After 20 years of working at insurance-based physical therapy clinics, I chose to open a “cash-based”/out-of-network clinic - for both YOU AND ME.
Cash-based physical therapy is a trend across the nation for good reason. Insurance companies are in the driver's seat and have become the decision-makers with not only how much physical therapy is worth but also what type of treatment techniques are effective.
As a physical therapist for 18 years, I’ve witnessed a dramatic shift in control. I can recall a time in which I was able to fully focus on my patient and the interventions I knew were best. I never thought or worried about what type of insurance plan he/she was on. I had one sheet of paper that I quickly wrote some notes for myself upon completion of the session.
The insurance shift
This progressively changed over the years, creating a completely different experience for not only myself but the entire department and the patient. My job duties began to include the need to understand a variety of insurance plans, a complicated electronic documentation system, attendance at meetings focused on insurance compliance, documentation that was geared towards optimal reimbursement, restrictions on specific interventions, point-of-service documentation (documenting during patient’s treatment session), and uncomfortable conversations with patients on the overall high expense of my services.
It is common across the country to experience “PT mills” in which patients are seen for 30 minutes by multiple clinicians including PTA’s and PT Techs with maybe 15′ seen by an actual PT. (This is well described HERE.) . Thankfully, the company I worked for emphasized the importance of maintaining 45-60 minute one-on-one appointments. However, it was necessary to share the majority of my patients with other PT’s or PT assistants. Although our communication was great, I did notice that I was much more effective with faster outcomes when I was able to keep the patient to myself.
A search for a better way
I began to search for a better way. I was noticing less enjoyment in my career and was frustrated with my day-to-day job. I knew I loved the knowledge in the world of PT and I truly enjoyed getting people more comfortably active. I just despised the enormous amount of paperwork and the conversations geared towards insurance compliance.
I came across multiple blog posts and podcasts regarding a new way of doing PT that sounded much like my experience during the early years of my career. I became obsessed with learning more and more and eventually this led to the creation of Juniper Physical Therapy. The following are the top 5 reasons I have chosen to go with the cash-based model. It can be a confusing mindset shift for people who are accustomed to an insurance-dominated world. However, when you truly understand it, it is very clear that this is simply better.
Top 5 reasons cash-based physical therapy is better:
1. It can be less expensive
This completely depends on your insurance plan and your overall use of your benefits. The per-hour rates are less at my cash-based clinic vs an insurance-based system simply because I do not have to rely on poor reimbursement from insurance companies. If you have no insurance, I am simply cheaper. If you have a high deductible plan that you likely will not fully meet, you will be paying out of pocket in both situations, and again, my rates are less.
2. 100% attention from a Doctor of Physical Therapy
You are guaranteed a full-hour session with just me, a doctor of PT. I will not “share” you with another PT, PT Assistant, or a Tech. I will better know you without the need to communicate and catch up on your case with another colleague.
3. Less documenting and more treatment
You will experience more attentive care and more time will be spent on treatment as I won’t have to be documented for insurance.
4. Faster results
You will typically experience faster results as I will have more time for treatment and I will be fully invested in your case as I will be the only PT taking care of you.
5. Your plan will be dictated by me, the PT professional, not the insurance company
I will be able to choose what I know is best for you. No more waiting for the insurance companies approval.
Here are a few more links to other professionals in my field who have been offering cash-based services. There are several more reasons why cash-based is the way to go.