PTPN Insights

Should cash-pay wellness services be a part of your practice?

February 22nd, 2013 |

Physiquality: A PTPN CompanyMichael Weinper, president and founder of PTPN, was not surprised when he saw that the list of available workshops at last fall’s Private Practice Section meeting for the APTA included two on wellness: one on wellness deliverables from cash-pay expert Jennifer Gamboa (creator of FitTEST Solutions™, a Physiquality partner) and one on medical fitness. And the APTA will offer a workshop at its 2013 conference on the connection between yoga and medicine. As he mentioned recently, “Not long ago, a session on cash-pay fitness or wellness services at APTA and other professional association meetings was the exception. Now it’s become the norm.”

Why it’s critical for therapists to offer cash-pay services

In the last five years since PTPN launched Physiquality, the first national wellness network for cash-pay health and fitness services offered by therapists, we’ve seen a number of trends that make it more important than ever for private practitioners to add or expand their cash-pay services.

  • Patients with high deductibles and co-pays — and dwindling paychecks — are setting limits on how much they spend on healthcare. Patients are feeling the squeeze from both ends. Insurance companies are raising co-pays and deductibles, while disposable income is shrinking. A 2010 study found that more than 25% of the respondents had foregone healthcare treatment to save money, and 20% had stopped taking medication as prescribed (for example, cutting pills in half to make them last longer). Patients in a traditional, insurance-based clinic may cut their number of visits short to save money, reducing your business from such referrals.

  • The demand for preventative care will grow because it is less expensive, in the long term, than treatment for illnesses and injuries. While patients may be cutting back their healthcare spending, that same study found that people are placing more of a priority on living healthier lives, working out more and eating out less. As Weinper says, “People are beginning to realize that paying cash to stay well may help them avoid high out-of-pocket expenses for illness later.”

  • Wellness can be a revenue center in and of itself. Most PTs consider wellness programs as a way to supplement their insurance-based clinical business and a way to transition patients into clients when therapy comes to an end. However, Mark Medcalf of Seven Oaks Physical Therapy and Fitness Center in Westlake Village, California, pointed out to Impact magazine (the publication of the APTA’s Private Practice Section) that strong wellness and fitness programs can actually introduce you to new clients. He says, “While the patient-to-client transition is key to getting started with cash-pay services, the real rewards come when each side of the practice feeds the other — patient-to-client and vice-versa.”

The most difficult part of this process may be shifting your mindset from the traditional insurance-based climate, where therapists react to an injury or illness and help patients recover, to one where you become the musculoskeletal expert that works with patients and clients to live a healthier life, preventing injury, as well as recuperating from it. “We need to think of our patients on a continuum of wellness, from patient to client, and not necessarily finish with them [once they are well],” Weinper stresses.

Where PTs should begin when launching a cash-pay program

As we noted in our last blog entry, market research is vital to your clinic’s success. You need to know what services are already available in your community, as well as where services are needed. For example, the fastest growing franchise in the U.S. is Massage Envy, proving that people want to feel good and are willing to pay cash for it, even in this economy. Many private practices already have space that could be used by a massage therapist on site, perhaps on the weekends or in the evenings, when clinical patients aren’t as frequent. But do that research — if a lot of new massage locations have opened in the last few years in your area, it may be better to offer something else.

A good place to start would be looking at your own client base and community. If you treat a large number of Medicare patients, consider offering programs geared toward senior fitness or fall prevention. If your community includes a large number of younger athletes, think about offering sports conditioning or injury prevention programs for children. And most practices would benefit from some type of gym or fitness center, to help those that are released from rehabilitation but would be more comfortable in a clinical environment, where they have familiar and knowledgeable people to help them regain their fitness.

You can also look at your own staff for ideas. Does an employee have an idea for a program, or a particular interest that would apply to a cash-pay program? Spectrum Rehabilitation and Wellness in Colorado Springs, Colorado, had a team member with previous experience as a strengthening and conditioning coach for sports teams; Aaron Knutson is now the Director of Operations and Program Development for the practice’s Max Performance sports conditioning programs.

Some PTPN members have found that it is much easier to take baby steps, initially offering a program that is already designed and proven, rather than creating one from scratch. Bryan Soulie, the owner of River Region Rehab in Louisiana, decided to take advantage of his membership in PTPN and incorporate CATZ Sports, a Physiquality partner, into his practice. The program prepares therapists and other staff members to offer programs in performance training, as well as general fitness, for athletes of any age. As he explained to Impact magazine, “We could get a business model that provided branding, marketing, plus hands-on training that would give us structure, support and networking with others.”

Soulie has expanded beyond the original program, offering programs for both children and adults and even evening classes for younger children. He notes that the cash-pay programs have brought more clinical business into his practice, and that his expertise with athletes has created brand awareness in his community. He encourages others to invest in such programs, stating that “it’s not hard to make your money back. Just doing a school pilot program allowed us to recoup 60% of our start-up costs.”

PTs can also learn from other clinicians that sell products, like dentists or dermatologists, and turn clients into customers for wellness products. Therapists have the expertise to point clients to products that are best for their needs, especially when it comes to such products as orthotics, exercise bands and equipment, and heart rate monitors. It’s an easy way to generate cash-pay revenue without investing a lot of time or money. “Not only can therapists get these wholesale,” Weinper says, “but through PTPN’s Physiquality program, we’ve established relationships with vendors who sell to our members at great discounts, so that profit margins can be even better.”

Printable version.

For further reading:

McUsic, Teresa. Cash flow. Today in PT, July 23, 2012. *

Boost your bottom line with cash-pay options: Discover wellness programs — a jackpot you can’t afford to pass up. Eli’s Rehab Report, June 2012. †

Brownridge, Daniel. Meeting of the minds: Ancillary programs and a multidisciplinary approach can open up new reimbursement streams. ADVANCE for Physical Therapy and Rehab Medicine, March 22, 2011.

Weinper, Michael. Cash-pay wellness services: Strengthening your financial footing in an uncertain market. Impact, January 2011. ‡

Weinper, Michael. Physical therapists have what it takes: Meeting the health and fitness needs of Americans in challenging times. Impact, May 2010. ‡

NBGH survey finds recession driving many American workers to make lifestyle changes to help control healthcare costs. PR Newswire, May 27, 2010.

Physiquality launches broad spectrum of health and wellness services for all ages. PTPN, February 1, 2008.

* Used by permission from Gannett Healthcare Group. All rights reserved.
† Used by permission from Eli’s Rehab Report and Eli Healthcare.
‡ Used by permission from the Private Practice Section, Impact.