Clinical Guidelines and Care Management.
TPI has a history of consistent and effective care management of physical and occupational therapy care provided for a broad range of musculoskeletal conditions. One of the TPI practices developed a very detailed set of clinical guidelines for 24 non-operative and post-operative clinical conditions covering over 100 diagnoses. The guidelines define the condition, list the common impairments and functional limitations, describe diagnostic and evaluative approaches, define accepted therapy treatment interventions based on the patient’s impairments and functional needs, define expected number of visits, list complicating factors, and set forth discharge criteria. These guidelines have helped shape the care management approach of all the practices, and use of the guidelines for a consistent care management approach has become part of our clinical culture over the past 15 years.
TPI has clinical guidelines for the following conditions:
| Conditions without Surgery | Post-Operative Conditions |
| Lumbar Strain Cervical Strain Shoulder Impingement Syndrome Elbow Dysfunction Epicondylitis Elbow sprain Wrist Fracture Carpal Tunnel Syndrome Hip Strain Knee Dysfunction Patellofemoral Dysfunction Ankle Sprain  |
Lumbar Spine Surgery Decompression Fusion Cervical Spine Surgery Rotator Cuff Repair Shoulder Decompression Surgery Shoulder Stabilization Surgery Carpal Tunnel Release Total Knee Replacement ACL Reconstruction Knee Arthroscopy |
TPI practices have proven that our therapists’ use of outcome-based clinical guidelines has resulted in very consistent care management across our network of 18 clinics and 80 plus PTs and OTs. We have maintained high patient satisfaction and excellent functional outcomes within an average utilization rate that is about half the national average rate of visits per episode of care.
If you would like more information about TPI’s clinical guidelines and outcomes for physical and occupational therapy, please contact Jim Hoyme at 651-747-4336 or jhoyme@therapypartners.com.
Specialized Programs
Chronic Low Back Pain Program.
TPI has created a specialized program for physical therapy management of chronic low back pain. This is a three phase program designed to help people with unresolved low back conditions (with or without lower extremity symptoms) avoid surgery. The first phase of the program requires that members with this type of condition see a TPI Physical Therapist who has achieved the designation of a chronic low back pain specialist. The second and third phases involve supervised, patient-specific exercise programs for long term self management of the condition. Phases 1 and 2 are covered by the health plan and Phase 3 is paid by the member. TPI is very willing to work with health plans on risk sharing payment arrangements involving FOTO – Focus on Therapeutic Outcomes – outcomes and value based purchasing. You can get more information about TPI’s use of FOTO outcomes in the section titled Patient Outcomes on this website and the Focus on Therapeutic Outcomes (FOTO) website – www.fotoinc.com. You can get details of our chronic low back pain program in the section Specialty Programs on this website.
We have implemented this program with one health plan, and we are confident this will be very effective in reducing the incidence of lumbar surgery and helping many people conservatively manage their low back pain.
If you would like more detailed information about the TPI program for chronic low back pain, please contact Jim Hoyme at 651-747-4336 or email Jim at jhoyme@therapypartners.com.
Innovative Contracting
Pay for Performance
TPI is well positioned and willing to share risk in contracting with health plans for the provision of physical and occupational therapy services to their members. Our practices use clinical guidelines and FOTO outcomes to help us manage our care consistently across our network and measure the effectiveness of our care. We have engaged in a pilot project using TPI’s FOTO outcomes (functional and utilization) in payment methodology.
If you would like to discuss pay for performance contracting methodology, please contact Jim Hoyme at 651-747-4336 or email Jim at jhoyme@therapypartners.com.
