Susan Lofton , 2025-06-24 13:05:00
After 15 years without major change, the Centers for Medicare & Medicaid Services (CMS) has issued a bold new strategic direction for the Center for Medicare and Medicaid Innovation (CMMI). Framed around three clear pillar — evidence-based prevention, patient empowerment, and expanded provider choice — this shift signals a new era for value-based care (VBC).
For rehab therapy providers, including physical therapists (PTs), occupational therapists (OTs), and speech-language pathologists (SLPs), the implications are significant. The work of rehab professionals has long aligned with prevention and functional outcomes. Now, CMS is explicitly calling for those priorities to lead the next phase of healthcare innovation.
So the question isn’t, “Can rehab therapy fit into this model?” The question is, “Will we rise to the moment and prove it?”
Prevention as policy: An opening for proactive rehab
The renewed focus by CMS on prevention offers more than validation for rehab professionals. It’s a challenge to make our value unmistakable. Therapists are already on the front lines of fall prevention, mobility restoration, chronic condition management, and speech and swallowing improvements. These are all services that reduce downstream costs and improve quality of life. But, historically, they haven’t always been captured in the outcome data CMS and payers rely on.
Now, that’s changing. CMS is signaling a commitment to early intervention across all care settings, with plans to redesign existing models to reflect this priority. The first of its three new pillars reads: “Promote evidence-based prevention.” For many in the rehab field, this is a call to action.
Outcomes, outcomes, outcomes
While prevention may be the headline, the subtext throughout the new CMS rollout is clear: Outcomes will be the currency of credibility. Whether through formal metrics, patient-reported progress, or claims-based results, rehab providers must demonstrate the impact of their care at scale.
Capturing and communicating outcomes isn’t a new idea, but many in the field still struggle to do it effectively. That gap could become a liability as CMS and the wider health system shift their focus more aggressively toward value and accountability.
A recent CMS-aligned webinar referenced the importance of outcomes more than 40 times in just the first hour. The message is clear: If your organization isn’t ready to quantify value, it may soon be left behind.
This moment invites rehab therapy to go beyond anecdotal success and align more visibly with the evolving reimbursement and care delivery frameworks. The good news? Therapists already have the patient’s trust, access, and real-world results. What is needed now is the infrastructure and the intent to prove it.
A more open playing field for independent providers
In another notable shift, the new CMS strategy emphasizes supporting independent providers, not just large health systems. For rehab professionals in outpatient clinics, rural practices, or small community settings, this could be a game-changer.
CMS explicitly states that Innovation Center models will be designed to “level the playing field for providers practicing independently.” That includes enabling upfront investment in patient care, something that smaller practices often struggle to access.
This initiative may create new opportunities for therapy practices to participate in value-based arrangements and pilot models without needing to be absorbed into large hospital systems. It’s also a timely reminder that scale isn’t the only path to impact—outcomes and alignment matter more.
What comes next?
The CMS vision is ambitious, but so is the potential for rehab therapy to shape its execution. To do that, providers must actively engage, document their impact, and advocate for their inclusion in evolving models of care.
This article is the first in a broader exploration of what value-based care means for rehab therapy and what is required to meet the moment. In the coming months, I’ll dig deeper into strategies for capturing outcomes, optimizing care pathways, and preparing your practice for the next wave of CMS-led transformation.
Photo: kutubQ, Getty Images
Susan Lofton is a physical therapist with 25 years of experience in clinical care, operations, and senior-level management. Susan has worked in multiple healthcare settings including acute, IRF, skilled nursing, home health and outpatient, giving her exceptional insight into the transitional needs of patients and the inner workings of the healthcare ecosystem. Susan is passionate about improving health care and has deep expertise in regulatory compliance and optimizing strategies for success. Susan serves as VP, Outcomes and Clinical Transformation for WebPT and is ED of Keet Outcomes Qualified Clinical Data Registry(QCDR) for participation in MIPS and other quality payment programs.
This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.
