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Today’s episode is an interview with Phil Plisky, PT, DSc, OCS, ATC, CSCS. Phil works at an insurance-based clinic that generates a large percentage of total revenue from cash-pay injury-prevention programs. I’m really pumped to start presenting more ideas of how any practice (cash-based OR insurance-based) can generate more private-pay revenue with non-treatment services.
As I’ve said before, being 100% out-of-network for treatment services will simply not be an option for plenty of clinics out there. So it is imperative that they find non-treatment cash-based services that can offset the decline of third-party payor reimbursement over time.
More specifically, we discuss these cash-based practice topics:
- How Phil moves people from insurance-based treatment into cash-pay programs.
- How these cash-pay injury prevention programs generate more referrals for the practice (both insurance-based AND cash-based clients)
- The Y-balance Test and other injury prediction tests you can utilize in your practice
- How they price their cash-pay sessions, though they are in a “lower income” area.
- A skillful way to “get your foot in the door” with local teams and athletic programs to implement these injury prevention programs.
- The great results they had with implementing an injury screening and prevention program with the Milwaukee Brewers and US Army.
- Phil’s answer to my question regarding the “turf-war” there seems to be between Athletic Trainers and Physical Therapists.
- What to do during a patient’s evaluation in order to maximize your results as well as the ability to move them into useful cash-pay programs.
Resources and Links mentioned in this episode:
- Milwaukee Brewers results:
- Phil Plisky’s personal website – great stuff on injury prevention as well as optimal speaking/communication.
- Move2Perform Injury Prevention Software (affiliate link)*
*I only promote products I believe in and know bring value to my audience. If you click through the link above and utilize the product, I will get a small commission and I deeply appreciate it!
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[Click to Tweet] Thank you @PhilPlisky for being an awesome guest on the Cash-Based Practice Podcast w/ @DrJarodCarter
Great interview, I’ve read a lot of articles from Dr. Plisky when I was in school at Duke because one of my professors is heavily invested in FMS/Y-balance research so I really enjoyed hearing Dr. Plisky’s viewpoint on it. I just opened a new practice cash practice in Cary NC where I am trying to carve out a niche working with youth athletes and we have been utilizing free injury prevention screenings to get athletes that need it into appropriate injury prevention programs. My goal is to get more athletes to use these screens as part of their pre-participation physical to compete in middle school and high school athletics, so we have nice objective data in case an athlete does get injured during their season so we have a better idea of when it is safe to return to sport by comparing pre-injury FMS scores to post injury FMS scores. It’s nice to see that someone else has been using this model successfully.
Congrats on opening your cash practice! Doing injury prevention presentations was a big part of getting my practice going, so it’s really exciting to see Phil’s software and research as a way to really quantify injury predisposition and move people into cash-based services as a result.
Hey Kevin,
Congratulations on the new practice! Keep up the good work changing the way sports injury prevention is approached!
Give me a shout if you need anything in the process.
Phil
Hey Phil
I appreciate it, I may take you up on that offer and pick your brain for some advice at some point.
Thanks again
Once again, great information, Jared. The two biggest things I glean from this podcast were:
– Using injury prevention/Sports screening as a niche
– Start your “discharge planning” conversation at day one. In other words, let your client know approximately how many visits their insurances will be giving them and discusd fee-for-service/cash-based strength and conditioning program options to make sure the clients meet their goals.
Thanks Richard!
I think those two points are perfect takeaways from this podcast episode. That’s the way my brain works as well… In any body of content, “where are the one or two Golden Nuggets I can take that will change my life/practice?”
Well done.
Good afternoon, have found that your information has been very informative and helpful. I am a private practice physical therapist, solo practitioner and this year has not been good because of decline in revenues. I am considering restructuring the practice and one of my questions involves MVAs. I work with several attorney offices on assignment and if I go to cash based, would I be able to still work on assignment and accept payments like that?
That would really be best asked of the attorneys offices you are working with. I know when I have patients who’ve had an MVA and are going through legal proceedings, there is no issue with me seeing them as a cash based practitioner. As an aside, I never accept a letter of protection promising to get paid for my services after settlements… Got screwed doing that one time, and ever since I have simply stated at if they want to receive my services, I take payment at the time of service.
Hi Jarod,
Can you think of a reason why a cash-based therapist couldn’t pay a fee to a personal trainer, massage therapist, Pilates studio or CrossFit box for each referral?
From a Starke Law perspective, can you think of a reason why a cash-based physical therapist couldn’t pay a physician for a referral? As long as Medicare is not involved does the Starke law even apply?
If the cash-based therapy is for performance enhancement (eg: tennis, golf, running or even non-skilled maintenance therapy) then you might be able to rebate physicians a fee even for Medicare patients.
From a purely business standpoint, it makes sense to pay for referrals – I know that statement provokes a gut-wrenching response from some therapists and I don’t mean to be provocative.
I’m simply trying to expand the PT scope of practice in every legal way I can think of.
A referral fee is also ethically sound, I believe, since the patient is still the economic agent paying the full cost for your service. Poor quality therapy will discourage the patient from returning. Poor quality therapy will also reflect poorly on the physician who will stop referring, fee or no fee.
What do you think?
Thanks,
Tim Richardson, PT
Tim, I would have to check with an attorney to answer those questions from a legal standpoint. From an ethical standpoint, I think (as you suggested) you would get a variety of answers depending on whom you ask. MANY other professions work off of a referral fee set up, but because it’s been such a “no no” in healthcare for so long, it gets that “gut wrenching” response from so many.
Just like with the cash-based business model, most people write it off simply because it’s so different than what they’re used to and expecting. If you look at your questions with emotions and pre-concieved notions aside, I think you have a very good point. If it were in fact legal to do so, I don’t see why the healthcare field couldn’t adopt that approach. Playing the devils advocate, I think there would also be the strong argument that decisions in healthcare (i.e. where to refer someone) should be about where the patient will get the best care, and NOT influenced by money … and it’s easy to say that poor care will diminish those referrals, but money will still likely be a factor for many people out there. (As an example, and on the flip side of that argument, there are physicians in my area who know their patients will get the best care at my clinic, but they do not refer them to me because I do not accept insurance… I.e. they base their decisions on finances … of the patient)