Ever since CMS announced the implementation of functional limitation reporting (FLR), people in our industry have been looking for ways to get by without complying. And because they couldn’t find a way to completely avoid FLR—and still get paid—they found a way to cheat. It’s what’s now known in the industry as crosswalking, or taking the results of an objective measurement tool and using a calculator to translate that number into an exact percentage of impairment (severity modifier).
So why is this such a big deal? Because aside from minimizing the importance of a critical reporting initiative, it’s stripping clinical judgment from the equation and basically telling the world that a monkey could do your job—or better yet, that a patient could go online, answer a few questions to complete an OMT, and self-diagnose. From there, it wouldn’t take much time to Google a few exercises, maybe a couple stretches. If that’s the case, who needs rehab therapists? What’s the point of fighting for autonomy, respect, and direct access if you’re going to tell the world that you don’t deserve it? Without specialized clinical judgment that comes from years of education and experience—and consideration of the context surrounding each individual case—there’s a huge piece missing from the patient’s story. That could be detrimental to the plan of care and ultimately the therapy experience.
We feel strongly that this could be the beginning of a very steep decline for our industry as a whole—if we succumb to this first step in a very slippery slope, that is. It also deeply saddens us to see some of our competitors falling over themselves to create these crosswalking calculators to “help” therapists get by. It’s not helping anyone. And you as therapists don’t need to just “get by.” You’ve fought for what you have. You’ve battled legislation trying to restrict your right to practice; you’ve kept your doors open despite the POPT moving in around the corner; and you’re a damn good therapist. So, prove it.
Show Medicare—and the world—that you’ve got this and you’re going to do it the right way—with honesty, integrity, and professionalism. Don’t fall victim to cheating, to crosswalking. If not for yourself, then for your patients. They need you—not a calculator, not Google, not software that plugs and chugs everything (thinks!) for you. You are, after all, the expert. Aren’t you?