Rehabilitative Therapy Practices

Industry Profile Report

Dive Deep into the industry with a 25+ page industry report (pdf format) including the following chapters

Industry Overview Industry Structure, How Firms Opertate, Industry Trends, Credit Underwriting & Risks, and Industry Forecast.

Call Preparation Quarterly Insight, Call Prep Questions, Industry Terms, and Weblinks.

Financial Insights Working Capital, Capital Financing, Business Valuation, and Financial Benchmarks.

Industry Profile Excerpts

Industry Overview

The 27,400 rehabilitative therapy practices in the US provide services to help patients restore function, improve mobility, relieve pain, and prevent or limit permanent disabilities. Rehabilitative therapy includes physical therapy, occupational therapy, speech therapy, and audiology. Practices may also provide therapy through art, music, dance, exercise and recreation.

Dependence On Referrals

While most states allow patients to have direct access to therapy services, many managed care and Medicare plans require patients to obtain a referral from a physician.

Demand Projected To Grow

The aging US population, earlier hospital discharges, and improved infant survival are projected to drive increased demand for rehabilitative therapy.

Industry size & Structure

A typical rehabilitative therapy practice operates out of a single location, employs 14 workers, and generates $1.3 million annually.

    • The rehabilitative therapy industry consists of 27,400 companies, employs about 386,700 workers, and generates about $36 billion annually.
    • Most rehabilitative therapy practices are small, independent operations; 67% have a single location and 89% employ fewer than 20 workers.
    • Large companies include Select Physical Therapy, US Physical Therapy, and Concentra.
                                Industry Forecast
                                Rehabilitative Therapy Practices Industry Growth
                                Source: Vertical IQ and Inforum

                                Coronavirus Update

                                Apr 25, 2022 - Rise Of "Pandemic Foot" may Boost Demand
                                • Podiatrists nationwide are reporting an uptick in foot trauma amid the COVID-19 pandemic, according to The New York Times. The Hospital for Special Surgery in New York City has seen a 20% to 30% increase in foot trauma — or "pandemic foot" as Rock Positano, co-director of the hospital's nonsurgical foot and ankle service, calls it. People aren't wearing supportive shoes as often because more time is being spent at home. Overuse injuries are also common from going barefoot more often. "Many of us have undergone atrophy and bone density loss from inactivity without noticing it, making it harder to stabilize ourselves on uneven surfaces," according to Jacquelyn Dylla, an associate professor of clinical physical therapy at the University of Southern California in Los Angeles. Bone density loss can mean that even small injuries may cause serious problems.
                                • The US Department of Health and Human Services (HHS) will seek to sustain and expand access to telemedicine after the federal government declares the COVID-19 public health emergency to be over, HHS Secretary Xavier Becerra said in late March. The Centers for Medicare and Medicaid Services significantly relaxed restrictions on telemedicine during the pandemic. Beneficiaries can now use telehealth in their homes because authorities suspended a requirement that they travel to rural health facilities to speak with providers in remote locations for most services. Medicare also expanded the number of allowable telehealth services by 146 and permitted providers to bill the same as for in-person visits.
                                • Many healthcare systems and facilities delayed elective surgeries to focus on COVID-19 patients, according to Becker’s ASC Review. Access to supplies will determine whether operations at some facilities will go on, according to Becker’s.
                                • Many people over the age of 65 are being referred to rehabilitative therapy to correct dizziness and loss of balance. The number of falls occurring at home is increasing due to physical weakness caused by months of inactivity. “Senior centers had lunches and exercise classes, but now, with senior centers being closed, people are home a lot more, and there’s an increased weakness and risk of falls," said physical therapist Amanda Roberts. "We’ve seen a lot more instability.” Some therapists who make house calls are going through the home with the patient and removing obstacles that could pose a threat to safety.
                                • The Centers for Medicare and Medicaid Services will allow rehabilitative therapy practices to bill for brief online assessment and management services, virtual check-ins, and remote evaluations as part of its 2021 Medicare physician fee schedule.
                                • Chronic fatigue, an aftereffect of COVID-19 on some patients, may be alleviated to a considerable extent through rehabilitative therapy. "The things that physical therapists can help with are graded exercise programs, to their tolerance, to hopefully get them back to a level of performance so that they don’t feel chronic fatigue,” said Sharon Dunn, president of the American Physical Therapy Association. While the novel coronavirus was once thought to primarily impact the lungs, Dunn says new research has shown that it is more a vascular disease than a lung disease. Because the vasculature and microvasculature – or blood vessels – are impacted, the results of rehabilitative therapy can vary among patients, depending on what their pre-COVID health status is.
                                • Physical therapists have expanded their telehealth service options when the coronavirus outbreak prompted patients to cancel in-person appointments. Telehealth appointments typically consist of a scheduled video call between the patient and physical or occupational therapist. The sessions allow therapists to conduct an evaluation, guide patients through different movements, check movement and range of motion, prescribe specific exercises, and then coach patients through those exercises. Industry experts say that while telehealth is not meant to completely replace in-person, hands-on treatment sessions, it is a safe secondary option.
                                • The Centers for Medicare & Medicaid Services (CMS) issued a widespread waiver that expands Medicare coverage to include telehealth services provided by physical therapists, occupational therapists, speech language pathologists, and audiologists. The waiver will remain until the coronavirus emergency declaration is lifted. Afterwards, rehabilitative therapy services via telehealth will return to non-covered status. The US Department of Health & Human Services (HHS) announced on October 2 that the Public Health Emergency (PHE) declaration for COVID 19 will be renewed for another 90 days, beginning on October 23 (the date the PHE was previously scheduled to expire) and extending through January 20, 2021. HHS retains the discretion to terminate the PHE at any time.
                                • Policymakers and insurers across the country say they eliminated copayments, deductibles, and other barriers to telemedicine, but the process hasn't always been smooth. Many insurers have waived copays and other telehealth cost sharing for in-network doctors only. Another issue is that carriers promoting telehealth have little power to change telemedicine benefits for self-insured employers whose claims they process. Blue Cross Blue Shield, Aetna, Cigna, and UnitedHealthcare, four of the largest insurance companies, say that improved telehealth benefits don’t necessarily apply to self-insured employers. Neither governors nor state insurance regulators can force self-insurance plans, which are regulated federally, to upgrade telehealth coverage.
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