July 2018 pulse

JULY 2018

- COMING UP THIS MONTH Wednesday, July 11 6:00 pm Waters region clinics at Griskus Sprint Tri Wednesday, July 18 6:45 pm Middletown clinic at Citizen’s Bank Summer Fun Run

WELCOME TO OUTCOMES! PTSMC is currently using WebPT’s outcome platform in Avon, East Hampton, Middletown and Southbury.

Thanks to those clinics for taking the lead in learning and helping smooth the road for the rest of our locations. Our intention is to begin tracking clinical outcomes in all PTSMC offices by August 1, 2018.

Outcomes aren’t new. As an organization, we have been following the development and utilization of outcome measures for several years. We decided to take a “wait and see” attitude with implementing an outcomes tool for multiple reasons, the main three being cost, work involved and value.

On the cost side, we are always reluctant to add costs to our business without good reason. Until recently, it was difficult to understand how we would use outcomes in a significant enough way to justify the cost of collecting and processing the information.

In addition, adding more work to already busy clinicians and non-clinicians made no sense. This was especially true and time-consuming when we were running on two different EMR systems. The integration of WebPT in all PTSMC locations, along with the progress WebPT has made in the integration of information, has lightened the amount of additional work required considerably.

System advances should continue to reduce data entry and analytic requirements.

Now we get to the big one: value. Until very recently few, if any, payers or employers paid much attention to outcome measures. They just didn’t care all that much, especially in Connecticut.

Medicare and many large health systems are talking about the migration from fee for service payments (how we currently operate) to “value-based” and “pay for performance” methods of paying for healthcare. Many large employers are fully engaged in the discussion as “value-based” care has been offered as a potential solution to the crazy rise in costs and insurance premiums.

When in Minnesota recently with Mike Durand, it became very clear that the time to jump into measuring outcomes was NOW! In the Twin Cities, many large employers and health systems are paying providers (including PTs) more or less per visit based on outcome performance. Those who can prove they provide great care at a reasonable cost are actually being paid more, while practices with poor outcomes or those that don’t track outcomes are being excluded from seeing patients at all. The “narrow network” is paying you differently (good or bad) based on what you deliver or excluding you altogether.

I look forward to tracking outcomes at PTSMC. They will help us measure performance and provide opportunities to continuously improve our clinical delivery and education.

I am confident that our PT for Life culture and our commitment to clinical excellence will help us thrive in the era of outcomes!

Thanks for all you do,

PTSMC CELEBRATES NEW OCS CLINICIANS Huge congratulations to Meagan Hoffman, Westbrook, Nick Almonte, Orange, and Melissa Lembo, Guilford (left to right). All recently earned their specialist certification in Orthopaedics from the American Board of Physical Therapy Specialities. All sat for their OCS exam in March and received the good news in mid-June!

Sunday, July 22 9:00 am Plainville clinic at Chip’s Family Restaurant Roadrace to benefit the Petit Family Foundation Thursday, July 26 6:00 pm Groton clinic at Blessing of the Fleet 5K Sunday, July 29 8:00 am Guilford clinic at Sea Legs Shuffle

PTSMC OUTCOMES We will be rolling out Outcome Collection Process training in July. Here’s the plan: Clinicians: REQUIRED recorded GoTo training session will be distributed by July 6 to be completed ASAP. This can be viewed individually or as a team.

PSCs & PSAs: GoTo Meeting training, July 10 at 11:15 July 10-31 - All PTSMC clinics will have access to begin to collecting Outcomes data on patients.

August 1 - Outcomes data will be made mandatory within the WebPT system. All IEs, PNs and D/Cs will require completion of an Outcomes questionnaire.

StriveHub Fab 5 I’m happy with my rate of recovery and the attention directed to my personal condition and well-being. - Branford I’m impressed with the skills of the physical therapists that I've worked with. Also, they use your prior baseline (or better) as the functional goal. They do not 'pad' on extra sessions - just what you need to improve. Also, they are compassionate. This is an outstanding team.

- Wallingford They are caring, friendly, and knowledgeable and know how to get results! - Waterbury If you require physical therapy, this is a positive atmosphere that promotes recovery.

- Watertown Professionalism and friendliness. Neatness of facility and equipment. Willingness to work with my fitness trainer at Joint Effort to modify my daily workouts. - Westbrook

CLINICIAN’S CORNER

BY MIKE ANTUNES, PT, DPT, OCS

PHYSICAL THERAPY IDEAL SETTING FOR CROSSFIT ATHLETES The rapid international growth and popularity of CrossFit creates an ideal opportunity for the physical therapy profession. Since PTSMC improves the quality of people’s lives by providing unmatched experiences, clinical excellence and lifelong relationships, CrossFit athletes are another patient population that PTSMC as a company can better serve. However, clinicians can experience a number of challenges, including understanding the terminology and specific exercise movements of CrossFit and determining the safety and effectiveness of CrossFit as an exercise form.

There are many terms in the CrossFit language that patients may use when seeking care from a healthcare professional. Below is a list of the most commonly used terms and exercise movements: Air Squat: Squat without weights Back Squat: Squat with barbell on your back Clean and jerk: Lifting movement of moving weight to rack position and then moving weight above head Chin Up: Bar is held with palms facing you (supinated grip); Pull body up to where chin crosses the bar Clean: Motion of moving weight from ground to rack position CTB/C2B: Chest to bar pull up; Pull body up so that chest crosses the bar Double Unders: Two turns of the jump rope per jump Front Squat: Squat with barbell in the “rack position” HSPU: Handstand push up Knees to Elbows: While hanging from pull up bar, raise knees up to touch your elbows Kipping: Rocking motion to help use momentum to complete a pull-up Muscle Up: Combination of pull-up and ring dip Overhead Squat: Squat with barbell held overhead Push Jerk: Holding barbell in rack position, slightly squat down and lift weight above head Push Press: Holding barbell in rack position, lift weight above head Snatch: Olympic lift; Hang Snatch, Power Snatch, Squat Snatch Thrusters: Hold barbell in rack position, drop down in squat position with barbell in rack position, return to standing position in exploding motion, pushing the barbell over your head Toes to Bar: Hanging from a pull up bar, bring toes up to bar Wall Balls: Using a medicine ball, drop into a front squat position and stand up using the momentum to push the ball to hit a target on the wall

Introducing the PTSMC RESIDENCY PROGRAM! We are excited to announce that PTSMC has been approved for a residency program though the ABPTRFE. This is a one of a kind program in CT! Many thanks to Mike Gans, Director of Clinical Excellence, for his leadership to see this application through to fruition.

Our first cohort will start in August. This is a fantastic new opportunity to grow our clinical excellence at PTSMC!

With regard to clinicians better understanding the terminology and specific exercise movements, debates on the level of safety of CrossFit as a form of exercise are present throughout the healthcare profession. Every single type of exercise, training regimen, or sport pose some risk of injury. When performed with proper techniques and monitoring, CrossFit can be a safe form of high-intensity interval training (HIIT). Injury Rate and Patterns Among CrossFit Athletes concluded, “The injury incidence rate associated with CrossFit training was low, and comparable to other forms of recreational fitness activities.” This study examined 386 CrossFit athletes and found a 20% prevalence injury rate while the study also referenced a systematic review involving long distance runners.

The systematic review found injury incidence rates ranging from 19.4% to 79.3%. (1,2) In relating to the safety of CrossFit, it serves as an effective high intensity interval training form of exercise. “CrossFit-Based High Intensity Power Training Improves Maximal Aerobic Fitness and Body Composition,” a study done in 2013, found “a 10-week CrossFit-based HIPT program significantly improves the maximal aerobic capacity and body composition in individuals of all fitness levels and genders.” In absolute terms, body fat percentage of all participants decreased by 3.7%. With relation to VO2max, men and women increased by 13.6 and 11.8%, respectively. (3) By better understanding the terminology/specific exercise movements and the safety/effectiveness of CrossFit as an exercise form, clinicians of PTSMC will continue to improve the quality of CrossFit athletes’ lives.

1. Weisenthal, B. M., Beck, C. A., Maloney, M. D., DeHaven, K. E., & Giordano, B. D. (2014). Injury rate and patterns among CrossFit athletes. Orthopaedic Journal of Sports Medicine, 2(4), 2325967114531177.

2. van Gent, B. R., Siem, D. D., van Middelkoop, M., van Os, T. A., Bierma-Zeinstra, S. S., & Koes, B. B. (2007).

Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review.

British journal of sports medicine.

3. Smith, M. M., Sommer, A. J., Starkoff, B. E., & Devor, S. T. (2013). Crossfit-based high-intensity power training improves maximal aerobic fitness and body composition. J Strength Cond Res, 27(11), 3159-3172.

Student Program Update Brian Reis began working with Joanna Fisher in the Waterbury office on June 18th. Brian is a student at Sacred Heart University and will be with PTSMC through August.

STUDENT PROGRAM UPDATE

Michael Ranando will be working with Ali Filer in the Southington office beginning on July 16th. Michael us a student at UCONN and will be with PTSMC through September.

Olivia Kane will be working with Steven deCastro in the Groton office beginning on July 23rd. Olivia is a student at UCONN and will be with PTSMC through September.

Jason LePage will be presenting “Training Concepts for the Physical Therapist” on July 12th at noon in Wallingford.

Laura Smith will be presenting “Tests and Measures of the Vestibular System” on July 29th at 1:00 pm in Branford.

ANTHEM VISION COVERAGE

Better health is right before your eyes! Are you taking advantage of this important benefit?

HR DEPARTMENT ROLE CHANGES

Effective in February, Sandra Boccialetti and Karen Havlicek swapped some of the HR roles. If you have questions or need information in any of the areas listed below, please reach out to the appropriate person.

Karen Sandra

Student Program coordination with Juliann Compliance Incident reports CT and Federal Labor Law posters Non-student observation hours

Exam Coverage Employees who are eligible and enrolled in one of the Anthem HSA plans are eligible for one routine eye exam per plan year, March1st – February 28th with no copay and no deductible.

Save Money with discounts & use your HSA money!

1-800-CONTACTS – Get contact lenses quick and easy plus discounts like $20 off when you spend $100 or more and free shipping.

Glasses.com – Get the latest brand name frames for just a fraction of the cost at typical retailers. Plus, you get an additional $20 off orders of $100 or more, free shipping and free returns.

CURRENT JOB OPPORTUNITIES AT PTSMC Physical Therapist Southbury (part-time) Waterbury (part-time) Patient Services Coordinator New Milford (evening)

Physical Therapy Aide Groton New Haven New Milford Waterbury Watertown Westbrook

Check PTSMC.com for our most up to date postings and feel free to share!

We’re always interested in connecting with referrals of colleagues and friends.

Have you seen the new PTSMC Windsor clinic yet?

MONEY BEAT

MONEY BEAT

JIM HUNGERFORD, CPA

SMART USES FOR YOUR TAX REFUND Pay Off Your Credit-Card Debt Using your refund to pay off a balance with an 18% interest rate is like earning 18% on your investments -- an incredibly valuable use of the money.

Boost Your Retirement Savings You can contribute up to $5,500 to a Roth IRA for 2018 (or $6,500 if 50 or older) -- and withdraw the money tax-free in retirement. You can contribute the full $5,500 as long as your income falls below $120,000 if you’re single, and $189,000 if married filing a joint tax return. You can make a partial contribution if you earn less than $135,000 if single or $199,000 if married filing jointly.

Fill Gaps in Your Insurance Purchase Liability Insurance. Cover your legal expenses if someone is hurt in your home or by your car. It generally costs just $300 to $500 to buy a personal umbrella policy that provides $1 million in coverage over the limits of your auto- and homeowners-insurance policies.

Build Your College Savings It’s always hard to juggle saving for college and retirement. Here’s an opportunity to use your extra money to contribute to a 529 account. And the new tax law now lets you use up to $10,000 per year to pay tuition for kindergarten through 12th grade, too.

You’ll be able to use the money tax-free for college bills, and you could get a state income-tax deduction for your contribution if you invest in Connecticut’s plan, CHET. Help Your Kids Save You can use the extra money to contribute to a Roth IRA for your child. Your kid is eligible as long as he or she has earned income -- from mowing yards or babysitting, for example. Your child can contribute up to $5,500 or the amount of his or her earned income for the year, whichever is lower, and you can give her the cash to do it. Helping your kids or grandkids contribute to a Roth IRA can give them a tremendous start on retirement savings and can double as a back-up emergency fund.

Take a video tour at www.PTSMC.com/Windsor

It is important to use the correct verbiage when asking for PT benefits from an insurance company. When asked what benefits you are calling for, you should reply “outpatient physical therapy benefits in an office setting”. If they ask if you will be billing an office visit, reply “we bill PT codes only and the services will be performed by a licensed physical therapist”. If further clarification is needed, we bill with a service code “ll”.

Establish an Estate Plan If you don’t have estate-planning documents, you can use your tax refund money to make your wishes known for the future. You can meet with a lawyer to draw up three key documents: a will that divvies up your assets and appoints a guardian for your children; a health-care proxy, which designates someone to make medical decisions on your behalf if you’re unable to; and living will, which outlines your wishes for end-of-life medical care.

Life Beat New England Style Crab Boil

Ingredients 1 cup water 2 cups white wine 2 bulbs garlic, cloves in half 1 lg white onion 2 lemons, halved 2 tbsp old bay seasoning 2 sprigs of fresh thyme 4 fresh corn, halved 2 lb baby red potatoes, halved 4 smoked sausage, small chunks 4 oz unsalted butter 4 crab clusters 1 lb shrimp, peeled & deveined 1/4 c chopped fresh parsely Directions 1. In a large stock pot, bring water, wine, garlic, onions, lemons, old bay seasoning and thyme to a boil.

2. Lower heat to medium and add corn, baby red potatoes smoked sausage and butter. Cook 15 to 20 minutes.

3. Add crab and shrimp and cook an additional 5 to 8 minutes or until shrimp are pink and fully cooked.

Toss everything gently to cover in cooking liquid.

4. Season with a little more old bay as needed and serve on a large platter.

5. Garnish with fresh chopped parsley.

Go ahead and serve right out of the cooking pot!

PTSMC ATHLETIC TRAINERS BECOME RED CROSS INSTRUCTORS

EMPLOYEE RECOGNITION JULY BIRTHDAYS Steve Platt Kaitlyn Pearson Amanda Bozzuto Laura Gallant Devon Macko Sandra Boccialetti Katy Sullivan Glen Gitterman Eric Welles Cody Filingeri Katie Rymsza Amy Fichman Arianna Athenian Stephanie Weyrauch Tara Melaccio Robin Norko Brittany Boscarino Scott Olmstead Allyson Melillo Chrys Graboski Anthony Ciaburri Roslin Wilhelm

July 1 July 1 July 2 July 5 July 5 July 6 July 9 July 10 July 10 July 11 July 11 July 11 July 13 July 18 July 24 July 25 July 27 July 27 July 28 July 28 July 30 July 30

Congratulations to Jenna Bouffard (Watertown office), Liz Saunders (New London office), Katie Urycki (Westbrook office), Bethany Grady (Groton office) and Caty Halpin and for volunteering to add this skill to their clinical expertise.

ANNIVERSARIES

HAPPY 1 YEAR

Sam Huebner, Westbrook PT Julie Jeski, Plainville PSC Mike Lynch, Naugatuck PT Brandon Robertson, New London PT Aide Andrew Wolak, New Haven PT Aide

Congratulations!

Congratulations to Josh McAdams, New Milford PT, and his family. They welcomed Juliette Ann on June 1, 2018!

NEW EMPLOYEES

Welcome to PTSMC. We’re so happy to have you!

Mikayla Carasone Branford PT Aide

On June 12th, five PTSMC athletic trainers (pictured with instructor William Benitez) successfully completed the two-day American Red Cross Instructor training to become certified to teach Adult/Child CPR and AED, as well as First Aid. While the skills required are not new to them as athletic training professionals, this new certification allows them to certify their PTSMC colleagues, school staff & faculty, and members of their communities to further extend our PT for Life mission.

Guilford Windsor Guilford Avon Plainville Admin Orange Branford Plainville Avon New London Newington New London Orange Guilford Branford East Hampton New London New Haven Avon Orange Avon

Tom Kassan Newington PT

Rowan O’Connell Admin Marketing Intern

Livia Shehu Watertown PT Aide

Andina Kukaj Waterbury PT Aide

Paulo Oliveira Waterbury PT Aide

Selina Sampieri New London PT Aide

Stephanie Weyrauch Orange PT

PTSMC Happenings

New London at the Niantic Bay 10K on June 9.

Branford and New Haven unite for lunch time inservice and celebration!

Team Newington hit the town for a round of fierce mini golf.

Waters Region takes on the Griskus Olympic Triathlon at Quassy Amusement Park.

Social Media Sensation Thanks to Cara McEvoy,Branford PSC for these awesome photos from the Branford Road Race!