company 2-3x what they bill per year, and we feel that consistent clinical outcomes should be rewarded by improved reimbursement rates.

Why are the fees higher than CPTN?
Quite simply, there’s more to do. As a single tax ID, we collect all the checks that insurances pay for your visit and distribute them to member clinics on a bi-monthly basis. CPTN does not collect money nor distribute reimbursement. In addition, RoMoRA is officially a “for profit” organization and there are taxes to pay as a result. Monthly fees may change depending on capital investments, actuary analysist, consultants we hire to help us advocate for private practice. We also have the salary of the Executive Director, his assistants, and physician office space and the utilities associated with a physical space.
Why can’t you tell me up front what your reimbursement is for certain plans?
For starters, we don’t even want to give a hint of unethical anti-trade practices, or a collusion complaint to the federal government. But the secondary advantage is we are not just looking for clinic owners who are only interested in getting better reimbursement with no effort on their part. We are looking for partners who share our vision and can commit to RoMoRA for the long term to optimize success.
How about I just look at who you’re contracted with and see if I can get a better deal?
Epically bad idea. This is how insurance companies have been dividing and conquering small practices. The plan has been to divide and conquer, sow disunity and infighting over the scraps they offer us, and never raise reimbursement rates. This has consistently worked for them for 20 years. It’s time to do something different: join, and stay strong for the fight that is to come.
Do the founding members get a “cut” of my fees?
No, fees only go to administration cost and investments in business operations. The founding members get the same advantages as new members when it comes to vendor rates and reimbursements.
Why do you use Heno?
Heno has a modern database that allows a member clinic to bill multiple tax IDs with a single log in. Three years ago, most EMR vendors did not have this ability. WebPT was initially approached by RoMoRA but they refused to work with our needs for using multiple tax IDs. Heno allows members to access RoMoRA contracts and use their own contracts for their individual clinic.

Heno has been a supportive partner of RoMoRA and they have been generous in offering us a competitive rate for billing collection as a result. As we gain more clinics, this rate may be lower due to the volume of clinics participating.

What do I get by joining?

The big picture is that what you get is an organization that will allow you to survive in this healthcare market. The founding members of the MSO do not believe private practice will be survivable unless you sell to a hospital or physician, go cash-based, be big enough to sell to a private equity firm, or join RoMoRA.

But to be clear, especially in this first group of new clinics, we are looking for practices who want something more than a passive organization where you get stuff and do nothing in return. We are going to require you to be an active participant in our organization and help us solve problems.

What is required for me to join RoMoRA?
There are a few concepts worth mentioning here:

  1. You will be required to think about the MSO when making contract decisions. If you are approached by a payor, we expect that you will bring the contract to the group as we all might benefit from the contract. This a cooperative and collaborative organization.
  2. We have standardized scheduling and billing procedures that we expect you to follow.
  3. We expect you to be part of the group for a period of at least 3 years. Early exit will lead to a monetary penalty.
  4. You do not negotiate any back door deals with our vendors and insurances. This will lead to immediate termination from the MSO.
  5. You may be required to participate in FOTO outcomes in the future, and successful clinical outcomes may be a requirement for maintaining good standing. This will require you to think less about technique specific care but rather the quality of your outcomes. We’re not going to tell you what models of care you use in the clinic, but we are going to hold you accountable to outcomes. If you’re not having good outcomes in a particular area, we will expect you to change your approach to something that does.
What if I just wait until you get more members and get better contracts and then I’ll join?
You can do that, but it will be more expensive for members who join later in the MSO rather than earlier. Unfortunately, there is more than one clinic who wants us to do all the work and then join to the benefits without having any risk. If you plan on joining later, it will cost you more.

For further information about this exciting group of practices, please contact:
Mark Engleman, Executive Director | cptn@comcast.net