In this episode of What’s Best for the Patient Is Best for Business, Jerry welcomes back Angela Diaz, PT, VP of Market Development at TailorCare, to move from the “why” to the “how” of value-based musculoskeletal care.
They dive deep into the operational engine of TailorCare, a risk-based care navigation company that partners directly with payers to manage the entire MSK journey. Angela breaks down exactly how patients enter their system—through both inbound referrals from network providers and outbound, predictive data analytics that identify members at high risk for surgery months in advance.
Jerry and Angela explore the crucial performance metrics that define a "high-value" physical therapy partner in this new landscape, from risk-adjusted cost per episode and patient outcomes to timely access and reducing low-value care. This episode is a masterclass in future-proofing your practice, emphasizing that the transition to value-based care isn't a distant threat—it's an opportunity happening now.
Key Takeaways:
• The Payer-Partnered Model: Learn how TailorCare operates "at the top of the funnel" by taking on risk from payers and why collaboration is grouped by payer network (e.g., Humana) rather than by individual provider relationships.
• Data is the New Currency: Discover how performance data—like risk-adjusted visit counts, patient outcomes, and avoidance of low-value care—is used to identify and partner with top-tier physical therapy practices and orthopedic groups.
• Inbound vs. Outbound Patient Engagement: Understand the two primary pathways: inbound referrals from PCPs and orthopedists, and outbound predictive outreach to high-risk members to guide them to the right care before they need costly interventions.
If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!