Success Stories

A large non-profit healthcare system in the Midwest determined that its outpatient PT/OT program with 40 physical and occupational therapists across four clinics was not performing to its true potential. We were retained to evaluate this PT/OT program and address areas that needed improvement. We compared internal referrals, payment rates, patient visits, group charges, individual productivity and other data against nationwide averages from comparable programs and determined that provider productivity, profitability, physician satisfaction and patient outcomes could all be improved.

Our primary tasks included implementing a new PT/OT leadership model by placing one lead therapist at each site who, in addition to treating patients, would supervise other providers and team with us to implement quality and productivity improvement initiatives. We assisted with recruiting new lead therapists and promoting qualified internal candidates to lead positions. We also provided both group and individual training to enhance assistant and aide utilization, scheduling, multi-tasking, coding and documentation - placing a strong emphasis on improving clinical competency. Additionally, we implemented a simple and understandable incentive compensation plan that rewarded productivity gains generating real financial returns. Utilizing productivity benchmarks and other performance-related measures, we also identified and replaced therapists and support staff who were not performing at the level required for a successful program.

As illustrated in the bar graph, we helped this system substantially increase PT/OT net income in each of the first four years following our engagement with an increase from $1.5 million in the year prior to our engagement to $3.16 million of net income in year four.


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A 30+ physician orthopaedic surgery group in the Southeast had provided PT/OT services to its patients for nearly 10 years. However, this group had been seeing a dramatic decline in PT/OT income and had tried a number of strategies to increase profitability, but made little headway.

This group retained us to help turn around its PT/OT program which at the time employed 50+ PT/OT providers practicing in eight locations. We first analyzed prior years’ results to determine why profits had declined and to gauge the productivity of individual providers and the profitability of each PT/OT location.

We then helped implement a number of key changes to this program, introducing a leadership model of one lead provider at each site, recruiting and training those leads, moving the director to a new role, recruiting and training a new director, revising the productivity-based bonus plan to more directly reward individual productivity, revising provider productivity expectations and improving scheduling, authorization and billing processes. We also provided extensive group and individual training to improve coding, charge capture, documentation and patient communications. Our web-based data reporting and benchmarking system was used to easily allow each provider to track his or her monthly results and identify the areas in need of improvement, and to provide management with an easy tool to monitor the progress of each PT/OT location and provider.

We also focused on patient satisfaction. We found that the PT/OT providers were not spending enough time with patients to allow for optimum outcomes and patient satisfaction. Many patients were paying high co-pays and would often opt out of therapy because they did not see the value. With operational changes and clinical skills training, the PT/OT providers were able to spend more time with each patient and appropriately increase daily charges in spite of decreasing their total daily visits. This change helped improve clinical outcomes, patient compliance and patient satisfaction while also enhancing staff satisfaction.

This group almost instantly benefited from these changes. A loss of nearly $20,000 in the year prior to our engagement was reversed and PT/OT earned net income of $620,000, $1,350,000, and $1,822,000 in years 1, 2 and 3, respectively, following our engagement.


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Over 10 years ago, members of our team were enlisted to help an orthopaedic group either rescue or close its PT practice. This group of 12 orthopaedic surgeons with four offices had built-out PT space in its flagship office and had contracted with the local hospital to staff and manage its PT practice. Under the hospital’s management, this PT practice struggled with only two PT providers and losses and each of the first two years without any prospect of reversal.

The physicians and their management team began to believe that PT was not viable in their area because of low payment rates and was seriously considering closing their PT practice. We were retained to analyze all aspects of their PT practice and determined that, although their PT payment rates were not generous, they were certainly high enough to allow for a viable, and indeed ultimately profitable, PT practice.

This group then brought us in to help manage PT in place of the hospital and we almost immediately helped them generate a profit by improving staffing, scheduling, charge capture and other processes. We also advocated not only expanding PT in their flagship office, but also opening PT clinics in their other offices to better serve their patient base. They were understandably skeptical about further expansion until we were able to manage the PT practice in their flagship office to profitability. We next helped this group expand PT to two other offices and establish profitable practices in both of those offices.

More than 10 years later, we are still providing PT/OT management support to this orthopaedic group which has grown to 20 physicians and six offices. Their thriving PT/OT practice now has 17 therapy providers and is on track to generate over $1.2 million in profits this year that will to be divided among the shareholders.