“[As providers,] we desire consistency of care and outcomes. If you’re not partnered, associated with, or closely tied to a rehabilitation or therapy group, the variability in what your patients will receive [after your care] will be detrimental to tracking [and maintaining] outcomes – and to establishing a patient base that is consistent and is your ‘brand builder’.”
This insight came to us from Gary Calabrese, the Senior Director of Rehabilitation & Sports Therapy at Cleveland Clinic. Calabrese has helped the organization expand and improve its rehabilitation programs since 1994, giving him extensive insight into how providers can best optimize their outpatient strategies. He spoke with us recently on a Fireside Chat alongside fellow industry expert Barbara Sack – Director of Systems Integration for Kansas City Orthopedic Alliance – who herself spent more than two decades as the Executive Director of an orthopedic surgery practice in Kansas City.
Each leader offered valuable recommendations on what providers should consider as they work to expand their footprints, but one nugget of wisdom stood out beyond the rest: patient outcomes, care consistency, cost-efficiency, outreach, and physician satisfaction all benefit from leveraging a strong third-party management partner.
The Power of Partnerships
For both professionals we spoke to, this took the form of working with Physicians Rehab Solution (PRS), a leader in the PT/OT clinic management field. The firm helps clients expand via new clinics, or can be called in to optimize existing locations, in each case handling the human capital, equipment/supply purchasing, and comprehensive oversight necessary to deliver world-class care. Even more impressively, their expansion model only requires clients to cover rent and utilities – all other management expenses are covered by PRS, despite the client retaining full clinic ownership.
Surprisingly, in evaluating their capabilities, we at Connex found that there’s still considerable friction within the clinic management market. Many providers – especially hospital systems – expect to handle clinic expansion and management themselves. However, achieving this is often more challenging than it seems. “Managing physical therapy is totally different,” expressed Sack when discussing the business case for outsourcing. “What I knew for sure is that we couldn’t be the ones doing this. We needed to partner with somebody.”
Sack’s concerns were far from unfounded. Even cursory examinations of historical clinic trends show that many providers struggle to make PT profitable, beset on all sides by challenges like patient leakage and staff shortages. “When we started [expanding clinics] 10 years ago, we were looking for ways of keeping physician income where it was, and hopefully increasing it,” explained Sack. “At the time, I was hearing from a lot of colleagues that they were getting rid of PT because it just didn’t make any money anymore. And I had learned that it was maybe 10 years before [I joined] that we did have physical therapy but got rid of it for the same reason.”
It was the strategic use of external partnerships that allowed her organization to avoid their previous pitfalls: “It's been very profitable for us […] Physicians only have so many hours each day, and no matter how good an idea a physician may have, they’re only getting paid for [care delivered] and how many times they do it. […] This [partnership] allows them to deliver better, more cohesive care to patients, bringing in more money. It's a win all the way around – for the patients and for the practice.”
Beyond the Surface
Sack’s commentary speaks to the core value such a partnership brings: managing and expanding clinics can be resource-intensive, so outsourcing provides a convenient way to offload administrative and supply chain responsibilities. However, the benefits run deeper than that, impacting care delivery and patient outcomes directly.
“[Without a partner] you don’t know where your patients are going,” explained Sack. This not only introduces variance but can result in a breakdown of care delivery. “[Independent clinics] don’t always follow all your orders, and sometimes information is hidden in the notes they send back to you.” In contrast, having a deep and direct partnership with PT experts has helped Sack’s team achieve more proactive care delivery. “Our physical therapists [are] very interested in doing exactly what we want them to do,” said Sack, adding that there’s been a significant increase in calls from therapists who have identified potential care plan improvements. “We believe that our patients get the best care the way we have it set up now.”
In keeping with Sack’s feedback, the narrowed focus of third-party clinic management also means those partners are much more likely to have the space, time, and resources needed to stay abreast of new advancements in medicine. “You want to be sure that you’re keeping up with the times,” explained Sack, “so it’s critical to have the right partner. […] I can’t keep up with all the newest things in physical therapy, [and it helps to have a partner] tell me, ‘this is something we’ve been watching for a while, and we want to introduce it to patients,’ or ‘we’ve got our therapists specializing and taking new courses’.”
A similar proclivity for improvement can be seen in how these clinic partners invest in their talent more broadly. For example, the aforementioned PRS not only leverages their reputation to source some of the nation’s most talented professionals but continually pushes them to new heights through rigorous development programs. That’s paired with a deep commitment to their servant leadership philosophy to ensure optimal performance both within and without the patient encounter.
Choices
Ultimately, these benefits hinge on finding the right partner. “Honestly, we went through probably 4 or 5 different companies’ models,” explained Calabrese. “We were looking for that cultural fit, and we wanted to ensure that our brand was consistent across all locations.” To a large name like Cleveland Clinic, maintaining a distinctive look and feel was critical – especially in this age of healthcare accessibility.
“Physical therapy is a shoppable commodity [for patients], and there's [options] on every corner of every city. […] You want a ‘wow’ factor. You want people to say, ‘you wouldn’t believe the care I got’,” explained Calabrese.
“The vendors I love most are the ones I never have to think about,” joked Sack, cheekily adding that the only time she does think about PRS is when meeting monthly to go over their reports. “There’s never someone rushing into my office with eyes as big as saucers saying, ‘you won’t believe what’s happening’ – people do that,” she laughed, “but it’s never about our PT.”
Typically, the path to finding the right partner starts with the right conversation, and that’s precisely why Connex sessions and events are geared towards collaborative, peer-driven thought leadership. Calabrese and Sack both shared more insight into their clinic strategies, vendor decision-making processes, and clinic successes than can fit in a single article – we highly encourage everyone to listen in to the full discussion HERE.
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