The Business Evolution of the Physical Therapy Industry, Part 2


The biggest changes are yet to come.

By David McMullan, PT

In Part 1 of this two-part series on the evolution of the physical therapy industry, we left off about 10 years ago, when the patient population began to decline as a result of increasing copays. At the same time, staff costs started to rise substantially and physical therapists saw a decrease in what they were paid. In Part 2 of this series, we will discuss how physical therapy clinic owners can successfully thrive in this ever-changing health care environment. We will explore how the combination of value-based care, advocacy, an informed patient population, and technology advances have the potential to push the physical therapy industry into a second boom.

A Boom in the Making

A huge influx of baby boomers is expected to be added to Medicare as its population ages. Due to several contributing factors, they are expected to live longer than generations before them, and they are living much more active lives far into their golden years. Whether moderately active or participating in more rigorous sports, like skiing or cycling, injuries are inevitable. Physical therapy and rehab will play a key role in enabling boomers to live the active lifestyle they desire.

The opioid epidemic also serves as a grim reminder of the value associated with treating a condition with therapy, rather than masking pain with drug treatment. Once deemed a more cost-effective option to treat pain, the use of opioids and the addiction that followed turned out to be more costly than anyone could ever imagine, both in the long-term cost of treating addicts and the ultimate cost, lost lives. Over the long haul, physical therapy and rehab have proven to be more affordable, safer, and effective treatments.

Now that Direct Access is available in all 50 states, the District of Columbia, and the US Virgin Islands, patients are able to seek some level of treatment from a licensed physical therapist without a prescription or referral from a physician. This has created new opportunities for physical therapy clinic owners. With copays and deductibles often higher than out-of-pocket costs, we are seeing a rise in self-pay patients. Because health care has become more consumer driven, patients are more informed and proactive. They are basing their decision to participate in rehab on the potential value it will have on their overall well-being. Therapists who demonstrate a track record of successful results stand to benefit most from Direct Access and the move toward health care consumerism.

Perhaps the biggest driver of this second boom is the move to value-based care, which elevates the importance of physical therapy and rehab as a critical component for patients to achieve positive outcomes. Prior to this move, patients were primarily sent to a PT only after a problem developed, and if a patient was not functioning as well as expected following a procedure. In this new outcomes-based model, therapists should and will play a much larger, more primary role in patient care.

Capitalizing on the Opportunities

For physical therapy clinic owners who deliver quality, effective care (i.e., true value) to their patients, rather than simply focusing on volume of throughput, this is the shift in the market they’ve been waiting for. The new value-based care initiative and advances in technology provide a unique opportunity for clinic owners to separate themselves from the pack and capitalize on this second boom.

Because value-based care forces data sharing across the entire care continuum, it will be easier for ancillary health care providers, like therapy and rehab, to access data and demonstrate the value they provide. Technology will play a critical role in tracking the status of a patient from when they arrived through their functional improvement as a result of therapy and how quickly they achieved this level. Tracking this information over time will enable PT owners to differentiate themselves by quantifying the quality of care they can deliver against other providers and ancillary services such as chiropractors. Having this level of data is only possible with a robust electronic medical record (EMR) system that has strong integration capabilities with ancillary systems.

Building a Bright Future

To capitalize on the impending boom, physical therapy owners must build their brand. They must show they have proven outcomes and successfully contribute to the overall improvement of a person’s health. Technology will be essential to track this information and to benchmark against other clinics. In addition to successfully managing the patients they see, physical therapy owners must also look for ways to bring in new patients; marketing will be a priority.

Patient acquisition and engagement tools will become a critical component for marketing services and communicating positive outcomes to the community. This includes becoming more active on social media platforms. Proactive outreach, such as offering tips and creating an engaging presence, will help draw people in. Evidence-backed research that demonstrates the value physical therapy provides and proven outcomes, tracked by technology, will help close the deal.

Take Away

Physical therapy owners who show the true value of physical therapy to patients and clearly demonstrate positive outcomes can expect to reap the rewards of this anticipated second boom.


David McMullan, PT, is the vice president of product therapy at Casamba. He can be reached at

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