An interview with Dr. Michael Weinper, PTPN Founder and President
When, why and how was PTPN founded?
I started PTPN with Fred Rothenberg, a successful insurance executive, in 1985. That was right in the middle of California’s historic managed care boom, as well as a sea of change in healthcare. No one else had thought about it, but we saw a need to ensure that therapists in private practice could participate in PPO, HMO and other managed care contracts. We grew very quickly, and soon therapists in other states were asking if we could help them. During the 1990s, we expanded across the country to offer therapists not only local and regional contracting opportunities, but also national relationships.
The new millennium saw many changes for us as well. In 2004, we earned the Health Insurance Industry Collaboration Effort (ICE) accreditation, which is recognized by leading health plans and insurers as the industry standard for quality accreditation. Back in 2007, PTPN launched the first mandatory third-party outcomes measurement program for outpatient rehab. Today PTPN’s network includes thousands of therapists and is contracted with hundreds of managed care organizations covering millions of Americans. (Learn more about the PTPN timeline here.)
What do you think the biggest change is in the therapy industry now compared to 30 years ago?
There are many, but among the biggest are the challenges created by increasing documentation requirements coupled with declining reimbursement. Whether it is the thousands of pages of Medicare regulations, such as Functional Limitation Reporting (FLR) or the Physician Quality Reporting System (PQRS), or the demands of private payers, therapists spend an increasing amount of their time filling out paperwork and reports while struggling to make time for actual patient care. While documentation may be viewed as a necessary evil, it’s also one we believe can be mitigated through organized and focused systems and support, like we at PTPN provide. PTPN is also leading the fight against declining reimbursement; we’re actually increasing reimbursement via our Pay for Outcomes incentive programs.
How has PTPN changed over the years?
I think one of the major ways we have clearly helped to shape our industry, not just our network, is in the area of outcomes measurement. In 2007, we launched the nation’s first outcomes initiative for outpatient rehab. Evidence-based medicine and Value-Based Purchasing (VBP) continue to be at the forefront of the fundamental changes in the healthcare system, and PTPN members are well-positioned to meet current and future requirements.
Additionally, when we started PTPN, the thought of helping build cash-based wellness programs was not on our horizon. Today, we are very proud of Physiquality (www.physiquality.com), our branded initiative that enables PTs to offer the growing population of Baby Boomers and seniors, as well as clients of all ages and fitness levels, access to top-shelf health and wellness programs.
What is the most important thing you have done for your members?
In addition to insights into how to increase revenue through cash-based services, I think it’s the knowledge, systems, tools and support we’ve brought around the area of outcomes and documentation — I’m very proud of that. The PTPN Outcomes Program gives therapists crucial information for documentation, creating an efficient and streamlined process and giving them more time to do what they love, care for patients.
We also recognize that compliance and efficiency equals better reimbursement. Therapists work so hard, we want to ensure they get reimbursed fairly. The future of healthcare today is in Value-Based Purchasing, and PTPN members have the experience, programs and support to capitalize on the changing healthcare marketplace. They don’t need to worry; they are ready.
When you started PTPN 30 years ago, where did you think you’d be in the future?
I certainly never thought we’d be in the business of providing so many practice management services, or be helping therapists set up cash-based programs, or that we’d need to hire a lobbyist for our members. One thing that has become clear to me over time is that PTPN is a company of change; the industry always evolves and we must always adapt. That’s the difference between us and companies that aren’t here anymore — we aren’t one-dimensional. We also always keep in mind the four corners of managed care: 1) the patient, 2) the provider; 3) the physician and 4) the payer. All those components must work together to make the system work. If they don’t — it will all fail.
What excites you about the future of PT industry?
No one has a crystal ball, and the past is not a guaranteed predictor of the future. But we need to utilize our best effort to create our own crystal ball by conducting research, looking at trends, and analyzing what we find. Our presence on Capitol Hill keeps us abreast of proposed federal changes and allows us to communicate with legislators and agencies. Based on our analysis, we clearly see more industry consolidation as provider groups merge to gain economies of scale.
I also truly believe that because of a growing body of proof around the value of quality care, payers will begin to realize that they have gone too far in cutting reimbursement. The good news is, therapists with PTPN can provide data showing that they achieve higher quality of care, shorter lengths of stay, fewer future problems and lower overall costs. We can demonstrate that quality providers, supported by best practices, leading-edge tech and expert guidance, produce the best results, outcomes and costs.
We have a lot more Baby Boomers and seniors entering the market, many motivated to stay healthy and active as long as they can. This population wants and needs therapy services; demand will only skyrocket. So while yes, there are challenges, uncertainty and more changes to come, therapists who partner with PTPN and adapt to change are going to be strategically positioned for what the future may hold.