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Rock Valley Physical Therapy CEO Discusses Employer Self-Insurance in PT In Motion Magazine

Publish Date: Wed, June 21, 2017 - 8:47:00


Rock Valley Physical Therapy's chief executive officer (CEO), Mike Horsfield, PT, MBA, ATC, was featured in the American Physical Therapy Association's (APTA) PT In Motion magazine in the month of June to discuss the growing opportunity for physical therapists to engage with companies utilizing employer self-funded health plans.  Preview the article below and read the full story on the APTA's website


"Among the reasons for becoming a physical therapist (PT), the chance to work with self-insured employers likely is near the bottom of the list. After all, says Mike Horsfield, PT, MBA, ATC, the average PT in an outpatient clinic or typical owner of a physical therapy private practice "doesn't even know when a patient's employer is self-funded, because it doesn't change the way that person is billed."

Self-insured plans are those in which employers use their own funds to cover associated costs and financial risks related to their employees' health care. Such plans require the employer to, for example, write a check to its employees' providers for all of their health care up to a certain point (minus any deductible and copays owed by the worker). Above that dollar amount—say $100,000—most employers turn to stop-loss coverage from a commercial carrier that protects them against expenses exceeding their budget.

That patient's insurance card likely will look the same as any other, with the corporate logo of Blue Cross Blue Shield, UnitedHealthcare, or another major carrier on its face, notes Horsfield. The reason: self-funded companies often turn to health plans to act as third-party administrators. Furthermore, most patients have no idea where their employer-provided insurance comes from. "If you asked them," he says, "they probably couldn't tell you, because for them it doesn't make a difference." Horsfield is the chief executive officer (CEO) and 1 of 10 PT owners of Rock Valley Physical Therapy, with clinics in Iowa and Illinois.

So, why should anyone other than employers care about self-insurance? "Because, if you're a PT, any company that self-insures represents an opportunity," Horsfield says. "If you can reach out to that employer and make the case that you can help them manage their health care costs, there's a good chance they're going to want to work with you."

Horsfield speaks from experience.

Rock Valley Physical Therapy, which comprises 31 clinics and nearly 300 employees, has worked with self-insured employers for nearly 2 decades. The practice's foundation is outpatient orthopedics offered in a traditional physical therapy setting, and Horsfield is a board-certified clinical specialist in orthopaedic physical therapy. But the practice also has revenue streams from direct contracting—it partners, for example, with industrial manufacturers to provide their workers with onsite physical therapy, occupational medicine, and wellness services. Rock Valley contracts directly with 25 self-insured entities in a wide range of business sectors, including financial services, construction, and transportation.

"We interact with employers in this space in a few different ways," Horsfield says. "One is by sending a therapist directly to the jobsite to work with employees for a specified number of hours per week." Under that kind of contract, Rock Valley's team might provide care when workers have musculoskeletal injuries and, if no one is injured, might conduct a series of ergonomic assessments in collaboration with the company's risk-management professionals.

In other cases, Horsfield says, Rock Valley provides physical therapist services the same way it does for its other patients and clients: in a treatment room at 1 of its practice sites. "One of our contracts is with a local municipality; they exclusively use our clinics," he says. "From the employer's perspective, a beauty of being self-insured is that they can create their own narrow network based on value. For any PT who can get into that network, the thing to keep in mind is that the employer is not necessarily looking for the lowest costs. What they want even more are predictable costs." Offer such predictability, Horsfield says, "and you can be a great partner—which can be rewarding both financially and professionally.""

Continue reading this article on the APTA's website.

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Mike Horsfield

PT, OCS, ATC, MBA & CEO, Rock Valley Physical Therapy

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