By Tom DiAngelis, PT, DPT
The primary responsibilities of the Government Affairs Committee (GAC) of the Private Practice Section (PPS) are to work with our lobbyists and board of directors on advocacy issues that represent physical therapists in business in regard to federal, state, and association laws, regulations, and policies. In this capacity the GAC serves as an advisory committee to the PPS board on various issues that impact private practice.
Following each election cycle, or every two years, the GAC meets with our lobbyist advisors to review the outcome of the election and recommend to the board our section’s priorities for the new Congress. This year, the highest priorities and areas of focus for the section have been to permanently replace the Sustainable Growth Rate formula and repeal of the therapy cap. Some of the other areas of focus for the GAC this year include the following:
- Legislation to opt out of Medicare
- Legislation to allow physical therapists (PTs) to use locum tenens
- Mitigate the negative effects of physician self-referral
- Work for consistent Medicare standards for supervision of support personnel
- Legislation allowing for physical therapy payment through Medicare and federal health plans for telehealth
- Continue to pursue fair and equitable Medicare reimbursement
- Mitigate the negative effects of market control by insurance plans
- Monitor, respond, and participate in tax reform efforts to benefit physical therapists in private practice
There are many more priorities for the section. A full list can be found on the PPS website at www.ppsapta.org/c/legagenda.cfm.
One of the biggest undertakings of the GAC has been the development of the Key Contact program. Our Key Contact task force has been working diligently on finding PPS members who want to participate in the process and be key contacts for their U.S. representatives and senators. Having a strong key contact program allows PPS to have more consistent contact with the decision makers and ensure our voice and messages are being heard by more than just our lobbyist and board of directors. I urge you to consider participating in this important program, and if you are interested please contact the chair of our task force, Cristina Faucheux, at email@example.com.
Election years are always a little different for the GAC due to the congressional workload decreasing significantly in the summer months through the election. As you are aware, members of Congress spend most of their time home in their districts during this period, which means there is not much movement with legislation at this time. However, as previously mentioned, in December following the election, the GAC will meet with our lobbyist and begin to understand the makeup of the new Congress and work on our advocacy and priority efforts moving forward. This is the ideal time for member input as to what you would like to see the section focusing on. I encourage you to contact any member of the GAC, or board, if you feel there is an issue we should be addressing so they can bring that forward at our planning meeting. In addition, the outcome of the elections will most likely create a need for additional or new key contacts, so if you can help by being a key contact please contact Cristina.
By Stacy M. Menz, PT, DPT, PCS
I have been waiting for this issue to come along ever since we laid out the editorial calendar back in May of 2015. I find entrepreneurialism fascinating and love the ideas that are out there regarding innovative business concepts.
As an owner of a pediatric private practice, I started my practice with the idea of looking at each problem or scenario with the thought of “how do we make it happen” and truly looking for the solutions to fill the holes in my current market, serve my unique population, and create a business that is sustainable. I love ideas, but sometimes I struggle with how to take my ideas from a concept to the reality of my business. I have been lucky enough to work with some great people who have been able to help me draw the line from a nebulous concept to a concrete plan for implementation and success. Some initiatives have worked and others haven’t. Even those ideas that haven’t come to fruition have opened up doors to other opportunities and relationships that have proven beneficial.
I believe that many of us who are private practice owners are entrepreneurs, and we started our practices because we saw a need in the marketplace and thought, “I can do that.” What separates us from others who have seen the same need and thought “I can do that” is that we actually made the leap. That is the hardest part and the things that differentiate entrepreneurs—the willingness to dream and then take the leap.
As our field continues to evolve and health care continues to change, I believe that entrepreneurs have a great opportunity to drive change. We believe in innovation and think outside the box. We know that innovation isn’t just rearranging the furniture; it’s changing the furniture altogether or changing the dimensions of the room. The current state of our health care system provides so many opportunities for us to create positive change. Our profession is uniquely trained to have a large impact on how things like chronic disease and musculoskeletal disorders are treated, all at a lower cost and in a more conservative way than many other medical interventions.
What are your stories of innovation and entrepreneurialism? Who influenced you? What was it that got you to take that leap of faith? I would love to hear your story.
By Allyson Pahmer
It is fitting that this Impact issue about innovative business and entrepreneurialism coincides with the Private Practice Section (PPS) Annual Conference in Las Vegas because that is also what our conference is about. Countless hours of work go into delivering an event that brings together the best minds in business and practice management to expand your thinking about new business models and renew the entrepreneurial spark that led you to private practice in the first place.
In fact, the mission of PPS is to champion the success of the physical therapist in business. I love the verb champion; its many meanings—advance, support, advocate, give a leg up to, defend, bolster, encourage, go to bat for—guide the programs and benefits that the PPS Board, Committees, and staff develop and deliver to you, our members, every day.
Several years went into studying business models under PPS Board-directed Business Model Task Forces. Physical therapist services have grown in response to societal demand and market forces, but uncertainty over health care reform and its consequences for private practice have stimulated conversation about the business models permissible under the PPS tent. To study and address these issues, the PPS Board commissioned a Business Model Task Force in 2011 and a second Board Business Model Task Force in 2014. (Their reports, as well as the results of an extensive survey of PPS members, are available to members on the PPS website.) In 2015, as a result of the Task Force’s work, the Board released a statement endorsing all physical therapists’ business models that improve the experience of care, improve the health of populations, and reduce per capita costs of health care. The Board also included a Business Innovation goal in the 2015-2018 PPS Strategic Plan that directs the section to “provide a safe and engaging place to share best practice and process improvement, and provide an exciting place to grow creative and disruptive business opportunities.”
Valuable benefits and exciting new programs have resulted from that goal. For example, PPS launched the Peer2Peer NetWorks earlier this year from an idea hatched by the Education Committee. The program, which is modeled after the Mastermind principle, brings together groups of individuals who meet on a regular basis to help each other achieve their highest potential by sharing best practices and holding each other accountable for innovation (see page 24 for more information). The “Class of 2016” was such a success, we’re now recruiting the next group of NetWork participants to kick off the Class of 2017.
The Education Committee is also to thank for PPS-presented webinars this year on forming strategic alliances, alternative delivery models, and cash-based wellness programming, to name only a few. This year also saw the launch of a five-part video series on Marketing your Practice and a seven-part video series on Finance.
The Annual Conference Work Group, responsible for planning the education in Las Vegas this month, takes to heart the PPS Strategic Plan objective to provide a forum for discussion to foster innovation in physical therapists’ businesses. I’m eager to hear Ann Rhoades, Keynote Speaker and author of “Built on Values,” share her ideas about building a business culture that outperforms the competition. So many of the sessions at the conference address business innovation. I can’t wait to hear how you’ve been inspired!
You read in the August Impact how the Payment Policy Committee has commissioned Task Forces on vertical integration and joint partnerships, as well as to develop a framework for a participating provider contract that could be held with a third party payer built on a value-based model. The very magazine you’re holding has been an invaluable resource to so many members in introducing new models of practice and informing members about innovating business models.
The examples above paint an incomplete picture of all the resources PPS has developed and launched since last year’s Annual Conference, all in the service of your success, and all just on the topic of business innovation and entrepreneurialism. There are so many more resources—on management, marketing, HR, and more—that we hope you will explore. I look forward to seeing many of you in Las Vegas. Let us know how we’re doing, and thank you—as always—for your membership.
Executive Director, PPS
By Lynn Steffes, PT, DPT
According to Harvard Business Review’s Contributor John Quench:
“The retail point of purchase represents the time and place at which all the elements of the sale—the consumer, the money, and the product—come together. By using various communications vehicles, including displays, packaging, sales promotions, in-store advertising, and salespeople, at the point of purchase (POP), the marketer hopes to influence the consumer’s buying decisions.”1
If you have ever purchased goods and services in the checkout line, you have been “sold to” at the point of purchase—the POP. It is a time when you have made choices and are poised to pay with your checkbook or credit card. It is also a time when you may be open to other suggestions. Many private practices include cash-based products and services while neglecting the retail strategy of POP marketing. Instead of offering your step-down rehab services, fitness services, and adjunct products at the point of discharge, begin your discussion, your “samples,” and your offer, during care.
What products and services do you offer your patients @ the POP?
It is well known that health care consumers are looking for value and convenience in their lives. According to a recent Deloitte Report:
“As consumers take on a larger share of the health care cost burden, they are becoming more active and engaged in managing their health. Many seek to curate their own experience and are approaching health care as they do other goods and services. Consumers want greater convenience, service, and support from their health care provider…”2
In addition to traditional therapy services, what additional value-added services might be important and appropriate for your patients? I call this approach “seeing the patient beyond the prescription.” Physical therapists can truly emerge not only as experts in musculoskeletal health but also as primary care practitioners of lifestyle medicine.
Consider the following from kascope.com/top-healthcare-trends:
“The health and wellness industry at large, including organic personal care, fitness clubs and yoga studios, will continue to grow . . . More signs of this trend include the growth of natural organic foods, meds, and wellness programs. The popularity of Silver Sneakers and grass roots exercise programs for seniors are another manifestation of the rise of the wellness generation.”3
Offering your clients additional cash-based services that you can educate them about or have them sample while they are in your practice is a great way to encourage their participation in appropriate health and wellness services.
- “Quick” cash-based physical therapy sessions and tune-ups
- “Comfort” services (massage, stretching)
- Yoga, Pilates, Tai Chi
- Medically oriented gym (MOG)
- Brain fitness programs
- Specific disease risk management/prevention (Parkinson’s disease, diabetes, cerebrovascular accident [CVA], Alzheimer’s, etc.)
- Sports performance analysis and training
- Health risk assessments
- Lifestyle coaching
- Nutrition and dietary resources
What could you offer that would add value and convenience to your clients? Having a well-appointed display with the retail sales items listed here, and actively using the correct ones in therapy first, is a great way to ensure that your patients walk away with the tools they need to actively implement their exercise programs and lifestyle modifications!
Retail Sales Item Ideas:
- Shoes (running, fitness, walking, diabetic)
- Orthotics, custom and over the counter
- Socks, apparel (fitness/running)
- Jumper’s knee strap
- Tennis armband
- Theracane, Tiger Tail
- Walkers, canes, specialized gait tools
- Dexterity gadgets (light switch adapters, key adapters, writing kits, etc.)
- Various therapy tools for pain/exercise (Thera-Band kits, foot wheel, core stretch, Strassburg Socks, fitness balls, foam rollers, compression hose, etc.)
- Books on health, fitness, running
- Lumbar rolls
- Gel Packs Extra-Large with LOGO
- Heel lifts
- Shoe inserts
- Supplements: (check with your state practice act!)
- Glucosamine and chondroitin supplements
- Balance B Complex supplements
- Omega-3 fish oil supplements
- Back/sacral supports
Examine what your clients would value and how you could bring them that value and specifically coach them on how to use it to improve their health and their lives. Carefully consider what your POP opportunity might be.
1. Quelch, Harvard Business Review, https://hbr.org/1983/11/better-marketing-at-the-point-of-purchase. Accessed August 2016.
2. www.deloitte.com/content/dam/Deloitte/us/Documents/risk/us-risk-deloitte-retail-health-and-wellness.pdf. Accessed August 2016.
3. kascope.com/top-healthcare-trends. Accessed August 2016.
The PPS Peer2Peer NetWorks program is modeled after the “mastermind” principle. A mastermind is a group of individuals who meet on a regular basis to help each other achieve their highest potential by sharing best practices and holding each other accountable. Many successful entrepreneurs, from Henry Ford to Bill Gates, have used masterminds to help grow their business and work on their personal development.
Have you ever wished you could just talk to another practice owner about a problem you’re dealing with, or about a new business model, or even “Should I buy a building?” “When do I hire that next person?” “Do I need an administrator?” We can all agree we didn’t get the business education we need to run our practices in PT school. And sometimes we feel like we’re running this thing by the seat of our pants!!
PPS Peer2Peer NetWorks bring like-minded Private Practice owners from different markets together in small groups to share best practices and expertise, discuss “hot topics,” establish key metric benchmarks, analyze operations, build life-long friendships, and work toward helping each other improve the bottom line. Peer2Peer NetWorks are networking on steroids!!
This program offers Private Practice owners access to invaluable resources to help grow and improve their practices. Participation in a NetWork benefits practices of all sizes and is especially valuable to the solo and small practice owners who will now have access to peers who understand and share the challenges that come with ownership.
If you would like more information or an application, please see the PPS website: PPSAPTA.org. Or contact the Peer2Peer NetWork Facilitator, Randy Roesch, PT, DPT, MBA, at firstname.lastname@example.org.