The Impact of Digital MSK on Rehab Therapy Business Operations

As explored in previous chapters, digital MSK care – the use of tools such as telehealth, remote therapeutic monitoring (RTM), virtual exercise programs, and digital communications and tracking – can enhance patient care, improve engagement and patient compliance, and elevate the quality and effectiveness of treatment plans designed by clinicians.

By themselves, these benefits can be transformational for individual clinic operations. As we demonstrate later in the chapter (see our digital MSK feature about mōviHealth), digital solutions can also help solve operational challenges related to staffing, reimbursement, and the healthcare-wide move toward value-based care.

When applied strategically, digital MSK tools and services can play key roles in facilitating the growth of programs by making it possible for clinic operators to:

  • Establish a new base of consumers
  • Expand reach into their existing consumer base
  • Grow additional revenue streams
  • Create a point of differentiation within the market
  • Extend the care and reach of limited staff

“One of the things that’s important for the growth of any business, including physical therapy (PT) practices, is the ability to diversify revenue streams and have a diverse composition of your book of business,” said Tannus Quatre, PT, MBA, senior vice-president and chief business development officer with Net Health Therapy. “Digital MSK offers a great vehicle into that by allowing a physical therapy practice to develop new programs, reach new populations of potential patients, and leverage strategic partnerships with local employers and health plans.”

In addition, digital MSK-based programs can help improve efficiency and reduce care costs, which help clinicians align with the goals of value-based care and patient-driven payment models (PDPMs) like the Merit-based Incentive Payment System (MIPS). Beyond these types of reimbursement structures, digital tools enable operators to roll out programs that reduce friction points between clinicians and patients, potentially altering care, providing them with new models for clinical, patient, and business success.

In other words, Digital MSK-related tools and services can revolutionize operations within rehab therapy practices. Below are some tangible ways industry experts see these changes occurring for the betterment of rehab therapy operations.

Establish a New Base of Consumers

While offering telehealth services to patients offers a level of accessibility that may attract new patients to a clinic, this just scratches the surface of digital MSK’s potential for reaching new populations of healthcare consumers.

As Confluent Health demonstrated through its mōviHealth program (see the digital MSK feature below), the strategic partnerships developed with local businesses and organizations looking to reduce healthcare costs are opportunities made possible thanks to digital solutions.

For example, early adopters of digital MSK tools have found them valuable in offering early consultation and intervention services for employees of self-insured companies – the goal being to reduce healthcare costs for partner companies.

Such programs, says Quatre, can provide local clinics with a base of customers who may never have seen a rehab therapist for their musculoskeletal ailments.

“Self-insured local employers are low-hanging fruit when it comes to pursuing a new base of customers,” Quatre said. “It’s a small but powerful value proposition. Digital tools make you easily accessible to their employees, they’re local, and you’re offering something right out of the gate that provides value.”

With a nationwide network of more than 600 rehab therapy clinics, Confluent Health capitalized on this opportunity by developing their own app, which they built a program around. Similar, more localized programs are possible, according to Quatre, without such high-level customization.

“At its most basic level, it comes down to simply making connections and forming partnerships with local self-insured employers,” he said. “The value-proposition around saving money is incredibly strong, and it’s supported by years of research. The role of digital MSK in all this is services like telehealth, secure direct messaging, digital exercise programs, and so on make it simple for musculoskeletal patients see a rehab therapist first, leading to a savings for employers.”

Confluent Health found they were able to save employers up to 40% in costs for each MSK case. At the same time, they successfully drove a new base of customers to their various clinics through a hybrid care model.

Plus, as Hathaway points out, clinics offering such services are not just benefiting the bottom line, despite this being the main selling point for business partners. By working with employers to incentivize a PT-first approach to musculoskeletal pain and injury, both Confluent and the employer are establishing care pathways that ensure safer and more effective patient outcomes.

“The whole idea is … changing the clinical pathways to match the research that’s been out there for years,” Hathaway said. “Seeing a therapist at 30 days or 45 days, which is the typical pathway, is very costly.”

Expand Reach into Existing Base of Consumers

While accessing new populations of patients through community partnerships is an attractive proposition, digital MSK services also enable clinics to reach deeper into their local consumer markets.

Virtual services enable this by dramatically lowering the friction points for patients to access rehab therapy (i.e., costs, commitment, travel time, etc.). By offering introductory consultations for those willing to give rehab therapy a try for their musculoskeletal issues, rehab therapists can demonstrate value to new patients suffering from pain and injury.

While many of these patients may only require home exercise programs and future telehealth check-ins, some will develop into long-term in-person or hybrid (i.e., a mix of in-person and virtual care) clients who may have sought evaluation and/or treatments elsewhere if not for the convenience provided by digital MSK services.

Regardless, an initial virtual visit can help establish a nurturing relationship that encourages patients to return when they need treatments and services in the future.

“There’s a real stickiness to the delivery of value digitally,” Quatre said. “By having aspects of your business or practice engaging with your market outside the ways of your clinic, you’re placing hooks into the community that can lead to relationships with more patients who will seek you out whenever they have a need.”

Such connections can create educational, marketing, and word-of-mouth opportunities that may otherwise not have existed without the convenience of digital MSK services.

Grow Additional Revenue Streams

The best way to generate more revenue through digital MSK services is by booking additional patients. This can occur through efforts made to establish a new base of consumers as well as within your current target market.

In addition, clinics that roll out remote therapeutic monitoring (RTM) efforts can generate additional revenue by using RTM codes, reducing cancellations, and motivating more patients to complete their plans of care.

Beyond this, says Quatre, offering specialized digital services and programs using a cash pay model can also attract new populations of patients, hence generating additional revenue.

“Let’s say I have a daughter who plays volleyball, and one of my local rehab therapy clinics is offering a semi-customized virtual program for volleyball athletes,” Quatre said. “Such a program offers simple value proposition to a specific consumer market, and parents like me would pay monthly for it in order to ensure our kids’ safety and success on the volleyball court.”

Such programs mimic many of the specialized performance training, injury prevention, and “get PT first” efforts many private practice organizations already offer for student athletes, weekend warriors, and high-level competitors. Offering a cash-based digital component that offers virtual training, performance tracking, direct messaging, etc., can provide additional value for a broader population of athletes.

Finally, as rehab therapists join the wider healthcare community in transitioning toward value-based care models, digital MSK tools and services help clinicians achieve positive outcomes while keeping healthcare costs low. For clinicians who participate in MIPS, that can mean great positive rate adjustments from Medicare.

“Value-based care really is the future,” Hathaway said. “I think there’s a huge opportunity for physical therapists to get involved in value-based care because we know that if we take our expertise and change the pathway, there will be savings.”

Create a Point of Differentiation in the Market

Competition among those who claim to provide high-quality musculoskeletal care can be fierce. Even clinicians who operate in areas with rehab therapy competition must contend with chiropractors, personal physicians, trainers, and even online apps that use algorithms to offer advice.

By offering digital MSK solutions and services like telehealth, patient portals, and apps that demonstrate and track prescribed home exercise programs (HEP), rehab therapy clinics can stand apart from competitors with weaker engagement and accessibility.

This can lead to patient growth – certainly the main goal of such programs – but it can also lead to the growth of local email lists and social media follows. This creates greater opportunities for educating potential patients about the role rehab therapy plays in improving lives, aligning one’s clinical brand with the achievement of positive healthcare outcomes.

In addition, services that promote better engagement, like appointment reminders, direct secure messaging, and RTM, can help improve patients’ experiences. Better patient experiences can lead to more positive online reviews, patient testimonials, and other marketing opportunities.

With staffing shortages affecting nearly every aspect of rehab therapy, digital MSK solutions can help clinicians work more efficiently and engage with more patients.

“With the staffing shortage as it is today, it’s going to take years to bring enough rehab therapists into the market,” Quatre said. “Until then, the only way to have supply equal demand [within the rehab therapy market] is to get more supply out of the same number of bodies. You can do that through technology.”

Offering shorter telehealth appointments, especially for new patient consultations, is one way clinicians may fit more patients into a typical day. And if a clinic offers cash-pay sessions for groups of athletes (i.e., volleyball players) or seniors looking to maintain balance, one-on-one or small-group appointments can be replaced by telehealth sessions with multiple participants.

For a new and changing cohort of clinicians who may want or need a variable work environment, telehealth enables practices to offer this flexibility. This can lead to improved morale that lowers turnover in the clinic.

“A lot of times there are people in our profession, like maybe therapists who’ve had a baby and don’t want to come back to work full time and they need a schedule that’s flexible … a lot of times we can allow that,” Hathaway said. “You can say, ‘Well, look, you can work from home so you don’t have costs and can spend more time with your baby.”

Patient portals that offer smart scheduling, secure direct messaging, automated appointment reminders, and HEP tracking also enhance efficiencies during a time when many clinics are short-staffed.

While it seems universally understood that the physical therapy landscape will continue to be impacted by digital innovations, not all transitions toward digital solutions will be rosy experiences. Rehab therapy operators should expect to encounter many challenges as they strive to realize the benefits of these tools.

For one, the language of digital MSK care remains elastic for many. While digital MSK is defined within this E-book to include a wide range of digital tools and services that create positive engagement and experiences for patients and clinicians, this understanding has yet to take hold throughout the wider consciousness of the profession.

Sometimes, communicating about digital MSK efforts – one’s needs and wants for strategic planning purposes – can be difficult.

Beyond language, however, other challenges clinical owners and operators may encounter when considering and rolling out digital efforts include:

The Lack of Cohesiveness

While several vendors aspire to put together comprehensive digital MSK tools that enable a wide range of services such as telehealth, RTM, HEP tracking, patient portals, scheduling, and so on, today’s systems lack this level of cohesiveness.

The reality is that to develop a thorough digital MSK effort will require a clinical operator to work with various vendors. This can make integration difficult within the system and a practice’s EHR software.

Establishing strong vendor relationships, especially with one’s EHR vendor, can help overcome some of these integration issues. Most of these problems, however, will likely work themselves out as software and services become more streamlined and compatible.

Achieving Staff Buy-In

Early digital efforts, such as the implementation and use of telehealth, can often be managed by an internal champion – a staff member or clinician who is hardwired and driven to advance professionally through the implementation of tech innovations.

As digital MSK programs grow, practices will likely find they must commit more personnel and resources toward these endeavors. From the establishment of programs and services to efforts to grow new revenue streams based on these programs, programs may require an investment beyond the cost of the tool or software.

The key to addressing these investment challenges thoughtfully and within one’s means is to grow digital MSK programs slowly and methodically. Avoid investing in multiple tools at once. Instead, operators should ensure all new digital tools are fully implemented, embraced, and utilized before adopting new digital tools.

Digital MSK feature:

mōviHealth Leverages Rehab Therapy, Digital MSK to Reduce Employer Healthcare Costs

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