Six Trends in the PT Industry for 2020

January 21st, 2020
By: Content Staff

The physical therapy industry continues to thrive, with job growth projected at 30% over the next 10 years and the total market expected to reach $45.7 billion by 2023, up from $30 billion today, according to the blog of BetterPT. The technology company offers inbound-patient management software for PT practices and publishes a blog covering industry issues.

The aging American population, our sedentary lifestyles, population growth and early specialization in youth sports all have contributed to an annual growth rate of 6.2% for the PT industry since 2007, according to BetterPT. But new innovations and technology have the potential to change the industry in meaningful ways in both the short and long term.

Here are six trends to look out for in the PT industry in 2020, according to BetterPT.

1) Merit-based incentive payment systems (MIPS) for PT billing – Physical therapists became eligible to enroll in MIPS last year, and they figure to see increased usage this year with clinics also eligible, according to BetterPT. MIPS are among the new innovations in PT that will replace PQRS data reporting, with the goal of lowering the cost of care while improving the quality.

The MIPS payment adjustment score for PT may be different for each provider because it is based on the following four metrics: quality (replacing PQRS), improvement activities, advancing care information and cost. A PT’s score according to the MIPS determines the payment adjustment applied to that PT’s Medicare B payments two years later, according to BetterPT.

2) More mergers and acquisitions in health care – Back in 2017, the 50 largest health-care companies represented only 25% of the total market, illustrating the highly fragmented nature of the industry. But mergers-and-acquisitions activity was especially strong in health care over the past two years, and 2020 likely will continue that trend, BetterPT reported.

Large corporations will continue to purchase smaller hospital systems to enlarge their established networks and gain market share, BetterPT said.

3) Using technology to boost referrals – Independent PT practices likely won’t be able to rely on physicians as their primary sources of referrals because hospitals and doctors are trying to keep patients within their network and are less willing to refer them out. That will lead privately owned PT practices to rely on tech advancements to help them maintain or increase their patient caseload, BetterPT said. Those advancements include direct access, social-media marketing and digital patient engagement tools.

4) Having more out-of-network providers impacts PT reimbursement – Lower reimbursement rates and stricter Medicare guidelines for PT billing will cause private practices to shift toward being considered out-of-network providers, according to BetterPT. As more patients seek out other options for care, that could result in Medicare changes for PT, the website said.

Clinics will have to maintain strong relationships with their patients, instead of with insurance carriers, since patients will be paying more for PT. Many patients will have to pay PT clinics out of pocket and await partial reimbursement from their insurance providers, or rely on their health-care flexible-spending accounts to pay for PT.

By leveraging their patient volume and clinics, corporately run PT practices will be able to retain in-network benefits with their PT billing. But smaller practices won’t thrive with this model for PT insurance reimbursement and will aim to become part of a PT network such as PTPN, according to BetterPT.

5) Advanced APMs expand upon Medicare guidelines for PT billing – Like MIMS, advanced alternative payment models (APMs) were established as quality payment program options for PT under the Medicare Access and CHIP Reauthorization Act. Both options involve PTs earning a score based on their job performance to determine Medicare guidelines for PT billing, according to BetterPT.

With advanced APMs, however, PTs take on additional risks in an effort to collect higher incentive payments based on patient outcomes. Advanced APMs will be a major part of a broader transformation of PT billing, BetterPT reported. With their emphasis on providing affordable, effective care, advanced APMs and MIPS are likely to help shape PT Medicare guidelines for many years to come, providing additional benefits and changes for all industry stakeholders, the website said.

6) Telehealth services will see increased use for initial evaluations and overall PT plans – PT practices seek to build meaningful relationships with patients to keep them connected to the clinic and encourage them to show up for their next visit, and technology will play an increased role in this effort, according to BetterPT. The expanded use of telehealth services can make PT practices more efficient and improve the patient experience.

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