4. February 27, 2019

5. Who We Are
The American Academy of Physical Medicine and Rehabilitation (AAPM&R):
The primary medical society for the specialty of physical medicine and rehabilitation
Kavitha Neerukonda, Associate Executive Director, Quality and Research Initiatives
Offers education, advocacy, networking, and practice resources to more than 9,000 rehabilitation physicians
In 2016, we began making a significant investment in developing a qualified clinical data registry
Beth Radtke, Senior Manager, Quality and Registry Initiatives
Richard Zorowitz, MD Attending Physician, Outpatient Physician Services
Professor of Clinical Rehabilitation Medicine
Georgetown University School of Medicine
MedStar National Rehabilitation Network

6. AAPM&R’s Vision
Physiatrists are the essential medical experts in value-based evaluation, diagnosis, and management of neuromusculoskeletal and disabling conditions.
Physiatrists are indispensable leaders in directing rehabilitation and recovery, and in preventing injury and disease.
Physiatrists are vital in optimizing outcomes and function early and throughout the continuum of patient care.
Data is an enabler of each of the components of the new vision (Essential, Indispensable and Vital)

7. Overview of the PM&R Specialty
~50% work in acute and post-acute care settings
~50% work in outpatient settings
Many clinical conditions
Many EHRs
Variable practice sizes; some multi-specialty practices

8. Physiatry’s National Quality Position:Our Challenge
The value (quality ÷ cost) of physiatric care is being challenged
Specialty-specific challenges related to quality
No national strategy to address quality
No acceptable tools to effect widespread quality change
Little high level evidence to guide care
No specialty specific measures

9. Since 2015, the Academy embarked on a quality journey and pursued the development of a registry.
2016
2017
2018
2019
Prioritize Quality as a focus of the Academy
Traditional options not enough for Academy to see benefits
Registry as an effective way to build a quality arm
Registry development began
Initial focus on spine patient population
Spine measures adapted from NeuroPoint Alliance (an arm of AANS)
Began planning for other areas of focus
Registry soft launch
Receive QCDR status
Identification of neurorehabilitation next area of focus for measure development
Partnership with PCPI for measure development
Receive QCDR status
Integrate PCPI developed measures into registry
Receive QCDR status
DATA CAPTURE
*QCDR - Qualified Clinical Data Registry

10. Evolution of Measure Development
PCPI Contract
QCDR 3rd year as a CMS- approved QCDR
Deep Dive in Spine 8 measures currently in the Registry
Deep Dive in Neuro-Rehabilitation
5 measures currently in the Registry
Deep Dive in Pediatric Rehabilitation
Coming in Fall 2019
Adapted existing measures

11. Process for AAPM&R’s Measure Development Journey
AAPM&R’s Evidence, Quality and Performance Committee identifies need for PM&R specific quality measures
AAPM&R Board of Directors approves and work with the PCPI to develop PM&R specific measures
Technical Expert Panel Chairs identified
Technical Expert Panel call for nominations
Technical Expert Panel member selection

12. Process with PCPI TEP Convened
Technical Expert Panel In-Person Meeting
TEP prioritized developing measures for patients undergoing management for the following conditions: stroke, acquired brain injury, spinal cord injury, cerebral palsy, and multiple sclerosis
Measure Specifications & Public Comment Period
Gain consensus around measure concepts for measure development and address key issues
E-Specifications of Measures
Measure specifications drafted and reviewed by Technical Expert Panel
Comments received from outside stakeholders on drafted measures
TEP finalized prioritized measure specifications
PCPI staff implemented e-specifications into AAPM&R’s registry

13. Final Measures
Assessment and Management of Muscle Spasticity - Inpatient Setting
Management of Muscle Spasticity - Outpatient
Post-Acute Brain Injury: Depression Screening and Follow-Up Plan of Care
Family Training—Inpatient Rehabilitation/Skilled Nursing Facility - Discharged to Home 
Functional Assessment to Determine Rehabilitation Needs
Full measure specifications are available at:

14. Technical Expert Panel
Co-Chairs
Richard Zorowitz, MD
Amy Houtrow, MD
TEP Members
Samir Belagaje, MD
Allen Heineman, PhD
Yohannes Endeshaw, MD, MPH, FAASM, AGSF
Valerie A. Jones, MD
Steve M. Gnatz, MD, MHA
Jennifer L. Moore, PT, DHS, NCS
Diedre Hannah, RN, CNS
Jilly Rye, DNP, RN, CCRN, CNL
Kimberly P. Hreha, EdD, Ms, OTR/L

15. Challenges CMS approval of measures “as-is” Adoption of measures
E-specifications automatic data capture

16. QUESTIONS?