By: Brady Hill, CEO
We’re all feeling the pressure to balance reimbursement challenges while still investing in our teams. It’s not easy. We want to reward effort and productivity, but we also have to protect what makes physical therapy so special — the relationships that are built, the quality of the experience, and the outcomes that our team delivers every day.
I also want to be clear that I’m empathetic to colleagues who use pay-per-visit models. Everyone is doing their best within a system that isn’t always fair or rational. There’s no single right answer.
But for us, I’d rather focus on changing the reimbursement model to better align with quality — not adjusting our compensation model to fit the inefficiencies of the system.
See below for why we’re committed to making sure PTs have a successful career and strong compensation growth, but why we want take a different approach:
1. PT Is Not Like the Rest of Healthcare
Physical therapy is different. It’s not procedural or transactional. Every visit is personal — a blend of clinical knowledge, communication, motivation and trust (with a dash of life coach mixed in). When we start to see all visits as equal, we risk cheapening what makes PT unique – and what makes patients experience so special. All visits are not created equal.
Visits are a means to an end, not the end itself. And that end — helping patients get back to the things that matter most — is the reason people choose this profession.
No one becomes a physical therapist to count visits. They do it to change lives. Our job as an organization is to make sure our systems never lose sight of that purpose.
2. We Don’t Want to Emulate What’s Broken
Much of healthcare has been built around volume — throughput, quotas, and transactional encounters. That model has led to burnout, inefficiency, declining trust, and unnecessary care.
We don’t want to emulate that. A system that prioritizes visit count over quality doesn’t bring out the best in physical therapy. It pushes us to chase numbers instead of results.
That said, you can provide great care and be efficient — they aren’t mutually exclusive — but quantity should never come before quality.
Our best clinicians prove every day that excellence and efficiency can coexist when care is intentional and patient-centered. That’s why we focus on being data-driven, not numbers-driven. Being numbers-driven means chasing volume. Being data-driven means asking better questions:
– Are we supporting our clinicians’ success?
– Are we improving outcomes and experiences for our patients?
– Are we learning from data to make care better and more sustainable? Visits are an output — not the goal.
The goal is helping out patients achieve their goals and building healthier communities around us.
3. Developing Great Clinicians (and Great Teammates)
For new team members, success shouldn’t be measured in visits — it should be measured in growth.
We want early-career therapists to focus on becoming great clinicians and great teammates: developing diagnostic confidence, learning to motivate patients, observing challenges, and evolving plans of care.
Those skills take time, mentorship, and collaboration.
Physical therapy is one of the most team-oriented environments in healthcare. Great PTs don’t work in silos — they collaborate, problem-solve, and learn together in real time.
Our responsibility is to create systems that allow that to happen — to make sure our incentives and structures help great clinicians grow, not get in their way.
Efficiency and quality aren’t opposing forces; when balanced correctly, you can balance patient access to care, quality outcomes, and financial sustainability.
4. Finding the Right Balance
I will fully acknowledge that there is a balance to hold between efficiency, access, outcomes and experience – but I think that balance is achievable, and we’re making progress in realizing a model that blends efficiency, access, outcomes, and patient experience.
We’ve made deliberate investments in better onboarding, mentorship, education, career paths, systems, data visibility, and team support — all with the intent of creating a future that balances the need to provide access with the highest quality care.
More importantly, we’ve continued to add incredible team members that believe in the impact that physical therapy can make and the potential to change patients’ lives.
We haven’t solved it all — but I fundamentally believe in a path that rewards and emphasizes the quality of care that we provide. A path that blends access, outcomes, and experience in a way that’s sustainable for our team and transformative for our patients.
5. The Future of PT: From Volume to Value
I’m confident that physical therapy is positioned to drive meaningful improvement in the MSK care model.
Healthcare needs to shift and is shifting – from a reactive model to a focus on helping our patients stay healthy and active. That’s exactly what PT is built for.
The future isn’t fee-for-service; it’s fee-for-value.
That means aligning both reimbursement and compensation around quality, outcomes, and experience. Doubling down on pay-for-quantity moves us backward.
6. Building Alignment That’s Lasting: From Volume to Value
That’s why our programs recognize both effort and excellence. Our bonus structure rewards teammates who go above and beyond – but the real opportunity is our path to partnership, which allows clinicians to become owners in the clinics they help lead.
That creates alignment that lasts – and rewards those who make a lasting impact.
Physical therapy isn’t a commodity. It’s a relationship, a collaboration, and a catalyst for better health. And the way we measure and reward success should reflect that.