9 Ancillary Services That Can Boost Practice Revenue

Leigh Page

Disclosures

August 07, 2014

In This Article

4. Physical Therapy

Some PCPs refer a high volume of patients with joint pain, osteoporosis. and sports injuries to outside physical therapy (PT) centers. This volume might be high enough to justify an in-house PT program.

Oak Mill Medical Associates, a 5-physician internal medicine group in Niles, Illinois, started this service a few years ago. Denise Alessi, practice manager at Oak Mill, said reimbursements for PT run $2000-$3000 per patient. She said start-up costs are relatively low, including removing walls between 3 exam rooms to create a larger exercise space, spending under $10,000 on equipment, and hiring a part-time physical therapist and a physical therapy technician. Equipment includes treatment tables, upright bicycles, a treadmill, and a heart rate monitor.

Alessi said that when Oak Mill started the service, its 5 physicians brought in enough patients to justify bringing in the physical therapist and tech 3 days a week. An advertising campaign attracted patients from other practices, allowing them to come in 4 days a week, and volume may soon be high enough to justify a full week, she said.

Alessi said Oak Mill's PT clientele includes elderly patients with such issues as damaged rotator cuffs, inability to balance, and osteoporosis. The center also treats younger patients injured in team sports, jogging, and even gardening.

Oak Mill's treatment regimen normally lasts 6 weeks, but the length varies, depending on the type of therapy. The therapist documents treatment, which occurs at least twice a week, and writes several evaluations over the course of treatment. Alessi said the practice is paid about $180 per evaluation and $200-$300 per visit. Oak Mill also sells treatment items to PT patients, such as hot and cold packs and cold laser treatment.

Before launching this service, Alessi said it's important to do your homework. Oak Mill undertook a detailed feasibility study. For 1 month, each physician recorded how many patients they sent to outside PT facilities, and the practice researched insurance reimbursements. "We realized we were outsourcing a lot of physical therapy," she said.

Be aware that some states require a permit to operate as a physical therapist. Whereas permits can cost around $150, New York's costs $2000.

Organizations representing private PT practices have been challenging physician-owned PT, saying that it poses a conflict of interest and violates bans on the corporate practice of medicine in such states as California and Washington. However, the Washington Supreme Court rejected this argument in 2010, and California authorities have been allowing PT in medical practices.

Consultants have mixed feelings about PT. Aburmishan endorsed this service but pointed out that the high investment in equipment and staffing make for low profits. Grant, on the other hand, argued that these services would be useful only if you had a sports medicine practice or treated a lot of elderly patients.

Physical Therapy Scorecard

Start-up costs: $25,000 for equipment, plus the cost of extra space.

Potential income: About $500,000 per year.

Pros: The cost of equipment is relatively low, and reimbursements for physical therapy run about $2000-$3000 per patient.

Cons: You may not have access to the young, elderly, and disabled patients who use PT, and will need to find space and hire trained staff for the work.

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