Innovative Business Concepts


How private pay allows for a truly patient-focused facility.

By Lisa Corsa, PT, DPT, MPT

Phrases like these are often used to differentiate one physical therapy practice from another. Of course we all want to provide the best possible care for our patients, but in light of today’s financial medical model, where insurance payments dominate the pay structure, owners of rehabilitation facilities have to make hard choices on the type and amount of care that can be administered.

When I started my physical therapy practice, 18 years ago, I set out to make a difference in the community with the kind of services my team and I could provide. That meant not accepting insurance of any kind and building my business strictly on a private pay model.

While some may view closing the door to insurance as a loss of significant revenue, we are all aware of the restrictions that insurance coverage can put on treatments and timelines. However, we found that the private pay model actually opened the door to the opportunity to provide elite rehabilitative services that are aligned more closely with the patients’ needs—and to me this is what defines a truly patient-focused facility. Having the freedom to make decisions beyond insurance barriers is enabling my team and me to rehab people to a level that is far beyond the standard outcomes, based on my experience. And I am proud to say that after nearly two decades in business, my clientele has been built strictly by word of mouth. We’ve never done any advertising.


Going Beyond Traditional Equipment
The route we took with our practice meant acquiring rehab equipment that goes above and beyond the traditional, investing in machines that give personalized information for each patient so we can specifically tailor the treatment program while purposefully using all the modalities we have on site.

One piece of equipment we have chosen to invest in is our advanced therapy pool equipped with an underwater treadmill and cameras. We have found that our patients are greatly benefitting from the nearly weightless environment the water provides to optimize recovery. People in wheelchairs, those with limited mobility—the opportunities are endless! And in fact, we’re finding the therapy pool is useful 99 percent of the time for patient rehab.

One of the incredible aspects of offering aquatic therapy as part of our practice is that we are now attracting a broader population of conditions to our clinic—for example, people with neurological and/or degenerative conditions. For these folks, being able to perform specific body movements in the water and see themselves on camera—cameras that can allow them to have better control over their movements—not only helps the patients physically but mentally and emotionally as well. They are reporting a new sense of hope about their situation when they can get out of their wheelchair or take those first few steps in the pool. We see people more motivated and intentional about recovering when they feel what it’s like to move again.

Always Seeking New Solutions
One of the areas I see that’s underserved is the preoperative market or “prehab,” that is, rehabilitation before surgery. While the concept of rehabbing a patient before surgery is fairly new, I’ve been a fan for more than a decade. It’s not covered under insurance so many clinics don’t offer it. But again, for us, this is where not accepting insurance works in our favor.

Our aquatic therapy offering has been a boon for the prehab service we now offer. By putting a patient in the warm water therapy pool on the underwater treadmill, he or she is able to perform exercises and remain active in spite of the discomfort on land. We essentially keep the patient “strong” in the weeks leading up to surgery.

After surgery, the patient returns for two weeks of post-op therapy—a rehab timeline that’s often shorter because of the prehab. This has been keeping our staff very busy.

Sure, there’s a financial barrier for patients to overcome before committing to paying out of pocket for prehab treatment, but once they see it leads to improved muscular responses postsurgery, they realize the value. And that value is hard to contain. Former patients are our best referral sources. Not only will they return for prehab before their next replacement surgery, but they share their successful outcomes with their friends. Word has gotten out about our prehab aquatic therapy program, and people fly in from all over the world to be treated by us.


Learning and Leading by Example
I am extremely passionate about my work and enjoy sharing my out-of-the-box ideas on the business side of owning a physical therapy clinic, including helping move the needle on new ways of thinking in our industry. I discovered early on that there is a segment of the population willing to pay you if you can improve the quality of their life and offer them a level of service not found in traditional medicine today. They appreciate and see real value in authentic one-on-one consultative physical therapy. Here’s a case study of how my flexible business model allowed me to transform someone’s life. A man came to me with a diagnosis of Parkinson’s disease. I started an exercise program for him based on that medical diagnosis, but he complained of a strange chest pain. He stated that he had had a routine stress test and cardiac workup, but the pain kept getting worse. I reviewed his past medical history, discovering he had never had a coronary CT angiography, so I contacted his cardiologist to discuss my concerns. The physician appreciated my extra attention and ended up ordering the test for the patient. The shocking results showed full blockage necessitating open-heart surgery, which saved the man’s life.

Had I been constrained by the need to base all my time with him on standard protocol exercises focused solely on Parkinson’s, I would not have delved deeper to get to the cause of his chest pain. This is why I’m a firm believer of taking a whole body systems approach to health care—really focusing on patients, seeing them beyond the diagnosis that brought them through my doors. My advice is to listen to their story. Stay focused solely on them. Never allow complacency to creep in. When you push beyond your facility’s perceived limitations, even just a little, the results can be transformative.

By Lisa Corsa, PT, DPT, MPT, is the owner of Premier Therapy Services in Boca Raton, Florida. She can be reached at

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