I don’t know about you, but I feel ready to usher out 2018—and welcome in a brand-new year. And that’s a good thing, because 2019 is coming in hot with a lot of changes for our industry. If you’ve read a lot of my past articles, then you know I make it a point to see change as opportunity. After all, it’s all about perspective. With that in mind, here are my seven PT predictions for 2019:
1. More Consolidation
At this point, consolidation isn’t anything new. In fact, I’ve covered it in at least two previous annual prediction posts. But, that doesn’t mean it’s slowing down anytime soon. In fact, consolidation—both on the organization side (i.e., hospitals merging and large practices acquiring smaller ones) and the payer side (i.e., insurance mergers)—is still on the rise.
So, what does that mean for you? If you’ve got a small to medium-sized private practice—and you’re interested in merging or being acquired—then you’ll want to get your ducks in a row to demonstrate your value and profitability to potential suitors. You can find a few strategies for doing so here. If you’re not interested in being picked up, then it’s time to further refine your value proposition—that is, the unique benefits that you provide to your patients. In other words, to remain competitive with large operations, you’ll need to have a very clear value statement you can use to convince patients that you provide a level of service they won’t be able to receive from a big company. After all, it’s unlikely that you will be able to compete on price alone.
Speaking of consolidation, I expect to see more of it in the technology sector as well, with larger tech companies merging with or acquiring smaller ones. As a result, providers and patients will have access to more integrated solutions that offer all-in-one services designed to improve workflows and compliance (as opposed to ad hoc services that may or not play well with one another).
2. More Consumer Brands
Health care is big business, which is why many consumer brands—including Amazon, Google, SalesForce, Uber, and Lyft—are getting into the healthcare game. And it makes sense for them to do so. After all, these companies are already experts at catering to consumers—and they have the technology and infrastructure to streamline patient access to care.
So, what does that mean for you? Only time will tell how these companies’ entrance into the market will impact the status quo, but it definitely will have an impact. On the positive side, these companies are known for innovation, and I’m sure we can all agree that our industry could use some. In the meantime, it’s a good idea to be aware of what’s going on with the healthcare environment at large. So, keep your ears on the ground for movements in this direction.
3. More Telehealth Opportunities
The world is becoming more connected through—and reliant on—technology, which is why it should come as no surprise that telehealth services will continue to expand in 2019. While this type of service isn’t widely used by—or available to—physical therapists yet, it seems likely that it will move in that direction. After all, access to telehealth enables more patients to receive the care they need.
So, what does that mean for you? For our industry to be able to take advantage of this movement, we’ve got to get pro-PT legislation passed that enables us to provide—and charge for—telehealth services. That’s going to require us to not only advocate for the benefits to our patient population (e.g., baby boomers who may be unable to make it to a clinic and millennials who may be more comfortable receiving care in the comfort of their living room or remotely while traveling), but also update the perception of our services. Yes, physical therapy is a primarily hands-on treatment modality. But, there are plenty of expert services we can safely provide at a distance that could monumentally improve our patients’ functional abilities—and quality of life.
4. More Focus on the Consumer
Notice that I didn’t put “patient” in the headline of this section. That’s because, with patients absorbing more of their care costs directly, they’re behaving a lot more like consumers. In other words, they’re researching their healthcare and provider options and making decisions for themselves before ever stepping foot into their primary care provider’s office—if they ever go there at all. Furthermore, with patient copays and deductibles continuing to rise, many beneficiaries are willing to go outside of their insurance networks to obtain the care they believe will be the most valuable to them—even if that means paying out of pocket. Thus, the practices that will be successful going forward are those that are willing to put their focus on the consumer.
So, what does that mean for you? It’s imperative that practices put themselves out there to garner attention from their ideal patient-consumers—instead of relying solely on physician referrals. While maintaining strong relationships with providers in different disciplines is still incredibly important—and beneficial—it’s becoming necessary to also maintain an online presence (and actively try to reach potential patients online), a fee schedule that’s affordable for cash-pay patients, and a cash-based plan. In other words, times have changed—and providers who aren’t willing to adapt (and by that, I mean market themselves directly to consumers) won’t be able to survive, let alone thrive.
5. More One-Stop Shop Approaches to Care
We’ve seen the one-stop shop approach to healthcare hit its stride in 2018—and it’s bound to gain even more momentum. After all, this structure is often more convenient—and in some cases, better—for patients. And it makes sense, considering the move toward more population health endeavors.
So, what does that mean for you? In order to take advantage of this movement, physical therapists must be open to—and, in some cases, actively seek out—partnerships with other types of providers. PTs’ aversion to some of these practice models—think POPTs, for example—is interesting, because while we’re known for our empathy, this perspective may not really align with what’s best for the patient.
6. More Reimbursements for—and Patient Access to—PTs
Thanks in part to opioid crisis-driven studies on conservative interventions like physical therapy, I believe that, in the coming years, PTs will start to see higher reimbursement rates and improved patient access to physical therapy. And that’s a great thing. After all, we know how beneficial first-line therapy can be—especially when compared to more risky, invasive, and costly interventions.
So, what does that mean for you? Keep up the good work when it comes to communicating the value of physical therapy to payers, patients, and providers in other disciplines. And if you’re not already collecting and using outcomes data to back up your claims, start now. We’ll continue to see a strong focus on the opioid epidemic, which gives us the perfect platform to reach more people—including policymakers. And that’s great for our industry and our patients. After all, we’re perfectly poised to help alleviate our nation’s dependence on dangerous prescription pain medications.
7. More Alternative Educational Options
The US education system on the whole is ripe for an overhaul, which is why it’s no surprise that 2019 will bring with it an influx of alternative educational options for physical therapists, including more online choices that may help shorten DPT programs. Much of this is being driven by the current student debt crisis, which is crippling students in all disciplines, including physical therapist grads whose school debt is often significantly more than their starting salaries. Evidence in Motion (EIM), for example, has partnered with several universities—including South College and Baylor—to offer accelerated, two-year hybrid DPT programs, making it easier for students to complete their coursework without incurring such significant debt.
According to John Childs, PT, PhD, MBA, FAPTA, the CEO of EIM, “Students [in these programs] can live anywhere in the country so long as they can travel to the campus several times a year for onsite, hands-on lab experiences.” And, because the program is only two years, “students can complete their degree in two-thirds the time it takes students to complete the vast majority of other DPT programs,” which means they enter the workforce sooner with significantly less student debt. So far, both South College and Baylor are enrolling 100 students a year, and EIM is in development with Tufts University, Hanover College, and Hawai’i Pacific University to create similar programs—with plans to finalize partnerships with several other universities in 2019. EIM and Baylor are also preparing to launch a similar occupational therapy doctoral program.
The University of Southern California (USC) has also launched a hybrid DPT program—although that program is three years. According to USC’s website, students in the hybrid DPT program “attend classes and access coursework using our online campus and classrooms, visit USC’s campus for regular in-person immersion experiences and complete clinical experiences in [their] community or nationwide.” As you might imagine, these types of programs make the DPT degree more accessible to a wider range of students, including those who may not be able to attend school on campus.
So, what does that mean for you? If you’re seeking out an advanced degree, these types of programs may be worth considering. Otherwise, just know that things are getting better on the educational front—and, as a result, you may have access to a better-educated, more diverse hiring pool in the next few years. And that is good for your business, your patients, and our industry.
This holds true for everyone—but especially for rehab therapists: in 2019, we must become more comfortable with change. After all, it’s the only constant in life. And it’s happening more rapidly than ever before, which means that what we’ve been doing simply isn’t going to work going forward. As an industry, we’ll inevitably hit a pain point that will force us to address the things that we’ve left untended—think a lack of unity in our profession, declining reimbursements, and a general sense of malaise among many of our peers (and that’s only for starters)—just as the opioid epidemic was the pain point that finally forced payers to change their tune on conservative treatment approaches. But, I don’t want us to wait until that type of an inflection point when we have the opportunity now to adapt to what’s coming—to embrace change—and develop an identity that allows for flexibility (not rigidity).
Change could be the best thing that’s ever happened to our profession. But, we’ve got to be the ones to shape it—and that requires a willingness to step up and not only better communicate our value through the use of data, but also acknowledge that we can’t best serve our patients by clinging to the status quo. This next phase of healthcare is going to require collaboration, innovation, creativity, adaptability, and a new level of maturity when it comes to how we operate individually and as a collective.
On that note, cheers to all that is possible for us in 2019.
What do you see on the horizon for the industry? Leave a comment and let me know.
About the Author
Heidi Jannenga PT, DPT, ATC/L is the president and co-founder of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi leads WebPT’s product vision, company culture, and branding efforts, while advocating for the physical therapy profession on a national scale. She co-founded WebPT after recognizing the need for a more sophisticated industry-specific EMR platform and has since guided the company through exponential growth, while garnering national recognition. Heidi brings with her more than 15 years of experience as a physical therapist and multi-clinic site director as well as a passion for healthcare innovation, entrepreneurship, and leadership.
An active member of the sports and private practice sections of the APTA, Heidi advocates for independent rehab therapy businesses, speaks as a subject-matter expert at industry conferences and events, and participates in local and national technology, entrepreneurship, and women-in-leadership seminars. In 2014, Heidi was appointed to the PT-PAC Board of Trustees. She also serves as a mentor to physical therapy students and local entrepreneurs and leverages her platform to promote the importance of diversity, company culture, and overall business acumen for private practice rehab therapy professionals.
Heidi was a collegiate basketball player at the University of California, Davis, and remains a lifelong fan of the Aggies. She graduated with a bachelor’s degree in biological sciences and exercise physiology, went on to earn her master’s degree in physical therapy at the Institute of Physical Therapy in St. Augustine, Florida, and obtained her doctorate of physical therapy through Evidence in Motion. When she’s not enjoying time with her daughter Ava, Heidi is perfecting her Spanish, practicing yoga, or hiking one of her favorite Phoenix trails.