Q&A: Cash Pay Physical Therapy & the Affordable Care Act

Questions?

Q: What are your thoughts on the future of cash based physical therapy under the Affordable Care Act?

A: I think with the changes that are happening in the traditional insurance world, especially with the ACA changes, that we are positioned to help more people and be a financially higher value option for them.

Two people have mentioned to me that they were recently notified by Blue Cross Blue Shield that their premium will be increasing from about $150 to over $300 for a $5000 deductible plan in 2014. I’m quite sure their co-pays are up near $50. Neither of these plans are the health care exchange plans.

The high deductible and $50+ co-pay plans that more and more folks will have going forward mean more and more people will search for a better value and choose cash based physical therapy practices just based on finances.  I had another patient say to me last week “I’m paying for it anyway.”   In my practice I have already had patients without insurance choose my practice based on the cost of therapy alone, not to mention that we each typically already have a specialty practice or niche which also attracts certain patients.

Now that people are realizing their health insurance is for catastrophes, more like their car insurance (no coverage for an oil change, flat/punctured tire, or failed water pump) they are starting to shop around to find the best value treatment and therapist.  It’s a great time to market directly to patients and let them know our value.

What are your thoughts?  How do you think the ACA and health care changes that are happening will impact a cash based therapy practice?

About The Author

Aaron LeBauer

Aaron LeBauer PT, DPT, LMBT started a 100% cash based physical therapy practice right after graduation. He's on a mission to save 100 million people from unnecessary surgery & enjoys helping passionate therapists build successful businesses without relying on insurance.

6 Comments

  • Great topic Aaron. I also think the ACA will continue to encourage consumers to be educated and sophisticated in their use of healthcare dollars. This too is helpful to therapists, especially those with specialized niche areas.

  • Aaron LeBauer

    Reply Reply October 7, 2013

    Thanks for your comment Susan!

  • Zack Duhamel

    Reply Reply October 10, 2013

    “Now that people are realizing their health insurance is for catastrophes, more like their car insurance (no coverage for an oil change, flat/punctured tire, or failed water pump) they are starting to shop around to find the best value treatment and therapist. It’s a great time to market directly to patients and let them know our value.”

    Couldn’t agree more! I think that’s a really good point. We are moving into a time where the simplicity (flat fee cash-based service) and the value of self pay are becoming more relevant.

    • Aaron LeBauer

      Reply Reply October 10, 2013

      Zack,
      Thanks for your comment.
      I have known friends who plunk down chunks of change for their pet to go to the veterinarian but do not value taking care of themselves and others who are willing to pay $100/month to join a gym or $50-100/session to workout with a personal trainer but who do not want to pay more than “their” $20-50 co-pay to see a physical therapist. We, physical therapists, do have to do a better job at educating the public and demonstrating the value of our services. What’s the value of feeling pain free and being able to workout again? Is that $20? or $1000? At some point, hopefully soon, patients will really start to understand the value of their health care services and what we as physical therapists have to offer.
      aaron

  • Carrie Jose

    Reply Reply August 4, 2014

    Thanks Aaron for the post. I also run a cash-based practice but have just relocated to a different city where cash-cased PT is not as common (I was previously in DC where it is very common and people are already used to paying out of pocket). I’m struggling with determining my “value” here and deciding on a good rate to charge. I like that you continue to remind us that your value is the most important thing to remember and that it is imperative to educate clients and spread that message. We can’t be afraid to charge what we feel we are worth.

    • Aaron LeBauer

      Reply Reply August 4, 2014

      Carrie,
      Thank you for your comments! Your website rocks and you’ll definitely have a successful practice wherever you land. When I moved from San Francisco to Greensboro, NC I actually raised my rate $10/hr. I felt like the increased competition in the city kept prices down. Maybe I wasn’t charging enough? You can always raise or lower your rates depending on the market demand. The important things to remember is to not charge too little and to over deliver on value. 🙂

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