I used to think the hardest task a manager had to perform was terminating an employee as a result of their poor performance or inappropriate behaviors. It is and never should be easy delivering such news to an employee, even if they are obviously unfit to complete the tasks and responsibilities they were originally employed to do.
To grow our business we must understand what drives patient satisfaction. Satisfied patients are more likely to return to our clinics and recommend friends and family.
One of my first jobs after graduating as a Physiotherapist was working in an occupational health clinic at a large car assembly plant in the United Kingdom. There were over 10,000 employees working at the assembly plant when I arrived, many having spent their entire working life employed by the company and at the same location.
BPOC Makes Strategic Investment in Alliance Physical Therapy Partners
Investment signals new phase of growth at Alliance as demand for physical therapy continues to increase
Dec 22, 2021, 07:00 ET
CHICAGO, Dec. 22, 2021 /PRNewswire/ — BPOC, one of the longest-tenured pure play healthcare investors, today announced a strategic investment in Alliance Physical Therapy Partners, LLC (“Alliance”), a leading provider of physical therapy services across the U.S.
Alliance is a national physical therapy operator offering outpatient physical therapy across a network of 90+ clinics in 14 states. In addition to traditional physical therapy, Alliance offers virtual physical therapy, a workplace therapy solution, in-hospital services, and a comprehensive electronic medical record platform. BPOC will partner with the existing management team, led by Richard Leaver, in order to execute on Alliance’s growth strategy and vision.
“We are incredibly excited to partner with BPOC as we enter our next stage of growth,” said Richard Leaver, CEO of Alliance. “Alliance was founded with the mission to become the leading physical therapy network in the country by delivering superior, quality and compassionate services to our patients. Together, we believe this partnership will allow for the continued expansion of high-quality patient services as we grow a community of exceptional physical therapy practices.”
“As the healthcare industry continues to shift towards value-based care, finding platforms designed to help patients avoid expensive procedures while improving clinical outcomes is critical,” said Troy Phillips, Partner at BPOC. “We have been extremely impressed with Alliance’s reputation for prioritizing patient experience and delivering excellent, cost-effective care. We look forward to partnering with the Alliance team and supporting the company’s growth strategies and long-term vision,” he added.
Alliance was represented in the transaction by the law firm of McGuire Woods. Cain Brothers served as exclusive financial advisor to Alliance in connection with the transaction. Kirkland & Ellis, LLP served as legal advisor to BPOC. Houlihan Lokey Capital, Inc. served as financial advisor to BPOC in connection with the transaction.
The transaction is effective immediately and financial terms were not disclosed.
Founded in 1996, BPOC is a Chicago-based private equity firm that invests exclusively in healthcare companies and is one of the nation’s most experienced investors in the industry having raised five funds with total capital commitments of nearly $1.8 billion. BPOC has invested in numerous provider, manufacturing, outsourcing, distribution and information technology companies through growth equity, management buyouts and leveraged recapitalizations www.bpoc.com.
About Alliance Physical Therapy Partners
Alliance Physical Therapy Partners is a leading, national physical therapy operator with 14 distinct outpatient physical therapy brands comprising 90+ locations and a network of 450+ licensed clinicians. In addition to operating a network of outpatient clinics, Alliance partners with hospitals and various industries by providing white-labeled contracted therapy and on-site injury prevention services. Founded in 2017 and headquartered in Grand Rapids, Michigan,
Alliance Physical Therapy Partners is committed toward delivering quality and compassionate services for patients nationwide. For more information, visit allianceptp.com.
Over the course of my clinical career, I have experienced the transformation of healthcare delivery from one that has been primarily transactional in nature to one that strives to embrace the concept of consumerism and delivering not only a satisfactory clinical outcome but an exceptional patient experience.
Many years ago I worked in a physician office as a physical therapist. Each day, the medical practice would schedule patients at every fifteen minutes interval from 10 am onward for the physician. As in any physician office, upon the arrival of the patient, they would be escorted to a private treatment room and basic history and vital signs taken by a medical assistant.
Are You Waiting for the Bus?
Thought Leadership: From the CEO’s Desk – Richard Leaver, CEO
After working as a physical therapist for more than 20 years I have had the opportunity to work with a diverse workforce in numerous specialties and various environments, ranging from high security prisons to Conductive education schools. What I have slowly realized over this time is that the patient’s level of perceived satisfaction is not limited to such factors as the therapists’ level of professionalism, educational background, clinical experience or handling skills. In fact, I would suggest that these issues are not satisfiers at all, rather dissatisfiers. For instance, if a patient receives a treatment episode that consists of accurately applied manual therapy techniques and appropriate therapeutic exercises in a safe and pleasant environment, it does not mean that the patient was highly satisfied with their care, only that they were probably not dissatisfied.
I have come across many therapists who are extremely skilled in the art of mechanical diagnosis and treatment who are not widely known within either the medical arena or general public. Then there are a small number of therapists who achieve widespread recognition and acclaim but have average clinical skill. So, what do we need to give to our patients to make them truly satisfied with their physical therapy experience?
I would argue that the single most important variable that differentiates a good or great therapy encounter is the passion exhibited by the therapist. The most successful clinicians that I have encountered all exude a huge quantity of passion when engaged in the evaluation and treatment of patients. The patient is acutely aware of the verbal and nonverbal behavior of the therapist. A therapist who is disinterested in their treatment will promote a similar attitude from their patients. This can sometimes be reflected by the level of cancellations / no-shows of patients.
If the therapist does not have a passion for what they do for eight hours a day, five days a week, then what is the motivation to continue doing the same thing day in and day out? As is often quoted, ‘life is not a dress rehearsal’. Whilst nobody enjoys the mountains of paperwork and bureaucracy associated with most types of employment there must be a component of enjoyment associated with the primary tasks completed every day.
The key to success and the therapist’s happiness is enjoyment of the job. I challenge each therapist to develop or rediscover his or her passion. It may mean attending more training courses or developing skills in a different specialty. For others it may require a paradigm shift in our thoughts and attitude. Whatever it is, don’t wait to get on the bus, develop your passion!
Big Problems need Big Ideas: Leveraging Technology to Drive Success in the Outpatient PT Space
Thought Leadership: From the CEO’s Desk – Richard Leaver, CEO
Where there are threats there are opportunities. Depending upon your perspective, virtual MSK providers are either a friend or foe to traditional brick and mortar outpatient physical therapy companies. While many of you may be aware of the existence of technology led MSK providers, I am sure there is limited understanding of their business model or how disruptive they have become in the MSK space within a short period of time.
I understand the skepticism and general reluctance to embrace telemedicine as a conduit of care delivery by many outpatient therapy providers. Demand for virtual therapy is limited and considered by many a distraction from our traditional business model. Were it not for the Covid pandemic, many clinics would not have launched their own telehealth service and I would probably not be writing about the adoption of technology.
Having launched Agile Virtual PT approximately 12 months ago, I have first-hand experience of trying to build a technology led MSK platform. I concede this has been challenging and as of yet, the monetization of the virtual service has been elusive. However, I am convinced there is a latent demand by consumers for virtual PT and the future of outpatient therapy must embrace such a product offering, along with many other technological solutions.
The threat of technology led MSK providers to our business is one of many issues that we need to address going forwards. The commoditization of healthcare services is gaining momentum and is indicative of the increasingly complex healthcare environment in which we operate and the direct result of how we have tried to manage such challenges.
The key to maintaining our relevance as the primary solution to managing MSK is dependent upon whether we can successfully meet ever changing and increasing consumer demands and demonstrate value. Pivoting our delivery of care in a manner that addresses consumers expectations surrounding ease and convenience and having healthcare fit into their lifestyle and daily routine, not the other way around.
While we have been preoccupied with fighting reimbursement cuts and trying to maintain income margins, new providers with new methods of care delivery and creative reimbursement models have appeared and become formidable opponents in managing MSK. Two very different ecosystems now exist. The traditional ‘bricks and mortar’ outpatient therapy providers and new entities that are technology led.
Within a very short period of time the technology led providers of MSK management have gained first mover advantage and established themselves as the self-proclaimed virtual solution for tackling MSK spend by many employers, commercial insurers, and a growing number of consumers.
The comparison of technology led MSK providers to Netflix is valid. Not in the context of them being the demise of traditional ‘bricks and mortar’ PT clinics, but rather pushing established businesses to enter the space and compete directly. For instance, Disney+ has successfully challenged Netflix and taken significant market share, even though Netflix was the indisputable leader and secured significant first mover advantage. Likewise, we are very capable of competing in the virtual space.
Even though telemedicine has grown by more than 40% in the past year, the majority of physical therapy visits remain in ‘brick and mortar’ clinics. Even during the height of disruption associated with the Covid pandemic, the percentage of patients who received virtual care was small. And since society has returned to a degree of normality that number has fallen for most providers.
In addition, the technology led providers have at this point played predominantly in the employer funded health insurance space. While significant and growing in scale, it represents a fraction of the entire patient population.
Even though we lost the first mover advantage of providing a robust virtual solution to technology led providers, we are certainly not too late to the party. In fact, we maintain a strong competitive advantage overall. We have the necessary infrastructure and experience operating in a heavily regulated environment, with significant clinician labor constraints and challenging reimbursement landscape. Although technology led providers are extremely capable of building a robust ecosystem to deliver services to a larger audience it will be difficult and time consuming.
The challenge will be whether we can sustain our competitive advantage given the anticipated cost of technology and the amount of resource and funding being invested in these virtual MSK providers.
The case for virtual physical therapy must not be viewed as a binary decision. It is not an either / or scenario, a debt or credit situation or brick & mortar versus virtual. The application of technology, of which virtual physical therapy is one component, needs to be discussed alongside the 90% problem. Technology can certainly enhance the patient experience for the 10% we already manage. However, what is more exciting is the adoption of technology to allow us to access the 90% who we have failed to engage and did not previously have access. Many of the barriers that existed pre-Covid no longer exist. With direct access, reimbursement parity for traditional and virtual visits, reliable HIPPA compliant video technology and increasing acceptance by clinicians of the value of virtual care comes the opportunity to serve a vast untapped market.
The situation we find ourselves currently in is like that of Circuit City and Best Buy in the early 2000’s. Circuit City doubled down on more and bigger stores. Best Buy, on the other hand, invested heavily in technology; customer facing; back office and supply chain management. The hybrid approach adopted by Best Buy, where technology complimented and enhanced the physical stores, was obviously successful as Circuit City closed their doors in 2009.
The question is not if healthcare consumers and other stakeholders see value in the adoption of technology, but rather how we can implement it to the advantage of the patient in a financially successful way.
When talking about technology, I am not referring to solutions, products or services that have yet to be developed. Instead, I am talking about the adoption and implementing of existing technology. Everything we need technology to be able to do, it can already do it for us.
From a practical perspective, what must be done immediately?
First – Embrace and leverage the technology solutions we already have available.
Second – Implement technology solutions to increase ACCESS to therapy services.
Third – If not done already – Implement a virtual capability, to provide your patients with a choice of how they consume therapy.
In the long term
- We must use data to help demonstrate value to patients and outcomes to payors to reverse the declining reimbursement rates.
- Integrate technology to enhance the overall patient experience regardless of whether it is in clinic, virtual or hybrid.
- Leverage technology so we can do more with less without compromising quality.
Leveraging technology is instrumental in helping us deliver patient care in a manner that not only addresses the existing challenges but secures and maintains our position as the primary MSK solution for the future, regardless of whether it is delivered in person or virtually. Collectively, we must identify and implement appropriate technological solutions with sufficient speed to offset current and future challenges.
Collectively, we have the knowledge, experience, acumen and most importantly the resources to find the solutions. Collaboration needs to occur between traditional and ‘non-traditional’ providers of MSK and Wellness if we are to achieve a paradigm shift and avoid becoming a Circuit City. We need the expertise of proven tech companies as much as they need our knowledge and resources.
In the long term, I do not see pure play ‘brick and mortar’ providers or pure play technology led MSK providers being successful. Just like Best Buy, it will be a hybrid approach that will likely dominate.