Change the Model: Why PT’s Business Model Is Breaking

Physical therapy doesn’t have a value problem.

It has a positioning problem.

In this episode, Jimmy talks with Matthew Pratte about why private outpatient practices are getting squeezed — and what to do about it.

Key Topics Covered:

• Why fee-for-service puts control in someone else’s hands
• How inflation + stagnant reimbursement compress margins
• Why scale favors hospital systems and large chains
• The rise of direct-to-employer contracting
• What self-insured employers are — and why they matter
• Why PT clinics can often command higher per-visit rates through employer contracts
• Misconceptions about size and selling
• A simple first step clinic owners can take this quarter

Big Takeaway

Waiting for reimbursement to improve isn’t a strategy.

Independent clinics must rethink who they sell to — and how they position PT as first-line musculoskeletal care.