Open Employers’ Doors and Step Into Direct Pay Revenue

man opening hanger door

Learn what it takes to build an industrial rehab program and partner with employers to keep their workforce healthy, moving, and productive.

By Glenda Key, PT and Jane K. Oeffner, PT, DPT, MBA

Do you want to…

  • Establish new referral partners and sources?
  • Modify your payor mix to benefit your bottom line?
  • Provide career growth opportunities for your staff?
  • Launch new services to diversify your sources of revenue?
  • Obtain direct payment for what you do?
  • Yield more profit?
  • Expand your business without expanding your footprint and overhead?
  • Raise awareness of your business in your community?
  • Shine and separate your practice from the rest?

Step out of your clinic door and step into all of the businesses and employers that are at your feet! You drive by and even patronize many businesses in your community every day, but have you ever asked them for their business of taking care of their employees? More and more employers are realizing the cost-saving benefits of working with physical therapists and physical therapist assistants (PTAs). They, and others in your practice such as OTs, OTAs, ATCs, and exercise physiologists, have the unique opportunity to become vital members of each employer’s team. When working with therapists to provide physical capability assessments; safety, prevention, and wellness education and programs; and consultation, employers’ illness and injury rates can drop significantly.1 Adding these services brings you and your staff into the employer’s world, creating business and revenue-building relationships as well as a deeper understanding of patients’ work environments. Each employer door you open can result in services delivered at both your clinic and their site and, when nurtured, produces not only several direct-pay sources of revenue but also downstream insurance-based revenue. Employer partners provide the link to their employees, who become patients and are a community link to other patients. And there are many billable events and revenue along the way!


  • Decreased injury rates
  • Decreased lost workdays due to injury and illness
  • Decreased absenteeism and presenteeism (present at work but not performing to highest level)
  • Decreased Workers’ Compensation costs
  • A healthy work force
  • Legally defensible and efficient screening of job applicants based on their capabilities when compared to the job requirements

Let’s explore the physical therapist’s and PTA’s roles in ability management and disability management within the worker care spectrum (Figure 1). There are so many touch points—potential new hires, current employees (well and injured), and employees returning from family/medical leave. The last group is particularly critical right now, considering what we are learning about the extended symptoms people are suffering post-COVID-19. Employees and employers alike need to know these employees are physically ready to return to work so as to avoid prolonged duration of symptoms and future injuries, and to ensure maximum well-being and productivity. The physical demands of current employees may have changed during the past year as we pivoted to new, more sedentary, less physical ways. In addition, our workforce is aging and more deconditioned than ever.

Physical capability assessments answer these questions in an objective, reliable, and valid manner. Return from family/medical leave assessments and healthy worker audits evaluate current employees. A post-offer, prior-to-hire assessment ensures the applicant’s physical capabilities match the requirements of the job, thereby screening potential employees in a legally defensible manner. Finally, on the disability management side of the equation, return-to-work (RTW) assessments, also known as functional capacity assessments, evaluate employees injured on the job. Your practice will be paid directly by the employer for ability management services and benefit from insurance-based revenue through 1) Workers’ Compensation for therapy services including RTW assessments, rehabilitation, and work conditioning, simulation, coaching, and modification, and 2) employees and their friends and families choosing your practice for non-work-related injuries because now they know and trust you! But services extend far beyond traditional PT services.


  • Incidence-driven injury-, body part-, and illness-specific prevention education sessions
  • Walk-arounds within the worksite to identify issues, coach, and provide solutions
  • Ergonomic analysis and advising
  • Wellness classes and programs
  • Job reviews and analysis
  • Monthly claims review assistance and consulting
  • Content expert/advisor in monthly HR/Workers Compensation/safety meetings

Providing limited key services with a pilot introduction phase is a great way to get started. You are also garnering valuable exposure for your practice that results in new patients, particularly from the education sessions, walk-arounds, and ergonomic analysis. Before you know it, you will be a trusted and integral part of the operations and be paid directly for these services.


Satisfied employer partners will share their cost-saving outcomes and successes, becoming a wellspring for potential additional employer partners. Ask for those introductions. In our experience, employers and their management staff are very willing to introduce you to their colleagues.

Search out opportunities to present the successful outcomes of your program and network with employers at local and state employer, human resources, and safety professionals’ conferences and Chamber of Commerce events. Sponsoring and exhibiting at these events brings incredible opportunities to meet and educate the decision makers of companies in your market. At the very least, become a member of these organizations and attend their events to network with the “ball carriers” who can get you in the door to demonstrate your program’s value. The business-to-business aspect of marketing and sales may be new to you, but the tenets are the same: Use your knowledge, charisma, curiosity, energy and passion to show other businesses how your business can bring them to new heights by ensuring their employees are working and living at their best.


First, get a handle on the employers in your expanded service area. It’s easy to compile information such as number of employees and job categories for businesses by state, county, and city. Resources include: Department of Labor & Industry, the US Bureau of Labor Statistics, and the Center for Workforce Information & Analysis. Target not only manufacturing and materials handling businesses, but also all forms of organizations in transportation, the hospitality industry, construction, waste management, mining and oil, warehousing, municipalities, hospitals, home health, and staffing agencies. Workers’ Compensation attorneys, auto accident insurers, and vocational rehab counselors are potential customers as well, particularly for RTW assessments.

Your most effective marketing tools are outcomes and data translated to dollars and cents. Utilizing published information about injury rates and associated costs to employers, prepare basic cost-saving analyses by industry to share when you exhibit and present at employer events. Incorporating their number of employees, customize this analysis to each employer you meet with as a way to begin your exploration (Figure 2). Pursue those pain points and ask probing questions to expose them. Remember, you will not be successful by simply telling the employer what your organization does, nor by asking or telling them what they want and need. Your job is to facilitate their realization of their needs and then provide a transformational solution.

Henry Ford said it well, “If I had asked people what they wanted, they would have said faster horses.” As they gather the requested data regarding their workforce injury rates, “task tension,” the interest or urgency that a customer feels about working with you on their problem, mounts, moving them to partner with you.


Your involvement in and contributions to the community will get you recognition and reap results from employers. Take every opportunity to demonstrate your commitment to keeping your community and its employees healthy, moving, and strong. Offering education and screenings at employers’ health fairs gets you in front of both potential employer partners and employees who can become patients. Showcase your services and value at community health fairs and “over 55” expos; sponsor walks, runs, and sports teams; and provide both in-person and digital education sessions so as to cater to all demographics. You want to stand out in your general and employer community as the therapy practice that takes the best care of their workers.


In addition to improving your bottom line, working with employers will enhance your staff’s professional growth and satisfaction. Helping employees be safer and healthier at work is very rewarding. Attaining new clinical knowledge, skills, and certifications increases engagement. Providing services on-site is invigorating, bringing variety to schedules and new perspectives to client care. Sharpening staff’s ability to think on their feet and honing their marketing, problem-solving, and communication skills benefits all aspects of your practice.

Industrial rehab is a field that, once the door is unlocked, you can just open it a crack or throw it wide open! As you explore, talk to colleagues about their successes. Tap the OHSIG (Occupational Health Special Interest Group), part of the Academy of Orthopaedic Physical Therapy, APTA and find content experts on the PPS website. Research is critical, but don’t get caught up in “getting ready to get ready.” Employers await you as your new customers and their employees as your new patients!


1Prall J, Ross M. The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist. J Exerc Rehabil. 2019;15(2). DOI:

Glenda Key and Jane Oeffner

Glenda Key, PT, is a PPS member, CEO of KEY Functional Assessments Network, and editor/author of Industrial Therapy. She can be reached at and Jane Oeffner, PT, DPT, MBA, a PPS and Impact editorial board member, is director of business development for KEY Functional Assessments Network and Lincoln Reimbursement Solutions. She can be reached at and

Copyright © 2018, Private Practice Section of the American Physical Therapy Association. All Rights Reserved.

Are you a PPS Member?
Please sign in to access site.
Enter Site!