Pictured, left to right: from left to right:  Mikey Thomas, Russ Overy, Alena Ryan, Jane Milliff and Katya Martinez-Ibarra.  


Alta Physical Therapy and Pilates in Boulder, Colorado, is a progressive physical therapy practice. In 2017, when most physician practices were still getting their arms around quality improvement and reimbursement under the Merit-Based Incentive Payment System (MIPS), Alta became a Transforming Clinical Practice Improvement (TCPi) practice and began the hard work of updating practices and focusing on quality.

HealthTeamWorks’ Jaclyn King, practice coach, and clinical health IT advisor Jennifer Halfacre provide assistance for Alta, an active practice with nine physical therapists and two assistants.

“TCPi helps us narrow down our quality improvement focus so we can really tackle a few goals,” says Jane Milliff, MMSc, PT, CBP, an Alta practice owner. “One of our goals we came up with jointly with HealthTeamWorks was to improve patient engagement with the goal of better outcomes and lower costs due to injury.” Alta has worked to standardize how it educates patients about injury prevention as one of its key improvement areas. “It’s a little early, but we believe we’re going to save the medical industry a lot of money down the road.”

Streamlining communication and documentation is critical for practice transformation, so Alta has been examining its front office systems to ensure it is gathering actionable information to optimize patient engagement. “At the front desk, HealthTeamWorks helped us write up protocols and revamp some of our intake paperwork at the front. We redid a lot based on their recommendations and help,” says Alena Ryan, Alta’s practice manager.

“We’re also looking at how we’re interacting with other provider offices and how we’re gathering the information we need to do our work most efficiently,” she adds. “Within our own practice group, it’s been helpful to get tips on a system for running a meeting—an affinity diagram—where we use sticky notes to get more participation from our practitioners.”

Data collection and measurement is a challenge. The practice uses its own data system, and it’s not able to connect with the various electronic record systems used in area hospitals. “Jennifer has helped us get the data we need so we can be as successful as possible with the outcomes,” Jane says. That expertise is critical as Alta prepares to take part in MIPS.

Alta also participates in regional and national TCPi learning sessions, where they continue to gain insight into practice improvement.

“It feels like every time we have a meeting we come back with a greater focus,” Alena says. “People at national meetings are really unclear about how physical therapy relates to the practice improvement game and the ability to participate in MIPS. We feel like we’re more informed and educated relative to most of our colleagues. We’re ahead of the curve.”

“Jaclyn and Jennifer, both, are very encouraging, and they’re all in to help us,” Jane says. “They have our best interests at heart and want to help us make our practice more efficient. They are tuned in to what we need and curious. They have a lot of resources to support us—and they’re really generous with them.”