Can there be a successful business model for the delivery of rehabilitative health care?

• Author: Carley, Patrick J.

Abstract

Healthcare has been moving more into the spotlight as a main topic of concern for the national debate. As a result, there is an intensifying interest in the implementation and delivery of those healthcare services to the changing demographics throughout the country. The current system for delivering healthcare has been met with general frustration in what can be best characterized as services delivered with restricted hours of operations and limited opportunities for scheduling skilled care. Rehabilitative care is a microcosm of healthcare that commonly engages the patient on a much more intimate level with repeated visits within a shorter time frame than the usual healthcare exposure. As a result, this sector exposes the patient or consumer to the physical settings and fluctuating levels of skilled clinical staffing of healthcare more intensely. This sector of healthcare delivery best illustrates the labyrinth of healthcare that can extend beyond the patient and even impact family members. This article presents two successful alternative business models for the delivery of rehabilitative healthcare for both inpatient and outpatient services. Each model offers different objectives, structures and rationale in promptly responding to the changing patient or consumer demands. Surprisingly, the two diverse business models present converging goals that justify their means for the unique but successful structures.

Introduction

The demographics of the United States population indicate a potential for a significant divergence in the needs and delivery of health care in the near future. The dominant expansion of that population has been towards the suburbs increasing urban sprawl throughout the country. In response to that shift, the classic model for delivering health care services has been from smaller surrounding hospitals. In the most recent decades, area hospitals have attempted to offer off-site outpatient locations. The mantra for this philosophy has been, "built it and they shall come". However, this approach has not resulted in the automatic success either operationally and financially that hospitals had projected for their future.

Heanberg Johnson (2002) discussed the modern challenges and physical problems associated with modern society. Physical therapy plays an important role meeting those changing demands of this revolutionized work place. As a result, the consumer is looking for providers that will meet their physical needs and time demands. Therefore, effective and responsive management is extremely vital for the successful delivery of rehabilitative services. These conditions and changing consumer demands presented an opportunity to create new business models for both the inpatient and outpatient delivery of rehabilitative services. Slow or resistant responses to changing consumer demands presented an opportunity to create new business models for both the inpatient and outpatient delivery of rehabilitative services.

However, this new business model would need to different for inpatient and outpatient services but have converging goals that would ultimately respond to the needs of the community. Those elements would have to confront variety of treating diagnoses, aging concerns, staffing work schedules, commuting times, family and personal commitments while maintaining a consistent high level of patient satisfaction. Utilization of services and consumer satisfaction will be the ultimate measure of success for that delivery of rehabilitative services.

The hospitals and corporate providers are reluctant to modified staffing configurations or expand hours of operations in these new independent locations. Often the community seeking rehabilitative health care services would experience difficulty in obtaining appointments, inaccessible weekend's hours, interact with overworked staff or rotating clinical staff with unfamiliar faces. Management of these factors is extremely vital for the successful delivery of rehabilitative services such as physical, speech and occupational therapy for either the inpatient or outpatient setting.

New Outpatient Model

Physical Therapy Partners is an example of an outpatient facility owned and operated by four physical therapists. The opportunity for the successful delivery of rehabilitative service business for Physical Therapy Partners is not unlike any other start up business. The large corporate providers of outpatient rehabilitative services have attempted another approach to successful delivery of rehabilitative services for the future. These typically involve purchasing a core group of owner-therapists practices that have demonstrated successful delivery of rehabilitative services. There is a usual infiltration of corporate accountants; marketing and operational staff that begins to profile the delivery of rehabilitation services as directed from a remote central location. There is an existing health care provider who currently underserves the customer'seeds or may be there is currently an absence of any health care provider for the community. The initial market survey data will typically substantiate the external components with regard to population characteristics, market potential, customer demands, competitor status, and potential growth. The business model will begin to take shape with a parallel formation of internal structural formation of the entrepreneurial stage. The typical structure is the owner (corporate or hospital) at the top with employees hired as therapists to provide the actual service with various support or clerical staff to assist with ancillary functions. However, these are usually encumbered with additional paperwork, regulations, policies and...