Change the Model: Why PT’s Business Model Is Breaking

WEBVTT

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Thanks, VoiceOverGuy.

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First, thanks to U.S.

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Physical Therapy.

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They were nice enough to host me at

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CSM.

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I got to hang out at their booth

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and do some live streams.

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If you've built something special,

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but scaling your clinic and planning for

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what's next, well,

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that can feel overwhelming.

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At U.S.

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Physical Therapy,

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they partner with clinic owners who want

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to grow with you

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without you having to give up your

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identity.

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You stay in control.

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They bring the support.

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Learn how at usphpartnership.com.

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That's usphpartnership.com, their website,

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USPH.

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Today,

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our guest believes physical therapy

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doesn't have a value problem.

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It has a positioning problem.

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I like this.

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He spends his time helping independent

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practices stop waiting for reimbursement

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to improve and start rethinking how they

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get paid altogether.

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While most clinic owners are stuck

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negotiating contracts, chasing referrals,

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or hoping legislation fixes their margins.

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Spoiler alert, it's not going to do that.

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He's asking different questions.

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What if the problem isn't reimbursement?

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What if the problem is the model?

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What if the call is coming from inside

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the house?

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You get the idea.

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He's gotten to work with practices that

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want more control over their pricing,

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their relationships,

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their future by building direct

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relationships with employers and

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positioning physical therapy as the first

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stop for musculoskeletal care.

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He's here to challenge the default system

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and give clinic owners in the audience a

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chance to think differently about power in

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healthcare.

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Let's bring him in, Matthew Pratt.

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Matthew, welcome to the show.

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Thank you for having me on.

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Pretty good intro, right?

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I tried to go NPR style.

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Yeah,

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I feel like I'm going to have a

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hard time living up to that,

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but that was really good.

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Thank you.

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All right.

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So I like bold statements and you say

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most PT practices don't actually have a

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reimbursement problem.

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They've got a business model problem.

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I like that because it changes the

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ownership on not our fault to it might

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not be our fault,

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but it is our problem.

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So break that down.

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Break that idea down for me.

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Yeah.

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Well,

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let me start by first saying reimbursement

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is an issue for a lot of practices.

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I'm not minimizing that in any way.

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The reason I say that the way that

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I do is because the current traditional

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fee for service system does not position

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physical therapy, for the most part,

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in a position to win.

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You're constantly,

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where your people come from,

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how much you get paid, your referrals,

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all of that is dictated by someone else.

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We're hoping legislation will change that.

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We're hoping referral partnerships will

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change that.

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We're hoping that

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the hospital system won't go out and

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acquire our competitor across the street

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and just refer everything in house.

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And so when you look at the reality

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of health,

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the healthcare costs in America continue

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to rise, right?

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I saw a post this morning by Dr.

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Eric Bricker and he, in his post,

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he talked about how for a family of

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five,

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the cost of healthcare for in Dallas,

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in the Dallas Fort Worth area was thirty

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five thousand dollars.

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which is, and that's my situation.

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I have a family of five, I'm married,

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I've got three little girls,

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and that's a lot of money, right?

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And so as these costs continue to rise,

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the people who are paying for care,

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patients and the people that employ them,

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they're looking for alternative methods to

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be able to bring those costs down, right?

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And so for physical therapy,

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I think that there's this unique

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opportunity to position, not as a,

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you know, a cheaper than option, right?

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As in, you know, outcomes are worse,

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but you save money.

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But in the reality of this does save

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you twenty seven hundred dollars on

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average per musculoskeletal claim for

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these employers and employers are willing

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to pay a premium for that.

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So to me, when I look at it,

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the positioning problem is that the value

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that P.T.,

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provides isn't being realized or

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recognized by the current system.

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So we need to look at alternative methods

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to go outside of, okay,

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who does value physical therapy and who's

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willing to pay what physical therapy is

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worth?

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Because I believe, you know,

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a hundred and fifty dollar reimbursement

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across the nation should be average.

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But I know a lot of practices I've

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talked to,

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sometimes they're getting fifty dollars,

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you know,

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sometimes they're getting seventy five.

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So that's why I say there's a positioning

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problem.

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It sort of changed.

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This part of the conversation feels like

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that Spider-Man meme, right?

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Is everybody sort of pointing at each

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other saying it's your fault.

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It's your fault.

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It's your fault.

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It sort of shifts.

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It shifts that ownership.

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I mean,

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I heard Jerry Durham say this a long

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time ago,

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which the fact that we still call it

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reimbursement and not getting paid like.

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i don't reimburse my plumber i pay him

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like i might get the invoice a day

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later but i still pay him isn't that

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funny how we even just the words like

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reimbursement it's like well thank thank

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you so much i appreciate you appreciate

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you allowing me to take your money for

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doing the thing i did right yeah yeah

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so what specifically breaks in the

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traditional fee-for-service model for

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independent practices where does it where

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does the where do things break down

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I think that a lot of it goes

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back to control and like control in the

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sense of in the traditional fee for

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service model,

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the way that things are set up right

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now, independent, you know,

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outpatient practices,

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they don't have the opportunity to dictate

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who do they treat, when do they treat,

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right?

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Obviously with greater direct access laws,

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some of that has opened up to a

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point,

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but I know certain States it's still,

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you know,

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there's caps on how many visits people can

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get on direct access and

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And so from a,

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the problem I would say with the current

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traditional fee for service model is it's

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not built to value physical therapy and

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for physical therapy practices to win,

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right?

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The people that are winning right now are

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the health systems,

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the people that are winning

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are the people who have the scale to

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go in and negotiate reimbursements.

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And I've even had this conversation with

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some people who agree and disagree with

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what I'm saying.

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And that's great.

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I think that that's the discourse that we

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need.

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That's how the industry,

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that's how health care gets pushed

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forward.

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We have these conversations.

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But when your practice is located in a

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large metropolitan area,

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you have the demographics and the wealth

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to say, oh, I offer cash pay.

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I offer these other wellness services.

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And I can scale to the point where

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now I can negotiate my contracts and get

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meaningful change in my reimbursement.

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But what does the small rural pediatric

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practice who services mainly Medicare

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patients, what do they do?

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that they're they're forced to say well i

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have to take what i can get from

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insurance and that that is what it is

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right and so and i even in that

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conversation i've had you know people have

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told me well they decided to do that

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that's their problem right and like i

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understand but i think we all would agree

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greater access to care is good like we

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want people getting into the care that

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they need so we've got to find a

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way that it at least works for the

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vast majority of people

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and and i i don't i'm not in

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any way advocating that we should just

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trash the traditional fee for service

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model i i don't that's not what i

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think would be most beneficial especially

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for most practices but i do think that

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we're kind of getting to an inflection

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point where the cost of providing care

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Inflation, rising overhead, staffing,

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how much it costs to pay your staff.

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People are coming out of PT school with,

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I think, you can correct me, Jimmy,

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I'm not sure.

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I think the average is like a hundred

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and fifty thousand in student loans is

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what people are coming out of PT school.

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So people with that much debt,

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they can't come in and start at sixty

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K.

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Right.

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Like they've they've got to make more

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money than that.

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Right.

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And we're getting to this point where it's

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getting incredibly hard for we'll call

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them the mom and pop private practices to

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operate.

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Right.

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Margins are getting so thin they can't eat

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the cost.

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Larger practices can.

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And for me,

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like just my my background and I think,

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you know, just uniquely to my experience,

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what I've been able to see,

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I've spent a lot of time

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emailing cold calling practices all across

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the country like some people who listen

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this you may even have a voicemail in

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your inbox from me at this very moment

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uh but in the month of january alone

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um i talked to two six location practices

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i'm obviously not gonna name names or

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locations uh talk to two owners who told

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me in january two six location practices

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that they were selling

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and i've seen that as a growing trend

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yeah over the last six months and i

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think we're getting to that point where

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the economics don't make sense that

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doesn't matter

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the math doesn't math and the concern that

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I have, you know, my background, um,

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I played football from fifth grade into

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college.

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I've, I've had,

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I've been on a lot of treatment tables.

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Um,

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I've got a very good friend who's a

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physical therapist here in where I live.

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Um, I,

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I deeply care about the industry and about

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physical therapy.

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And my concern is that in,

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in five years, the,

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the

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The PT student coming out and saying,

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I want to go start my own practice

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because I just want to treat and serve

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my community.

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And maybe we scale it in the future.

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They're not going to be able to do

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that.

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Their only option is going to be,

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I've got to go,

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I've got to go work for this very

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large company.

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And we're going to only going to have

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four or five of those.

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Maybe that's, that's my concern.

00:10:02.100 --> 00:10:03.782
That's what I've been hearing,

00:10:03.802 --> 00:10:05.202
and that's what some of the smart people

00:10:05.222 --> 00:10:05.923
that I hang out with,

00:10:05.942 --> 00:10:08.203
which is you can do this as an

00:10:08.384 --> 00:10:09.644
individual provider.

00:10:09.825 --> 00:10:11.365
This is where they say the rise of

00:10:11.405 --> 00:10:14.787
the one point five FTE location, right?

00:10:14.886 --> 00:10:16.227
It's like you running it,

00:10:16.607 --> 00:10:18.269
you bring someone on part time.

00:10:18.808 --> 00:10:20.490
But when you go to a step bigger

00:10:20.509 --> 00:10:20.929
than that,

00:10:22.044 --> 00:10:24.265
that that next step doesn't make any sense

00:10:24.525 --> 00:10:26.407
the other end of the spectrum is a

00:10:26.466 --> 00:10:30.208
giant multi-state um chain or a hospital

00:10:30.249 --> 00:10:32.389
system or you know you sort of do

00:10:32.409 --> 00:10:34.750
what danny mattei and his group talk about

00:10:34.770 --> 00:10:36.312
which is like it's just cash but will

00:10:36.331 --> 00:10:37.133
that work everywhere

00:10:37.932 --> 00:10:38.533
Maybe not.

00:10:38.653 --> 00:10:38.933
Right.

00:10:39.014 --> 00:10:40.134
Like, so,

00:10:40.173 --> 00:10:41.914
so the question I always ask people is

00:10:41.936 --> 00:10:43.275
like, what game are you playing?

00:10:43.716 --> 00:10:45.116
What game do you think you're playing?

00:10:45.457 --> 00:10:46.778
I heard someone say it on a podcast

00:10:46.817 --> 00:10:47.178
recently.

00:10:47.198 --> 00:10:48.519
I, you know, just somebody was saying,

00:10:48.600 --> 00:10:48.860
Oh my God,

00:10:48.879 --> 00:10:50.220
I'm just done with this corporate America.

00:10:50.240 --> 00:10:51.360
I'm just going to go open a, um,

00:10:51.541 --> 00:10:52.142
a coffee shop.

00:10:52.921 --> 00:10:54.601
And the guy was probing and he goes,

00:10:54.841 --> 00:10:54.981
well,

00:10:55.001 --> 00:10:56.522
do you like spreadsheets and ordering

00:10:56.562 --> 00:10:58.582
coffee and cups and lids and napkins?

00:10:58.602 --> 00:10:59.303
And they're like, no,

00:10:59.384 --> 00:11:01.043
I want to hang out and talk and

00:11:01.104 --> 00:11:01.825
hand coffee over.

00:11:01.845 --> 00:11:03.784
He goes, you want to be a barista?

00:11:04.645 --> 00:11:06.186
That's what a barista does.

00:11:06.225 --> 00:11:08.907
So a coffee shop owner doesn't really does

00:11:08.927 --> 00:11:10.187
that one percent of the time.

00:11:10.888 --> 00:11:12.087
So I think when people are like,

00:11:12.107 --> 00:11:14.249
I'm frustrated by doing whatever this is,

00:11:14.349 --> 00:11:15.668
either a clinician or an owner,

00:11:15.788 --> 00:11:17.489
understand what game you're actually

00:11:17.528 --> 00:11:17.769
playing.

00:11:17.788 --> 00:11:18.908
Because right now for owners,

00:11:19.370 --> 00:11:21.029
it sounds like margin compression,

00:11:21.429 --> 00:11:24.370
referral dependency, or I mean,

00:11:24.429 --> 00:11:25.191
I've said this before,

00:11:25.510 --> 00:11:27.171
you need to be a marketing engine first

00:11:27.191 --> 00:11:28.931
that happens to sell physical therapy.

00:11:29.591 --> 00:11:31.692
Red Bull is a marketing company that

00:11:32.091 --> 00:11:33.831
happens to sell an energy drink,

00:11:33.991 --> 00:11:34.892
not the other way around.

00:11:35.653 --> 00:11:36.312
And then, I mean,

00:11:36.393 --> 00:11:37.773
we've heard just in the last couple of

00:11:37.793 --> 00:11:38.072
weeks,

00:11:39.928 --> 00:11:41.710
Clinicians saying I signed on to that

00:11:41.750 --> 00:11:43.711
contract knowing I'm losing money every

00:11:44.111 --> 00:11:44.452
visit.

00:11:44.513 --> 00:11:44.673
I'm like,

00:11:44.812 --> 00:11:45.714
how do you do that with a straight

00:11:45.734 --> 00:11:46.153
face?

00:11:46.433 --> 00:11:46.594
Like,

00:11:46.774 --> 00:11:48.275
how do you do that with a straight

00:11:48.316 --> 00:11:48.655
face?

00:11:49.277 --> 00:11:50.778
So overall,

00:11:51.057 --> 00:11:53.620
we can say you've said PT needs better

00:11:53.700 --> 00:11:55.601
positioning.

00:11:55.682 --> 00:11:57.623
What does that look like to you in

00:11:57.643 --> 00:11:58.283
a practice?

00:12:00.136 --> 00:12:00.277
Yeah,

00:12:00.356 --> 00:12:03.258
I think the two ways that come to

00:12:03.278 --> 00:12:05.119
mind, you mentioned it a second ago,

00:12:05.178 --> 00:12:05.739
right?

00:12:05.938 --> 00:12:06.940
There's cash-based,

00:12:07.899 --> 00:12:10.160
and I think that should be a mix

00:12:10.400 --> 00:12:13.383
of every practice's payer mixes is just

00:12:13.403 --> 00:12:14.523
cash-based patients.

00:12:15.043 --> 00:12:18.524
I think the hard part with that is,

00:12:21.870 --> 00:12:23.971
And I could be completely wrong on this,

00:12:24.052 --> 00:12:26.153
but I haven't seen many practices that are

00:12:26.173 --> 00:12:28.855
cash based be able to scale really well.

00:12:28.895 --> 00:12:30.738
And I think part of the problem with

00:12:30.758 --> 00:12:32.658
that is you're very demographic dependent,

00:12:32.698 --> 00:12:32.899
right?

00:12:33.379 --> 00:12:35.042
Just like the example I provided earlier.

00:12:35.062 --> 00:12:35.721
I mean,

00:12:35.861 --> 00:12:37.964
I grew up in a pretty rural area,

00:12:38.104 --> 00:12:39.065
blue collar family.

00:12:39.466 --> 00:12:40.826
We would have never had the money.

00:12:41.226 --> 00:12:42.788
to pay to go to physical therapy

00:12:42.827 --> 00:12:44.610
cash-based never would have had the money

00:12:45.191 --> 00:12:47.371
and so i think that's where you know

00:12:47.451 --> 00:12:49.254
the cash pay you know you get into

00:12:49.333 --> 00:12:51.075
well what are direct access laws you know

00:12:52.035 --> 00:12:54.798
does this work in every demographic it can

00:12:54.938 --> 00:12:57.321
to some extent right but i i don't

00:12:57.341 --> 00:12:59.942
think it's the solution in my opinion

00:13:00.082 --> 00:13:00.442
where

00:13:01.224 --> 00:13:04.086
I think the biggest opportunity for

00:13:04.566 --> 00:13:06.147
physical therapy and for physical therapy

00:13:06.206 --> 00:13:09.729
practices is in the direct direct

00:13:09.908 --> 00:13:11.750
contracting model with employers.

00:13:12.490 --> 00:13:15.712
And I'll tell you why I think that's

00:13:15.753 --> 00:13:16.192
the case.

00:13:18.114 --> 00:13:21.095
it alleviates some of the problems that we

00:13:21.115 --> 00:13:22.014
just talked about, right?

00:13:22.054 --> 00:13:23.576
Like, oh, this is a rural area.

00:13:23.895 --> 00:13:25.275
These people don't have a lot of money.

00:13:25.336 --> 00:13:27.356
They can't afford to pay me cash pay,

00:13:27.596 --> 00:13:27.797
right?

00:13:27.817 --> 00:13:28.496
But I also,

00:13:29.116 --> 00:13:31.118
I'm not really happy with the contracted

00:13:31.177 --> 00:13:32.317
insurance rate, right?

00:13:32.357 --> 00:13:34.578
That I'm usually getting in the same area.

00:13:35.538 --> 00:13:37.980
When you contract directly with a

00:13:38.299 --> 00:13:40.921
self-insured employer, and Jim,

00:13:41.020 --> 00:13:42.041
are you familiar, Jimmy,

00:13:42.061 --> 00:13:44.261
with like what a self-insured employer is?

00:13:44.830 --> 00:13:46.129
Yeah, but just explain again,

00:13:46.169 --> 00:13:48.191
because I don't know if everybody does.

00:13:48.230 --> 00:13:48.451
Yeah.

00:13:48.910 --> 00:13:49.871
So basically,

00:13:49.932 --> 00:13:51.591
when an employer is self-insured,

00:13:51.611 --> 00:13:53.732
they have their own group health plan.

00:13:54.552 --> 00:13:57.413
And instead of paying premiums to Blue

00:13:57.433 --> 00:13:59.154
Cross Blue Shield, UHC,

00:13:59.894 --> 00:14:02.134
they basically they have a third party

00:14:02.174 --> 00:14:03.895
administrator that can be someone like

00:14:04.096 --> 00:14:05.255
Blue Cross or UHC.

00:14:05.716 --> 00:14:07.576
But instead of paying for premiums,

00:14:07.657 --> 00:14:09.357
they're just paying all of the claims out

00:14:09.398 --> 00:14:09.878
of pocket.

00:14:09.918 --> 00:14:12.359
So for their covered lives.

00:14:12.698 --> 00:14:12.958
Right.

00:14:12.999 --> 00:14:13.139
So.

00:14:13.899 --> 00:14:15.399
Anyone who's an employee and then an

00:14:15.460 --> 00:14:16.539
attendant on their plan,

00:14:17.139 --> 00:14:19.660
they pay all of the healthcare costs for

00:14:19.721 --> 00:14:20.841
those people, right?

00:14:21.461 --> 00:14:26.663
And what that means is when my wife

00:14:26.722 --> 00:14:27.884
pulls her back at the gym,

00:14:28.754 --> 00:14:30.035
And then she has to go to the

00:14:30.056 --> 00:14:30.716
PCP.

00:14:31.277 --> 00:14:32.836
And then the PCP says, yeah,

00:14:33.278 --> 00:14:35.639
I don't really get musculoskeletal.

00:14:37.039 --> 00:14:38.541
Let me refer you to a specialist.

00:14:39.301 --> 00:14:41.802
And then you go to the specialist and

00:14:42.023 --> 00:14:43.543
you might get a great specialist who's

00:14:43.583 --> 00:14:44.083
like, oh yeah,

00:14:44.124 --> 00:14:45.284
this sounds more like a PT problem.

00:14:45.304 --> 00:14:47.005
Let's get you into PT, right?

00:14:47.225 --> 00:14:49.267
My experience having gone through this

00:14:49.307 --> 00:14:51.128
before, they're gonna wanna do imaging.

00:14:51.788 --> 00:14:52.828
And then once you get imaging,

00:14:52.869 --> 00:14:53.889
they're either gonna say,

00:14:54.330 --> 00:14:56.692
let's do surgery or pain management.

00:14:57.451 --> 00:14:59.113
or maybe PT, right?

00:14:59.153 --> 00:15:01.014
But I think it's pretty rare that people

00:15:01.054 --> 00:15:02.936
go, they get pushed directly into PT,

00:15:03.096 --> 00:15:03.336
right?

00:15:03.956 --> 00:15:05.638
All of those stops along the way,

00:15:05.918 --> 00:15:07.119
it just inflates the costs.

00:15:07.818 --> 00:15:09.900
And these self-insured employers who are

00:15:09.961 --> 00:15:12.342
paying every cost along the way,

00:15:12.682 --> 00:15:15.585
every PCP visit, every specialist visit,

00:15:16.745 --> 00:15:18.647
they're looking at this rising cost of

00:15:18.687 --> 00:15:19.488
healthcare and going,

00:15:20.248 --> 00:15:21.370
How do I,

00:15:21.971 --> 00:15:23.215
how do I make this work?

00:15:23.716 --> 00:15:23.917
Right?

00:15:23.956 --> 00:15:25.541
Like I only have so much budget that

00:15:25.600 --> 00:15:28.827
I can put towards this and then how

00:15:28.868 --> 00:15:29.490
do I make it work?

00:15:30.740 --> 00:15:33.602
So they are willing to be self-insured

00:15:33.643 --> 00:15:34.222
employers.

00:15:34.403 --> 00:15:36.706
And the majority of employers in America

00:15:36.885 --> 00:15:38.147
are actually self-insured.

00:15:38.307 --> 00:15:40.629
And what we've been seeing in our

00:15:40.668 --> 00:15:42.630
conversations at like Second Door Health

00:15:43.131 --> 00:15:45.874
is basically more and more employers,

00:15:46.095 --> 00:15:48.035
even smaller and smaller employers,

00:15:48.096 --> 00:15:50.198
because the premiums are getting so

00:15:50.239 --> 00:15:50.839
expensive,

00:15:51.539 --> 00:15:53.201
they're looking to go self-insured.

00:15:53.341 --> 00:15:54.702
It just costs too much.

00:15:55.447 --> 00:15:56.469
It's a gamble,

00:15:57.009 --> 00:15:58.649
but now there's skin in the game.

00:15:58.850 --> 00:16:01.730
So now you're advocating for better

00:16:01.750 --> 00:16:02.871
decisions and you're like, well,

00:16:02.892 --> 00:16:04.312
if this on average,

00:16:04.331 --> 00:16:05.653
because everything's an average, right?

00:16:06.253 --> 00:16:08.014
This on average tends to lead to lower

00:16:08.053 --> 00:16:09.315
costs and better outcomes,

00:16:09.754 --> 00:16:11.096
getting that person back to work,

00:16:11.535 --> 00:16:12.495
covering them, right?

00:16:12.535 --> 00:16:14.017
Giving them care, back to work,

00:16:14.336 --> 00:16:14.956
solving the problem.

00:16:15.097 --> 00:16:15.878
And it's less money.

00:16:16.138 --> 00:16:17.158
Well, I'm going to want to do that.

00:16:17.198 --> 00:16:19.099
I'm incentivized to do that.

00:16:19.399 --> 00:16:20.580
Whereas the insurance company,

00:16:20.960 --> 00:16:22.160
you have paid them.

00:16:23.586 --> 00:16:25.625
Now they are now practicing medicine

00:16:25.645 --> 00:16:26.427
without a license,

00:16:26.486 --> 00:16:28.787
essentially where they will deny or use

00:16:28.826 --> 00:16:31.067
strategies to pay as little as possible.

00:16:31.508 --> 00:16:33.087
It's just, it's moving where the money is.

00:16:33.107 --> 00:16:34.768
It's moving where the decisions are made.

00:16:35.408 --> 00:16:36.168
Yeah.

00:16:36.227 --> 00:16:36.389
Yeah.

00:16:36.448 --> 00:16:36.528
And,

00:16:36.729 --> 00:16:39.288
and the reason why I think this is

00:16:39.349 --> 00:16:39.869
such a,

00:16:41.570 --> 00:16:42.750
I think it needs to be a very

00:16:42.789 --> 00:16:45.250
important model for the future of physical

00:16:45.309 --> 00:16:46.971
therapy and especially private outpatient

00:16:46.990 --> 00:16:48.890
physical therapy is that

00:16:50.340 --> 00:16:51.581
these employers,

00:16:52.480 --> 00:16:55.221
they're not looking to pay you less than

00:16:55.260 --> 00:16:57.381
your current contracted rate with Blue

00:16:57.402 --> 00:16:58.081
Cross Blue Shield.

00:16:58.621 --> 00:17:00.363
Most of the time when we've had these

00:17:00.403 --> 00:17:01.802
conversations with employers,

00:17:02.403 --> 00:17:05.104
they're willing to pay above and beyond a

00:17:05.183 --> 00:17:06.644
per visit rate of what you're getting

00:17:06.703 --> 00:17:07.064
right now.

00:17:07.403 --> 00:17:09.585
The reason being you're saving them on

00:17:09.664 --> 00:17:09.944
average,

00:17:09.984 --> 00:17:11.825
twenty seven hundred dollars per claim for

00:17:11.865 --> 00:17:12.846
musculoskeletal care.

00:17:13.165 --> 00:17:13.405
Right.

00:17:13.766 --> 00:17:15.046
So they're looking at that and they go,

00:17:15.086 --> 00:17:15.185
well,

00:17:15.205 --> 00:17:17.386
if I had two hundred claims last year,

00:17:17.987 --> 00:17:19.508
that's five hundred and forty thousand

00:17:19.548 --> 00:17:21.650
dollars potentially in savings.

00:17:22.130 --> 00:17:23.852
That's that's yeah.

00:17:24.311 --> 00:17:25.353
They like that math, too.

00:17:26.173 --> 00:17:29.457
And the reason in all that being said,

00:17:29.517 --> 00:17:29.696
like,

00:17:31.057 --> 00:17:32.719
This model, it's not easy.

00:17:32.999 --> 00:17:33.778
It takes time.

00:17:33.818 --> 00:17:35.259
It takes time developing the

00:17:35.299 --> 00:17:36.780
relationships, the conversations,

00:17:36.861 --> 00:17:37.721
and it's new, right?

00:17:37.760 --> 00:17:39.821
Anytime you're trying to introduce a new

00:17:39.862 --> 00:17:41.482
business model, a new product,

00:17:42.083 --> 00:17:42.824
it takes time.

00:17:43.364 --> 00:17:47.665
But the reason I think that it needs

00:17:47.685 --> 00:17:48.586
to be a part of the future of

00:17:48.605 --> 00:17:49.727
physical therapy is one,

00:17:50.967 --> 00:17:51.867
margins are an issue.

00:17:52.228 --> 00:17:53.568
This is a great way to solve margin

00:17:53.588 --> 00:17:54.628
problems, right?

00:17:55.229 --> 00:17:55.950
And, you know,

00:17:56.769 --> 00:17:58.490
When you have those direct contracts,

00:17:58.891 --> 00:18:00.832
you can set that up as onsite services,

00:18:01.271 --> 00:18:02.913
or you can just have people fed right

00:18:02.952 --> 00:18:04.054
into your clinic, right?

00:18:04.114 --> 00:18:05.575
If you wanna go onsite and you've got

00:18:05.595 --> 00:18:06.535
the infrastructure for that,

00:18:06.974 --> 00:18:07.615
you can do that.

00:18:08.215 --> 00:18:08.655
If not,

00:18:09.116 --> 00:18:10.537
you can just have people funneled straight

00:18:10.576 --> 00:18:11.198
into your clinic,

00:18:11.698 --> 00:18:13.179
most likely for a higher reimbursement

00:18:13.199 --> 00:18:14.859
than what anyone else is paying you at

00:18:14.880 --> 00:18:15.240
the moment.

00:18:16.039 --> 00:18:18.300
And it solves the problem we talked about

00:18:18.361 --> 00:18:20.362
earlier with the cash pay or the

00:18:20.402 --> 00:18:21.403
cash-based model.

00:18:22.063 --> 00:18:24.403
Because even in rural communities,

00:18:24.844 --> 00:18:26.384
your municipalities,

00:18:26.644 --> 00:18:27.806
your school districts,

00:18:28.205 --> 00:18:29.306
your fire departments,

00:18:29.385 --> 00:18:30.307
your police departments,

00:18:30.386 --> 00:18:32.327
those are all generally self-insured.

00:18:33.127 --> 00:18:35.108
So no matter where you're located,

00:18:35.628 --> 00:18:37.410
you have people that you can go out

00:18:37.450 --> 00:18:41.311
and contract with and be able to fulfill

00:18:41.352 --> 00:18:42.112
this type of model.

00:18:42.567 --> 00:18:43.868
We'll get to misconceptions in a minute.

00:18:43.888 --> 00:18:45.528
I want to say thanks to Empower EMR,

00:18:45.949 --> 00:18:47.089
one of the organizations supporting the

00:18:47.109 --> 00:18:47.250
show.

00:18:47.269 --> 00:18:48.569
If your clinic is stuck on an EMR

00:18:48.589 --> 00:18:49.310
but slows you down,

00:18:49.790 --> 00:18:50.730
that's a choice you made.

00:18:50.871 --> 00:18:51.932
You don't have to do that forever.

00:18:52.372 --> 00:18:54.093
Empower gives you speed, clean workflows,

00:18:54.113 --> 00:18:56.013
and features PTs actually ask for.

00:18:56.433 --> 00:18:58.114
Better notes, faster documentation,

00:18:58.173 --> 00:18:59.115
smoother operations,

00:18:59.674 --> 00:19:01.215
all wrapped in customer support that just

00:19:01.236 --> 00:19:01.996
doesn't ghost you.

00:19:02.175 --> 00:19:04.017
Upgrade your clinic's brain with Empower

00:19:04.156 --> 00:19:06.657
EMR at empoweremr.com.

00:19:06.892 --> 00:19:07.652
dot com.

00:19:08.593 --> 00:19:09.633
Misconceptions.

00:19:09.913 --> 00:19:11.394
So with direct to employer,

00:19:11.874 --> 00:19:14.115
there's some misconceptions I bet that PTs

00:19:14.154 --> 00:19:14.634
have about it.

00:19:14.674 --> 00:19:16.075
You just touched on it a second ago.

00:19:16.295 --> 00:19:17.215
I'm too small.

00:19:17.875 --> 00:19:19.036
I don't know how to sell.

00:19:19.375 --> 00:19:20.916
That's only for big groups.

00:19:20.957 --> 00:19:21.116
I mean,

00:19:21.136 --> 00:19:22.076
I guess two of those have to do

00:19:22.096 --> 00:19:24.678
with size, but are all those wrong?

00:19:24.817 --> 00:19:26.138
Are those wrong?

00:19:26.538 --> 00:19:28.058
Should people change their viewpoint on

00:19:28.078 --> 00:19:29.779
that if you're a PT listening?

00:19:32.587 --> 00:19:34.489
They – the size, yes and no.

00:19:34.509 --> 00:19:37.990
And this is – how I would answer

00:19:38.030 --> 00:19:40.492
that is when you're pursuing these

00:19:40.553 --> 00:19:41.893
contracts with employers, right,

00:19:42.394 --> 00:19:44.674
you have to have the clinic density and

00:19:45.915 --> 00:19:49.298
geographic coverage to be able to service

00:19:49.357 --> 00:19:51.318
the people that are employed by them.

00:19:51.338 --> 00:19:51.699
Got it.

00:19:51.719 --> 00:19:54.681
So where you are and where you're –

00:19:55.515 --> 00:19:57.517
where the organization is located is not

00:19:57.596 --> 00:19:58.998
actually where the people live because

00:19:59.018 --> 00:20:00.219
they might also get it so i'm

00:20:00.259 --> 00:20:02.980
understanding that god yes yeah so that

00:20:03.300 --> 00:20:06.183
that can be a problem and like we

00:20:06.223 --> 00:20:07.644
you know at second door like i've talked

00:20:07.664 --> 00:20:10.027
to single location practice practices that

00:20:10.067 --> 00:20:12.248
were like hey i want to do this

00:20:12.268 --> 00:20:13.710
direct to employer thing like let's get it

00:20:13.750 --> 00:20:15.550
going and i'm like i want you to

00:20:15.590 --> 00:20:16.070
do it too

00:20:17.082 --> 00:20:19.423
But you have one practice and there's two

00:20:19.463 --> 00:20:22.305
hundred employees at this one employer.

00:20:22.365 --> 00:20:23.625
They probably have five hundred covered

00:20:23.665 --> 00:20:24.126
lives.

00:20:24.807 --> 00:20:26.647
You on your own can't service that.

00:20:26.928 --> 00:20:27.088
Right.

00:20:27.148 --> 00:20:29.789
And I think that's where I think for

00:20:29.849 --> 00:20:32.352
so long, because, you know,

00:20:32.652 --> 00:20:33.893
I would say just, you know,

00:20:33.932 --> 00:20:34.834
my humble opinion,

00:20:35.473 --> 00:20:36.294
I think in physical therapy,

00:20:36.314 --> 00:20:39.016
we've operated out of a scarcity mindset

00:20:39.036 --> 00:20:39.777
for a long time.

00:20:39.997 --> 00:20:42.278
And like the practice across my street,

00:20:42.317 --> 00:20:43.179
that's my competitor.

00:20:43.659 --> 00:20:45.000
I've got to beat them for referrals.

00:20:45.059 --> 00:20:46.340
I've got to, right.

00:20:46.381 --> 00:20:47.923
And, and I understand that.

00:20:48.182 --> 00:20:49.703
And to some extent that's been reality,

00:20:50.263 --> 00:20:51.625
but when you're looking at, okay,

00:20:52.705 --> 00:20:54.548
I can continue in the model that I'm

00:20:54.607 --> 00:20:55.208
in now,

00:20:55.848 --> 00:20:58.891
or I can partner with the other practices

00:20:58.911 --> 00:21:01.053
in my area and say, Hey, let's,

00:21:01.673 --> 00:21:04.836
let's start a network or like second door

00:21:04.875 --> 00:21:05.096
health.

00:21:05.115 --> 00:21:07.657
Like we have a network of practices that

00:21:07.698 --> 00:21:10.339
are able to opt into employer contracts

00:21:10.359 --> 00:21:10.420
and

00:21:11.704 --> 00:21:14.926
let's band together and we can all treat,

00:21:15.527 --> 00:21:17.208
win this contract and treat it this

00:21:17.347 --> 00:21:18.169
negotiated rate.

00:21:18.189 --> 00:21:20.549
So size can be a barrier,

00:21:20.930 --> 00:21:21.951
but I think that's where,

00:21:22.131 --> 00:21:23.411
like as an industry,

00:21:23.451 --> 00:21:25.071
we have to be willing to come together

00:21:25.172 --> 00:21:26.992
and say, like, you know,

00:21:27.053 --> 00:21:28.814
rising tide lifts all boats.

00:21:29.494 --> 00:21:32.395
Like let's all benefit from this and more,

00:21:32.516 --> 00:21:34.317
and I want that more than I necessarily

00:21:34.356 --> 00:21:36.117
want to beat my competitor across the

00:21:36.137 --> 00:21:36.438
street.

00:21:37.038 --> 00:21:37.199
Right.

00:21:37.219 --> 00:21:38.239
How about, how about,

00:21:38.318 --> 00:21:39.099
I don't know how to sell.

00:21:40.682 --> 00:21:40.903
Yeah.

00:21:41.002 --> 00:21:45.607
So I would say most practice owners don't

00:21:45.627 --> 00:21:46.689
give themselves enough credit.

00:21:47.308 --> 00:21:48.150
If you're a business owner,

00:21:48.170 --> 00:21:49.030
you're selling, right?

00:21:49.050 --> 00:21:51.073
And I would even say clinicians sell every

00:21:51.113 --> 00:21:51.532
single day.

00:21:52.114 --> 00:21:53.714
You've got to sell patients on a plan

00:21:53.734 --> 00:21:54.155
of care.

00:21:54.756 --> 00:21:56.137
Someone comes in for an eval.

00:21:56.678 --> 00:21:57.919
You've got to sell them on, hey,

00:21:57.959 --> 00:21:58.880
this is what I think is going to

00:21:58.900 --> 00:21:59.361
be best.

00:21:59.780 --> 00:22:01.323
This is how we're going to address what

00:22:01.343 --> 00:22:02.523
you presented in the eval.

00:22:03.344 --> 00:22:04.486
You're selling all the time.

00:22:04.846 --> 00:22:05.787
But I also get

00:22:07.070 --> 00:22:08.913
Most practice owners don't have the time,

00:22:09.394 --> 00:22:09.614
right?

00:22:09.894 --> 00:22:11.957
They don't enjoy it and they don't have

00:22:11.997 --> 00:22:15.622
the time to go out and sell this

00:22:16.162 --> 00:22:17.203
model to employers.

00:22:17.804 --> 00:22:19.346
And I think that's where, you know,

00:22:19.807 --> 00:22:21.229
I know some larger practices,

00:22:21.249 --> 00:22:23.411
they have their own staff that goes out

00:22:23.432 --> 00:22:24.152
and sells this model.

00:22:24.732 --> 00:22:26.614
But for what we're doing at Second Door,

00:22:27.453 --> 00:22:29.934
that's what we've basically that's what

00:22:29.954 --> 00:22:31.756
we've been doing is we say, OK,

00:22:32.236 --> 00:22:33.655
we know you don't want to sell.

00:22:34.116 --> 00:22:35.957
We know that's probably not your specialty

00:22:35.977 --> 00:22:36.837
and you don't have the time.

00:22:37.417 --> 00:22:38.837
Let us go and sell for you.

00:22:39.057 --> 00:22:40.578
And then when a contract comes in,

00:22:41.118 --> 00:22:43.619
you just you you work with us through

00:22:43.640 --> 00:22:44.861
the negotiation process.

00:22:44.941 --> 00:22:45.161
Right.

00:22:45.461 --> 00:22:46.500
When a contract comes in,

00:22:46.601 --> 00:22:47.981
you treat it the negotiated rate.

00:22:48.442 --> 00:22:50.583
And I think that's where, you know,

00:22:50.863 --> 00:22:53.284
if anyone's ever seen anything I've posted

00:22:53.324 --> 00:22:53.784
on LinkedIn,

00:22:54.304 --> 00:22:55.965
Like the work that Second Door is doing

00:22:56.006 --> 00:22:56.467
as a company,

00:22:56.547 --> 00:22:58.909
I think is really important to the future

00:22:58.949 --> 00:23:00.971
of the industry because I don't know of

00:23:01.031 --> 00:23:02.814
many other organizations that are going

00:23:02.894 --> 00:23:04.474
out there and selling that model.

00:23:04.596 --> 00:23:06.738
I know that there's some like MSOs,

00:23:08.500 --> 00:23:10.201
some of those types of organizations that

00:23:10.241 --> 00:23:12.223
are trying to do some of that.

00:23:12.984 --> 00:23:14.125
The hard part is...

00:23:17.071 --> 00:23:19.513
now you're getting into understanding how

00:23:19.653 --> 00:23:21.596
all of this crazy insurance works, right?

00:23:21.635 --> 00:23:23.857
Like if I go to a self-insured employer,

00:23:23.917 --> 00:23:25.098
do I need prior off?

00:23:25.499 --> 00:23:27.300
Do I not?

00:23:27.740 --> 00:23:29.803
Am I under direct access laws?

00:23:29.942 --> 00:23:32.204
Am I not under direct access laws?

00:23:33.474 --> 00:23:34.496
Yes, it gets convoluted.

00:23:34.576 --> 00:23:36.576
I will say the answers to that are

00:23:36.596 --> 00:23:37.156
pretty simple.

00:23:37.176 --> 00:23:39.198
When a self-insured employer creates their

00:23:39.238 --> 00:23:40.718
plan, they get to dictate that.

00:23:41.338 --> 00:23:42.759
So if you go to an employer and

00:23:42.778 --> 00:23:43.880
you say, hey,

00:23:43.940 --> 00:23:45.840
we can save you twenty seven hundred

00:23:45.881 --> 00:23:46.721
dollars per claim.

00:23:47.000 --> 00:23:48.801
If you get your people into PT first,

00:23:49.461 --> 00:23:51.722
they can say, OK, we don't want prior.

00:23:51.903 --> 00:23:53.703
We just want our people to go that

00:23:53.723 --> 00:23:55.664
they can set that up because they're not

00:23:55.904 --> 00:23:57.645
they're they're not dictated by what

00:23:57.705 --> 00:23:58.405
insurance says.

00:23:59.186 --> 00:24:01.147
They make their they make their decisions

00:24:01.167 --> 00:24:01.788
for their own plan.

00:24:02.970 --> 00:24:04.470
If a clinic owner is listening right now,

00:24:06.270 --> 00:24:07.770
more often than not, they're like, okay,

00:24:07.810 --> 00:24:08.310
I'm nodding,

00:24:08.432 --> 00:24:10.251
but I might feel stuck or there's a

00:24:10.271 --> 00:24:10.652
barrier.

00:24:11.672 --> 00:24:14.833
What's one practical first move you can

00:24:14.873 --> 00:24:16.513
give them to make this quarter?

00:24:16.594 --> 00:24:18.554
Something that checks something off the

00:24:19.173 --> 00:24:20.775
box, but does move the ball forward.

00:24:22.252 --> 00:24:22.353
Yeah,

00:24:22.613 --> 00:24:25.816
I would say the first thing I would

00:24:25.875 --> 00:24:28.176
encourage practice owners to do is sit

00:24:28.196 --> 00:24:29.939
down and make a list or a spreadsheet

00:24:30.199 --> 00:24:32.661
and think about all of the connections

00:24:32.701 --> 00:24:34.882
that you have in your area,

00:24:35.083 --> 00:24:37.443
that your staff has in the area, right?

00:24:38.125 --> 00:24:40.767
You may have treated a COO at a

00:24:40.807 --> 00:24:41.988
local company, right?

00:24:42.428 --> 00:24:45.730
You may have treated someone who oversees

00:24:45.790 --> 00:24:47.791
the benefits of a self-insured employer in

00:24:47.811 --> 00:24:48.311
your area.

00:24:49.333 --> 00:24:52.434
Start with that list and look at who

00:24:52.535 --> 00:24:53.096
do I know?

00:24:53.135 --> 00:24:54.296
What connections do I have?

00:24:54.355 --> 00:24:56.438
And the reason I say start there is

00:24:56.458 --> 00:24:56.978
because it's like,

00:24:56.998 --> 00:24:57.939
how do you eat an elephant?

00:24:58.239 --> 00:24:59.880
Like one bite at a time, right?

00:25:00.220 --> 00:25:03.102
So like start there and see like, oh,

00:25:03.842 --> 00:25:05.442
actually, I have just myself.

00:25:05.462 --> 00:25:07.744
I have twenty connections between business

00:25:07.765 --> 00:25:09.665
networking groups and other connections in

00:25:09.705 --> 00:25:10.125
the area.

00:25:11.426 --> 00:25:13.288
My staff maybe even has more.

00:25:13.910 --> 00:25:15.852
There's real potential for this.

00:25:16.571 --> 00:25:18.074
And then I would,

00:25:18.273 --> 00:25:21.196
I would say reach out to someone like

00:25:21.356 --> 00:25:24.259
Second Door Health who is already has,

00:25:24.279 --> 00:25:26.101
has walked through that selling process,

00:25:26.602 --> 00:25:28.343
who is doing that selling process right

00:25:28.384 --> 00:25:28.624
now.

00:25:29.263 --> 00:25:30.746
The people there, Scott Hebert,

00:25:30.766 --> 00:25:32.768
Ryan Kleps, like their heart is,

00:25:33.127 --> 00:25:34.388
is for the industry as well.

00:25:34.469 --> 00:25:36.151
They love, they love, they,

00:25:36.351 --> 00:25:37.553
Clinicians, they love practices.

00:25:37.573 --> 00:25:39.055
They want to see the industry succeed.

00:25:39.776 --> 00:25:42.058
And they have a ton of free resources

00:25:42.318 --> 00:25:44.060
online as well that you can go and

00:25:44.260 --> 00:25:46.384
download or even listen to their blogs

00:25:46.904 --> 00:25:48.207
just to be able to see, okay,

00:25:48.326 --> 00:25:50.328
is this something that's feasible for me?

00:25:51.069 --> 00:25:52.031
And if it isn't,

00:25:53.670 --> 00:25:57.351
There are other ways that you can pursue

00:25:57.471 --> 00:25:58.491
to make that possible,

00:25:58.592 --> 00:26:00.413
whether it be through someone like Second

00:26:00.432 --> 00:26:02.933
Door who's providing a network where you

00:26:02.953 --> 00:26:05.555
can band together and treat those types of

00:26:06.654 --> 00:26:07.714
contracts with employers,

00:26:08.175 --> 00:26:10.435
or whether that's joining an MSO if you're

00:26:10.556 --> 00:26:14.077
not a part of an MSO or an

00:26:14.178 --> 00:26:15.258
IPA, something like that.

00:26:16.199 --> 00:26:18.699
So that's what I would say,

00:26:18.859 --> 00:26:19.619
first and foremost,

00:26:21.080 --> 00:26:23.501
start with who do i know and see

00:26:23.521 --> 00:26:25.443
that there's actually like it's probably

00:26:25.544 --> 00:26:28.144
easier than you think it is sure okay

00:26:28.945 --> 00:26:30.425
uh looking towards the future there's got

00:26:30.445 --> 00:26:31.926
to be pain if there's no pain people

00:26:31.946 --> 00:26:33.867
don't move what happens if independent

00:26:33.968 --> 00:26:38.590
clinics don't evolve i mean i'm i'm what

00:26:38.611 --> 00:26:39.892
are mistakes besides just straight up

00:26:39.912 --> 00:26:43.993
going out of business i mean yeah yeah

00:26:44.114 --> 00:26:48.176
i in in my opinion

00:26:50.145 --> 00:26:51.788
and I would say as someone who does

00:26:51.827 --> 00:26:54.309
not claim to be an expert on this

00:26:54.369 --> 00:26:56.291
matter, I've never owned a clinic, right?

00:26:56.332 --> 00:26:57.192
I probably never will,

00:26:57.232 --> 00:26:58.855
although I would love to potentially own

00:26:58.914 --> 00:26:59.474
one in the future.

00:27:01.057 --> 00:27:01.737
I think that

00:27:02.988 --> 00:27:05.070
My hypothesis, just in my opinion,

00:27:05.731 --> 00:27:07.133
I would say in five years,

00:27:08.173 --> 00:27:09.715
it's going to be very,

00:27:09.756 --> 00:27:12.859
very hard for the majority of private

00:27:13.099 --> 00:27:14.622
outpatient practices to continue to

00:27:14.642 --> 00:27:15.021
operate.

00:27:15.423 --> 00:27:18.105
Those who are already at scale,

00:27:18.425 --> 00:27:20.048
I think that they may be able to

00:27:20.167 --> 00:27:20.669
continue.

00:27:22.170 --> 00:27:22.790
But with...

00:27:23.815 --> 00:27:27.777
where cost is going where reimbursement is

00:27:27.856 --> 00:27:29.438
and we're reaching this point where like

00:27:29.978 --> 00:27:31.818
even if we get a three percent increase

00:27:31.858 --> 00:27:34.079
in reimbursement what did inflation do

00:27:34.099 --> 00:27:36.961
this year killed it like yeah i mean

00:27:37.182 --> 00:27:38.603
inflation increased more than three

00:27:38.643 --> 00:27:40.502
percent so like you're still getting paid

00:27:40.542 --> 00:27:45.185
less right and so my my fear and

00:27:45.226 --> 00:27:48.027
my concern and why i'm i'm passionate

00:27:48.106 --> 00:27:50.689
about this type of model for physical

00:27:50.709 --> 00:27:52.950
therapy practices is i i want

00:27:53.589 --> 00:27:56.191
practice owners to have the freedom to

00:27:56.391 --> 00:27:57.771
treat how they want to treat.

00:27:58.291 --> 00:27:59.912
If they want to start a practice and

00:28:00.031 --> 00:28:01.512
scale to twenty locations,

00:28:01.992 --> 00:28:03.094
I want them to have the ability to

00:28:03.114 --> 00:28:03.394
do that.

00:28:03.433 --> 00:28:06.214
If they want to start one single location

00:28:06.535 --> 00:28:07.934
or maybe just treat out of a gym,

00:28:08.434 --> 00:28:09.516
I want them to be able to do

00:28:09.536 --> 00:28:10.115
that as well.

00:28:10.415 --> 00:28:11.596
I think the problem with the

00:28:12.817 --> 00:28:14.498
fee for service model at the moment,

00:28:15.077 --> 00:28:17.680
is all of those things, who you treat,

00:28:18.180 --> 00:28:20.320
how you get paid, when you get paid,

00:28:20.621 --> 00:28:23.422
it's in somebody else's hands, right?

00:28:23.521 --> 00:28:25.963
And so going going direct to employer is

00:28:26.044 --> 00:28:26.443
hard.

00:28:26.844 --> 00:28:28.244
And it's scary because it's new.

00:28:28.744 --> 00:28:30.105
But what's the alternative?

00:28:30.185 --> 00:28:30.365
Sure.

00:28:30.566 --> 00:28:32.909
Keep waiting for someone else to make a

00:28:32.969 --> 00:28:33.329
change?

00:28:33.769 --> 00:28:33.970
Yeah.

00:28:34.270 --> 00:28:36.574
I mean, it doesn't matter, you know,

00:28:37.054 --> 00:28:38.256
even like the APTA,

00:28:38.375 --> 00:28:39.676
all of the great work that they do

00:28:39.717 --> 00:28:40.778
for lobbying, right?

00:28:41.159 --> 00:28:42.280
You're going up against,

00:28:43.201 --> 00:28:45.884
is the APTA putting more money into to

00:28:46.045 --> 00:28:47.346
lobbying than pharmaceuticals?

00:28:48.048 --> 00:28:48.428
Are they?

00:28:48.488 --> 00:28:49.068
Are they?

00:28:49.148 --> 00:28:49.269
No.

00:28:50.650 --> 00:28:51.631
And so, of course,

00:28:51.851 --> 00:28:52.951
pharmaceuticals are going to push for

00:28:52.971 --> 00:28:53.771
GLP-Ls,

00:28:54.332 --> 00:28:57.512
and we'll probably see subsidies for

00:28:57.532 --> 00:28:59.794
people to get GLP-Ls way before we see

00:28:59.834 --> 00:29:01.795
any kind of subsidy for payment in

00:29:01.835 --> 00:29:02.575
physical therapy.

00:29:03.796 --> 00:29:07.257
And so we can continue to wait and

00:29:07.336 --> 00:29:09.498
see who is something actually going to

00:29:09.518 --> 00:29:12.298
change, or we can pave our own path.

00:29:12.419 --> 00:29:15.779
And I believe the path is there because

00:29:15.819 --> 00:29:18.020
employers can't continue to pay these

00:29:18.080 --> 00:29:19.321
outrageous costs of healthcare.

00:29:19.940 --> 00:29:20.180
Agreed.

00:29:20.240 --> 00:29:20.441
All right.

00:29:20.480 --> 00:29:21.622
Last thing we do on each episode is

00:29:21.662 --> 00:29:23.324
called the parting shot.

00:29:23.344 --> 00:29:26.547
This is the parting shot.

00:29:27.087 --> 00:29:28.509
One last mic drop moment.

00:29:29.170 --> 00:29:29.951
No pressure.

00:29:30.412 --> 00:29:32.513
Just your legacy on the line.

00:29:33.924 --> 00:29:35.384
All right, big thanks to Sarah Health,

00:29:35.404 --> 00:29:37.185
the remote care platform helping clinics

00:29:37.226 --> 00:29:38.006
boost revenue,

00:29:38.165 --> 00:29:39.885
which is good without adding staff.

00:29:40.326 --> 00:29:42.007
Sarah automates daily patient check-ins

00:29:42.047 --> 00:29:42.567
via text.

00:29:42.646 --> 00:29:44.448
No app, no logins, just better outcomes.

00:29:44.827 --> 00:29:46.867
Simple way to meet those RTM requirements,

00:29:47.268 --> 00:29:48.208
improve follow-through,

00:29:48.228 --> 00:29:49.648
and actually get reimbursed for the care

00:29:49.669 --> 00:29:50.308
between visits.

00:29:50.729 --> 00:29:51.989
Easy to set up, simple to use,

00:29:52.009 --> 00:29:52.750
and patients love it.

00:29:53.069 --> 00:29:53.990
SarahHealth.com.

00:29:54.009 --> 00:29:56.549
That's S-A-R-A-Health.com.

00:29:56.891 --> 00:29:57.951
All right, parting shot, Matt.

00:29:58.010 --> 00:29:59.631
What do you got for me?

00:29:59.651 --> 00:30:00.330
Change the model.

00:30:01.352 --> 00:30:02.352
The model has to change.

00:30:03.682 --> 00:30:06.424
If physical therapy wants to continue to

00:30:06.464 --> 00:30:08.105
be successful and to grow,

00:30:08.226 --> 00:30:09.165
not just survive,

00:30:09.506 --> 00:30:10.507
we've got to change the model.

00:30:10.527 --> 00:30:11.487
Love it.

00:30:11.507 --> 00:30:11.707
All right.

00:30:11.747 --> 00:30:12.768
Find them on LinkedIn.

00:30:12.788 --> 00:30:13.667
I'll give you a link in the show

00:30:13.688 --> 00:30:13.907
notes.

00:30:13.928 --> 00:30:14.409
Matthew Pratt.

00:30:14.429 --> 00:30:15.249
Appreciate your time, man.

00:30:15.989 --> 00:30:16.609
Appreciate it, Jimmy.

00:30:16.730 --> 00:30:17.009
Thank you.

00:30:18.788 --> 00:30:19.869
That's it for this one,

00:30:20.130 --> 00:30:21.790
but we're just getting warmed up.

00:30:22.271 --> 00:30:24.173
Smash follow, send it to a friend,

00:30:24.393 --> 00:30:26.055
or crank up the next episode.

00:30:26.575 --> 00:30:27.496
Want to go deeper?

00:30:27.935 --> 00:30:30.057
Hit us at pgpinecast.com.

00:30:31.337 --> 00:30:33.539
Or find us on YouTube and socials at

00:30:33.559 --> 00:30:34.580
pgpinecast.

00:30:34.980 --> 00:30:37.282
And legally, none of this was advice.

00:30:37.343 --> 00:30:38.983
It's for entertainment purposes only.

00:30:39.023 --> 00:30:40.726
Bullshit!

00:30:40.766 --> 00:30:41.346
See, Keith?

00:30:41.546 --> 00:30:42.626
We read the script.

00:30:42.906 --> 00:30:43.567
Happy now?