How Launching a Practice in Remote Alaska Prepared One PT Clinic for COVID-19
By Heidi Jannenga, PT, DPT*
If you were deciding where to open a physical therapy practice, would a rural Alaska town of 6,000 people — which already had three outpatient physical therapy clinics, including one that operates within the local hospital — be your first choice?
Most people would say no. But the physical therapists at Summit Physical Therapy aren’t like most people.
In many ways, the Summit PT team are champions of innovation. After identifying a growing need for physical therapy services driven by their community’s expanding Medicare population, they set out to fill the gap. In its first year, Summit PT proved its ability to not only enter a competitive market and thrive both financially and clinically, but also successfully navigate the many challenges that came with setting up shop in Homer, Alaska. And this was just the start.
When COVID-19 hit, the Summit PT team again demonstrated their dexterity. Like many other clinics across the country, Summit PT closed its doors to in-person patient care for more than a month. But that didn’t translate to time off. Instead, the team used the downtime to gather resources, connect with other professionals, lobby for pro-PT telehealth legislation, and secure financial assistance. As a result, Summit PT emerged from lockdown stronger than ever before.
As our industry continues to evolve in tandem with fast-paced changes in health care brought on by COVID-19, it’s imperative that we not only celebrate, but also learn from clinics that defy all odds to positively impact people’s lives. Summit PT’s story is an inspiring one that highlights the importance of ingenuity, perseverance, and collaboration. Here’s a look at how Summit PT created a resilient practice model from the start, and how the clinic’s approach to business allowed it to thrive in 2020.
UNDERSTANDING THE COMMUNITY
Many people would see Alaska’s sparse population and harsh climate as insurmountable hurdles, but instead, Summit PT used the area’s many geographical, logistical, and natural challenges to better connect with and understand the community.
As the team knows, Alaskans are hard-working, courageous individuals with an outdoors-centric lifestyle that can take a physical toll. Careers and hobbies prevalent in the area include commercial salmon and crab fishing on treacherous seas, hiking mountains of snow and ice to ski the backcountry, scaling rocky cliffs to hunt for goats in Grizzly territory, and diving into the ocean to dredge for gold, just to name a few. Because Homer’s residents push their bodies to the limit in a multitude of extreme ways, Summit PT’s clinical staff often engage in popular local activities to supplement their clinical knowledge with firsthand experiences. These include ice hockey, trail running, hiking, fishing (both recreational and as charter deckhands), kayaking, paddle boarding, hunting in remote areas, snowmobiling, skiing, and snowboarding. This has helped them tailor their treatments, services, and professional growth opportunities to meet the needs of their dynamic clientele.
They also actively participate within the community as members, volunteers, and sponsors of various community-wide initiatives and events, which has helped them further develop relationships with their stakeholders, earn respect within the community, and more efficiently identify ways to grow in alignment with their patients’ diverse and evolving needs. This level of personalized attention continues to differentiate them from their competitors, and it has been crucial to the practice’s success through the pandemic.
CULTIVATING RELATIONSHIPS WITH AREA PHYSICIANS
The Kenai Peninsula — where Homer is situated — is home to a large number of Medicare beneficiaries who require access to physical therapy. However, even with three outpatient physical therapy clinics already operating within the town, these individuals often waited six or more weeks for an appointment. Recognizing this as an opportunity, Summit PT made widening access to much-needed rehab therapy services its primary business goal.
To that end, the clinic’s first course of action prior to opening was contacting each of the area’s referring physicians to notify them of Summit PT’s open date and make sure they knew that the clinic would be ready to accept all major insurances — including Medicare and Medicaid. During these conversations, the team also highlighted their therapists’ impressive background and their status as preferred providers for the most common commercial insurances in the area.
The relationships they formed with referring providers early on created a solid foundation for outreach throughout the pandemic. “We made it a priority to keep our referring physicians in the loop, providing prompt updates on clinic changes, telehealth offerings, and our re-opening,” said Jay Cherok, PT, DPT, co-founder of Summit PT. “This focus on communication paid off big time when we reopened and were quickly inundated with both existing and new patients.”
HARNESS TECHNOLOGY TO SUPPORT CARE CONTINUITY
Providing outstanding patient care is a physical therapist’s top priority, but it’s tough to do that without the right technology partners. Summit PT’s leadership knew this from the beginning and were proactive in identifying and implementing technology that aligned with their practice’s workflow.
Earlier this year, Summit PT began collaborating with a virtual reality system that allows patients to be fully immersed in an environment that distracts them from pain, challenges their reaction time, and helps them practice functional reintegration movements (with a physical therapist nearby to ensure their safety and the quality of their movements). This system allowed Summit PT to leverage machine learning and better tailor each patient’s experience to his or her individual goals.
When the clinic closed to in-person visits, the team worked quickly to get up to speed on telehealth billing and reimbursement so they could provide virtual appointments as an option for patients. They also assembled a library of patient-facing how-to videos and emails detailing:
- How telehealth works (and how the clinic maintains security when providing virtual appointments)
- How patients can schedule their telehealth appointments
- What is required for a successful telehealth session (i.e., a device with video capabilities and internet connectivity)
- What to expect during a telehealth session
Within a week’s time, Summit PT had telehealth up and running, and the team has completed more than 100 virtual sessions. They plan to continue offering this service in the future with the hope of using telehealth as part of a hybrid model for patient care (i.e., one that incorporates both in-clinic and virtual visits).
MAINTAIN FORTHRIGHT COMMUNICATION
Summit PT’s ability to continually grow since day one is a direct result of the radical transparency each team member employs when communicating with patients. The front office is especially keen on this to ensure the billing process is clear and consistent. Their explanation of benefits printouts — which they review with every new patient — are concise and easy-to-understand, thus helping avoid financial surprises when patients pay their bills. As an added touchpoint, they provide a thank-you letter with the zero balance statement following each patient’s discharge visit. That way, patients leave therapy knowing they don’t owe anything and that Summit PT appreciates their business.
Summit PT’s commitment to maintaining forthright communication was integral to helping their patients navigate the operational changes prompted by COVID-19.
“During the pandemic, we kept in close communication with patients, updating them on clinical changes, their telehealth efforts, and how they could continue to receive care when in-person visits aren’t possible,” said Cherok. “We offered patients several communication channels — including phone, email, and their HEP portal — all of which they monitored from 8 a.m. to 5 p.m. daily.”
Prioritizing the patient above all else has helped Summit PT optimize patient care since the clinic first launched. After all, the more patients feel valued, the more likely they are to adhere to their care plans, overcome impairments and pain, and, ultimately, have a positive physical therapy experience — even if it’s by way of virtual care.
TREAT NEW CHALLENGES AS OPPORTUNITIES
Since its launch, Summit PT has been guided by the mantra “adapt or die.” Having intentionally built this durability into their culture has helped them turn new challenges into opportunities, from launching a practice in a place many have never heard of to navigating the uncertain waters of COVID-19 and the rapid rise of telehealth. Through collaboration, innovation, and an astute understanding of the technology required to optimize patient care, Summit PT has overcome adversity, continued to scale, and maintained a close-knit culture that makes patients feel welcome and cared for.
As a result, Summit PT has maintained the impressive momentum established soon after the practice’s launch to carry it through one of the toughest years our industry has faced. By implementing telehealth, Summit PT enabled its therapists to continue practicing remotely, and it was thus able to keep its full staff employed.
Since reopening its doors in May, Summit PT continues to operate at full capacity and has experienced a steep increase in net revenue, productivity, and patient arrival rates. To manage this steady influx of patients, the clinic actually had to increase staff, hiring one part-time physical therapist and another pro re nata (PRN) physical therapist. Today, Summit PT boasts an all-time high Net Promoter Score (NPS) of 92 as well as an average referral conversion rate of 98% over the last 12 months.
Thanks to the team’s organization, perseverance, and commitment to maintaining their high standards for patient safety, Summit PT has also resumed care in its second clinic, which is located in the even more remote town of Seldovia, Alaska.
“Currently, we have physical therapists flying twice a week to the town of 300 to provide rehabilitative services to people who generally have to fly or take a boat to see a physician,” said Cherok. “Many of these people have gone without physical therapy services for years. Regardless of where you’re located, value-based care shouldn’t be out of reach for anyone. Re-opening our second location enables us to continue providing evidence-based treatments to those who need it most throughout Alaska.”
What’s next for Summit PT? Now that both locations are back open, Summit PT plans to focus on furthering therapist education in special interest areas in order to improve patient care and continue operating as the premier physical therapy practice in the region. Considering what this practice has accomplished during such a tumultuous time, we should expect nothing less.
Dr. Heidi Jannenga, PT, DPT, ATC, is the co-founder and Chief Clinical Officer of WebPT, the nation’s leading rehab therapy software platform headquartered in Phoenix, Arizona. Heidi can be reached via LinkedIn or Twitter at @HeidiJannenga.
*The author has a professional affiliation with this subject.