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6 Physical Therapy Predictions for 2020

January 15, 2020 • Business • Heidi Jannenga

We’re on the cusp of ushering in an entirely new decade—and hopefully, a new era for the physical therapy industry. With that in mind, let’s take a look at some of the top trends that I predict are going to take center stage in the coming year:

1. Telehealth will get a lot more attention—and a lot more use.

As I mentioned in last year’s predictions post, telehealth is primed for an explosion. Given how much we rely on technology—and how much it is interwoven with our everyday lives—procuring healthcare services via an Internet-enabled device from the comfort of our own living rooms makes perfect sense. Not only is this an incredibly convenient means of accessing care—especially for individuals who may have a more difficult time getting to a provider in person—but it also creates more opportunity for patient-consumers in rural areas to seek out specialty providers who they may not otherwise be able to see. As consumer interest and provider utilization surge, so too will regulatory attention. While physical therapists are still limited in their ability to provide telehealth services, you can expect that to change as more pro-PT legislation comes to the forefront and expands our ability to use and bill for these services. Even with PT being a primarily hands-on treatment modality, there is still plenty of value we can provide to patients from a distance. Plus, with the impending payment reduction changes impacting our revenues, improvements in efficient, cost-effective visits and volume are imperative. In order to really make an impact on patient volume—and start tapping into the 90% of patients who could benefit from physical therapy but aren’t receiving it—we must meet patients where they are.

2. More PTs will participate in MIPS.

The number of therapists mandated to participate in CMS’s Merit-Based Incentive Payment System (MIPS) program will certainly increase with the growing incidence of consolidation in health care, as providers in larger practices with higher patient volumes are more likely to meet the mandatory reporting criteria. Furthermore, as I alluded to above, CMS is hitting rehab therapists with a reimbursement reduction double-whammy in the next couple of years. These cuts are going to hit a lot of providers hard, and I predict that as a result, many therapists who nixed opting into MIPS participation in 2019 will give it a shot in 2020—as complicated and less-than-ideal as it may be. As I explained here, next year’s MIPS program offers both higher risk and higher reward than previous years: “participating therapists will need to submit more data and perform better than ever before in order to avoid a downward payment adjustment that can fall as low as 9%.”

Unfortunately, the reward isn’t likely to offset Medicare’s 8% across-the-board cut or its 15% cut to PTA-provided services—but it might be better than nothing. To give you an idea of what you can expect, according to CMS, the highest incentive payout in 2017 was 1.88%, and that included the exceptional performance bonus. Even with the anticipated increase to 2019 payouts, the risk inherent to participation may still outweigh the reward, especially for small practices. As such, I strongly recommend that you do your due diligence prior to deciding whether opt-in participation is right for you. (You can start by watching this free MIPS webinar, which I recently recorded with PT compliance expert Rick Gawenda.)

3. Burnout will become a problem we can’t ignore.

While the issue of burnout isn’t exclusive to the healthcare industry, we have a notoriously high incidence of it. After all, the stress of being responsible for our patients’ physical and mental wellbeing can take a major toll—and that’s on top of our culture’s obsession with being busy. Unfortunately, that all comes at a cost, and we’re now paying for it. Thankfully, we’ve reached a point in the rehab therapy community where this topic is being discussed more openly, and with more attention comes the opportunity for change. In 2020, expect to see the issue of burnout getting more air play with a wider audience—and with more emphasis on developing strategies to combat it. To that end, I foresee greater adoption of the technological developments available to us to support our practices and our people—everything from software that enables us to automate patient appointment reminders (thus completely removing that task from our team’s plate) to the above-mentioned telehealth technology that enables us to provide essential care to patients in a more efficient, cost-effective manner. This year, we’ll also see a rise in artificial intelligence (AI) and AI-supported rehab therapy that ultimately improves our patients’ lives as well as our staff’s. All of these are sustainable measures we can take to help combat revenue losses—without burning out our people by stuffing their schedules and overworking them.

On a practical note, we covered some tips for dealing with burnout at the clinic level in the Miscellaneous section of this FAQ post.

4. Revenue diversification will increase.

As another means to combat decreasing payment rates, practices will start incorporating more and more alternative revenue streams, and that includes cash-pay wellness services. After all, wellness continues to be a booming industry. According to Fast Company, in 2018, the Global Wellness Institute announced that “the wellness market, which encompasses everything from boutique fitness gyms to day spas, is now valued at a whopping $4.2 trillion, having grown 12.8% in the last two years.”

As holistic healthcare providers, we are uniquely well qualified to provide services that support our patients’ overall wellbeing—including services that fall outside of the traditional physical therapy scope. Even Medicare permits its beneficiaries to pay out-of-pocket for wellness services, which means PTs can provide these valuable services to clients who need them, set their own prices, and collect payment—all without getting third-party payers involved. Just be sure you’re clearly delineating between PT and wellness services–and that you’re adhering to all guidelines set forth by your state practice act and liability insurance contract. When in doubt, discuss your plans to branch into the wellness space with your healthcare attorney.

Beyond diversifying our own clinic offerings, I believe rehab therapists can support the holistic health movement in a few ways, including developing collaborative relationships with other providers. After all, improving health and wellbeing at scale is going to require a team effort with everyone from nutritionists and psychologists to physical therapists and physicians on board. We also have an opportunity to expand our reach beyond individual patients by developing relationships with employers. Employee wellness programs are excellent initiatives that can encourage large groups of people to shift their lifestyle habits for the better—everything from making more nutritious food choices to being more active and less sedentary at the office.

5. Data will continue to be king.

Big data isn’t going anywhere in 2020. However, I predict that the focus of data collection will expand beyond using outcomes data to demonstrate the value of our profession (although that pursuit is still crucial). As we kick off the new decade—our practices fortified with diverse service offerings and even diverse provider types—clinic owners and executives will need to increasingly leverage data to intelligently adjust strategies and processes, streamline operations, and minimize financial waste. In other words, PT practices will use data to optimize for efficiency and encourage lean business practices.

This will prove especially important with respect to Medicare’s impending 15% payment cut for PTA-provided services. The only sure way for practices to offset this cut is to make operational changes—including using assistants more effectively. To do that, though, you must use data to establish a baseline for your practice and monitor how any changes you make are impacting care quality, the patient experience, staff morale, and your bottom line. (Hint: NPS and eNPS are wonderful tools to help you collect actionable data on patient and employee loyalty.)

To learn more about how to maximize your assistants’ time—and thus, help offset the PTA reimbursement cuts—check out this blog post.

6. The brand of physical therapy and musculoskeletal care will evolve.

The opioid crisis has gotten a lot of attention this year—and it will get even more attention next year, because we’re nowhere near solving it. Although we, as PTs, are a viable solution for helping affected patients as well as preventing future addiction, we have not maximized that potential. As I discussed here, CMS’s decision to cut rehab therapy reimbursements completely undermines countless studies proving the efficacy of first-line physical therapy for patients with musculoskeletal conditions. In other words, despite the blinding media spotlight on the dangers of opioids, CMS is continuing to put its money behind conventional, invasive treatments that are propagating the problem. Thus, it’s even more important that we leverage this movement to establish ourselves as the go-to providers for patients with musculoskeletal pain—and our best opportunity for accomplishing that is delivering this message directly to patients. Some of the foundational work has already been done, and the momentum will continue as long as we take full advantage of the opportunity.

Aside from the opioid crisis, we’re seeing more emphasis being placed on population health and the social determinants of health—both of which present additional opportunities for us. We must speak up and have a presence in these conversations; after all, we are some of the best-equipped providers to help patients make fundamental behavioral changes that will stick over the long term. Patients are looking for solutions—and thanks to the massive amount of information at their fingertips, they are more involved in their healthcare journeys than ever before. It’s up to us to meet them where they are searching for that information—and then steer them toward our clinics. (Here are six simple tips for doing just that.)

That’s where I see us going in 2020. In short:

  • using technology to reach more patients;
  • improving our culture to address provider wellbeing;
  • offering a greater breadth of services to help our patients achieve their functional goals;
  • optimizing our practices to minimize waste; and
  • leveraging the opioid crisis to establish ourselves as go-to providers for patients in pain.

I’d say this is bound to be a good year—and a phenomenal start to the new decade. The opportunities are endless. What do you think? What do you see in our future? Share your own predictions in the comment section below. I’d love to hear them.

Want even more predictions for 2020 and beyond? Join me and a handful of my colleagues on Thursday, February 6, 2020, for a live webinar titled, “The Roaring 2020s: 7 Rehab Therapy Predictions for the Next Decade.” You can register here. We’ll cover everything from provider burnout and payment reductions to revenue diversification and legislative trends in depth—as well as how to capitalize on these trends. Trust me, you won’t want to miss it.

Heidi Jannenga

Heidi Jannenga, PT, DPT, ATC/L, is the president and co-founder of WebPT, the leading practice management solution for physical, occupational, and speech therapists. Heidi leads WebPT’s product vision, company culture, and branding efforts, while advocating for the physical therapy profession on a national scale. She co-founded WebPT after recognizing the need for a more sophisticated...

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Bruce Sessions

Commented • February 13, 2020

Nice and Best Blog about the Physical Therapy Predictions of 2020. Good Work and Keep it Up Guys!


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