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Opportunities Amid COVID-19

The past few months have been extremely challenging for physical therapy clinic owners around the country as the COVID-19 pandemic struck the nation and forced clinic closures and reduced hours for just about every physical therapy practice in the country. Between a cancellation of non-essential surgeries, patients opting not to go to the clinic, and mandatory closures, treatment volume was down around the nation, and Prompt clinics were no different. 

In the month of April, Prompt clinics averaged a 65% reduction in visit volume, a 68% reduction in dollars of claims submitted, and a 59% reduction in collections. Those reductions appear poised to carry on, although a rise in telehealth adoption and some portions of the country beginning to ever so slightly open back up may help us see a turn in those trends. Even once clinics begin to re-open, it is unlikely that volume instantly returns to normal. Instead, I predict a slow rise back to normal operating capacity that may take 6-12 months. 

However, despite the carnage that was the month of April, May sparked new hope as clinic owners around the country began thinking outside the box about how to improve their practices. In talking to dozens, if not hundreds of owners, here are a few things that stood out to me as a cause for hope.

Owners focusing on their A/R and billing habits

One of the biggest issues I have seen in the private practice physical therapy industry is bad billing habits and enormous A/R in clinics. A major benefit of the decrease in visit volume is it allowed often over-burdened owners to focus on their billing and accounts receivable. 

In the month of April, I had countless conversations with owners who were normally swamped with the day to day of running their business about how to better manage their billing and improve billing practices in the post-COVID world. Luckily for Prompt owners, they are easily able to manage their A/R and visualize what is going on with our easy-to-understand reporting

Preparing to re-open – a shifting focus to marketing and maximizing patient retention

Another massive issue in the physical therapy industry is patient retention and marketing. Clinic owners often focus on the metric of new evals per week or new evals per month but do not focus on more important metrics like average visits per patient or plan of care compliance. 

With patient volume way down and new evals falling to zero, the month of April provided owners with time to focus on their clinic and how they can ensure each patient attends the maximum number of visits allowed.

This focus on maximizing patient retention will lead to more successful patient outcomes and a higher bottom line for clinics, a win-win for the patient and the practice. Clinics often spend their entire marketing budget trying to drive new patients, but focusing on existing patient relationships will likely lead to a far better return on investment. 

The rise of telehealth

Third and finally, the rise of telehealth and telehealth reimbursements was a major win for the physical therapy industry in April. In speaking with owners and clinicians around the country, telehealth is clearly growing in this time of need and I believe it will be here to stay when things return to normal. 

One Prompt clinic owner was able to maintain about 50-60% of her normal volume by shifting focus to telehealth, and even managed to treat patients from around the country (check with your state practice act and malpractice insurance to see if you are allowed to treat patients through telehealth living outside your state). 

Another win for the industry was that many large carriers, including Cigna, Aetna, United, and a lot of Blue Cross plans, are now covering telehealth at normal in-clinic reimbursement rates. While it is unclear if that will last in a post-COVID world, it is a start. If patients speak highly of their experience with telehealth and it leads to similar outcomes at a lower cost, we could see carriers continue to cover telehealth when things normalize. 

Either way, the success of telehealth in the industry shows the willingness to adapt for both clinicians and patients and shows an ability to adopt innovative technology that has not been seen in the physical therapy industry previously. We are proud to offer physical therapy telehealth in our software and encourage owners to reach out for a free demonstration if they are interested in exploring that option.


April was a brutal month for the physical therapy industry, along with the rest of the country, with large-scale layoffs, massive drops in volume and collections, and widespread devastation around the entire country. 

While the numbers are not likely to rebound quickly, April resulted in a shifting focus that will benefit the private practice physical therapy industry for years to come when things settle back in over the course of the next few months. 

Owners spending more time improving their billing practices and re-focusing their marketing efforts to maximizing the retention of existing patients will have long-term benefit that will help the industry rebound and rebuild stronger after the pandemic ends.

Adam Baliatico

Co-Founder and Director of Operations at Prompt Therapy Solutions

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