Know how to play the direct contracting game
Know how to play the direct contracting game
Use these tips to land clients
They didn’t teach you this in physical therapy or occupational therapy school. You’re trained to take care of patients, not to wine and dine them. But a growing trend in the rehab industry — and many other areas of health care — is to increase referrals by bypassing insurance companies and contracting directly with employers (see related story on p. 64).
So where do you get started after you’ve identified a few key corporations that could benefit from such a relationship with your outpatient rehab department or practice? Here are tips from two therapists who have been there: Joe Mancuso, PT, owner of Twinboro Physical Therapy in Central, NJ, and Marilyn Roofner, PT, director of outpatient rehabilitation at Orlando (FL) Regional Health Care System.
Know your costs. In order to put together a proposal for a potential client, you need to know how much it’s going to cost your department or practice to provide the service. How many hours will you or your therapist spend with clients and on related projects, such as preparing a presentation or drive time to the facility? Will you need to provide equipment? In most cases, costs involve staff time, Roofner says.
Does the facility have a site that is suitable? Mancuso advises practitioners do what they can to provide services on-site, even if there is not a designated wellness center or medical facility. The reason: Reducing lost work time is a major selling point in favor of an exclusive relationship with a physical therapy unit. One company Mancuso had approached for three years finally accepted a proposal when Mancuso offered to get started at no out-of-pocket costs to the employer. "I said, Just give me a room.’ I brought the exercise mats and worked with patients. Right now, we do hands-on treatment and teaching. Anything that requires the use of exercise equipment, they come here." The insurance company is billed directly.
Whenever possible, bill the employer directly rather than billing the insurance company. "We [rehab providers] can provide the service at a less expensive rate if we don’t have to bill the insurance company," says Roofner. Roofner says 99% of her direct contracting business does not involve billing the insurance company — despite being located in a fairly mature managed care market.
Include the insurer in the communication loop. Roofner says she meets with each employer’s insurance company as she is pitching the account. "You’re better off explaining the program to anyone that may prevent you from doing it," she says. "It’s very hard for an insurance company to argue with a way to lower costs. Once they see that physical therapy is such a small part of costs, it’s less threatening. And if you’re offering a way they can help reduce premiums, that’s a benefit. At first, some insurers I’ve talked with were concerned. But the longer we talked, the more they realized we were on the same team."
Pick your on-site therapists carefully. Mancuso himself often sees patients at the employer sites, while Roofner selects her staff therapists who see these patients with care. You need someone who is as comfortable talking with a blue-collar employee as with the chief executive officer of the company, both Roofner and Mancuso say. "You need someone who can think on their feet, who’s always got their eyes and ears open, and can communicate well in a politically tricky environment," Mancuso says. "It’s important to know when to step in and say, I notice your employees are having problems with this particular doctor.’
Good relationships = good marketing
As always, provide excellent customer service. Provide employees with better service than they or their employers expect, and be flexible, Mancuso says. "If you show up and there are three patients away, figure out a way to make it work. There’s a different attitude you have to adopt when you’re a staff therapist."
Provide results-oriented information. Roofner gives clients scheduled reports detailing how much her services have saved the company. She compares average costs for specific types of injuries — usually pulled from worker’s compensation filings or national journals — compared with the costs and average number of visits Orlando Regional Healthcare has achieved for the company’s employees. Numbers can also help in a sales presentation. "I might tell an employer that the average cost of back surgery is between $60,000 and $70,000, including time away from the job. That compares with a $500 or $1,000 expenditure for a back education program for employees."
Realize that word of mouth and good relationships are the best marketing tools for this type of business. Approach benefit managers or other executives with companies with which you have an existing relationship. And be patient! Roofner says the average amount of time it takes her to land an account is two years.
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