{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:46:11Z","timestamp":1791989171295,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"ABSTRACT<\/jats:title>\n \n Importance<\/jats:title>\n As health care transitions toward value-based care, outpatient physical therapy lacks a practical metric that objectively integrates quality of care and cost into a single measure of clinical value.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The objective was to develop a single-number value metric (VM) integrating clinical effectiveness, patient experience, and cost efficiency in outpatient physical therapy and to determine its concordance with blinded manager assessments of therapist value.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n This was a retrospective observational cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The study was conducted at 8 outpatient physical therapy clinics within a single health care system, including freestanding ambulatory clinics and hospital-based outpatient departments.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n The study included twelve licensed physical therapists and 2400 outpatient episodes of care.<\/jats:p>\n <\/jats:sec>\n \n Intervention(s) or Exposure(s)<\/jats:title>\n Therapist-level patient-reported outcome measure (PROM) improvement, clinic-level Net Promoter Score (NPS), and financial data were combined to calculate a single-number VM. Blinded clinical managers independently ranked therapists according to perceived value.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome(s) and Measure(s)<\/jats:title>\n VM scores were calculated for each therapist. Concordance between VM rankings and blinded manager rankings was assessed using Spearman rank correlation coefficient.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n VM scores ranged from 1.39 to 4.76 (median = 2.39; interquartile range = 1.99\u20133.13). Across 2400 episodes of care, 72.8% of PROM changes met or exceeded published minimal clinically important difference thresholds. Among ambulatory therapists, VM rankings demonstrated a strong inverse correlation with manager rankings (Spearman \u03c1 = \u22120.82). Among hospital-based therapists, VM rankings demonstrated perfect inverse agreement with manager rankings (Spearman \u03c1 = \u22121.00).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The proposed VM integrates clinical effectiveness, patient experience, and cost efficiency into a feasible, single-number measure of value in outpatient physical therapy. VM scores were strongly aligned with blinded managerial assessments of therapist value.<\/jats:p>\n <\/jats:sec>\n \n Relevance<\/jats:title>\n The VM offers a potential framework for evaluating clinical value in outpatient physical therapy and supporting the transition from volume-based to value-based care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ptj\/pzag109","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T11:48:47Z","timestamp":1791632927000},"source":"Crossref","is-referenced-by-count":0,"title":["A Single-Number Value Metric Integrating Quality and Cost in Outpatient Physical Therapy"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0911-7577","authenticated-orcid":false,"given":"Bryan","family":"Bourcier","sequence":"first","affiliation":[{"name":"AdventHealth Innovation Tower , 265 E Rollins St, Orlando, FL, 32804 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ruediger","sequence":"additional","affiliation":[{"name":"Fortify Physical Therapy , 216 Marciel Dr, Fort Wayne, IN 46825 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-276X","authenticated-orcid":false,"given":"Christine","family":"Walck","sequence":"additional","affiliation":[{"name":"Embry-Riddle Aeronautical University , 1 Aerospace Blvd, Daytona Beach, Fl 32114 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean M","family":"Kennedy","sequence":"additional","affiliation":[{"name":"AdventHealth Innovation Tower , 265 E Rollins St, Orlando, FL, 32804 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,14]]},"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzag109\/71946678\/pzag109.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzag109\/71946678\/pzag109.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:02:02Z","timestamp":1791986522000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article\/doi\/10.1093\/ptj\/pzag109\/8916453"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,14]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ptj\/pzag109","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,14]]},"article-number":"pzag109"}}