It’s become an annual tradition of mine to look ahead to the new year and forecast the trends that are most likely to impact the rehab therapy industry. While I don’t have a crystal ball—what would be the fun in that?—I’ve gotten pretty good at predicting what’s on our horizon. (You can check out my 2017 post here and my 2016 one here.) There’s nothing on my list for this year that should come as a surprise to you—we’ve been moving in this direction for a while now—but there are several things worth noting, because these items will surely play a role in your practice’s future success. Here are the top four trends for PTs, OTs, and SLPs in 2018:

1. Patients will experience an increased financial burden.

This, of course, is due to the effects of continued healthcare and health insurance reform efforts, including the proliferation of high-deductible health plans (HDHPs). To give you an idea of just how much of a financial burden patients are having to shoulder with HDHPs, this CNBC story (which we also referenced here) reported that a bronze plan from the federal healthcare exchange in 2015 carried a deductible of $5,181 for an individual and $10,545 for a family. Silver plans, which are “by the far more popular plans sold on those exchanges,” come with an average deductible of almost $3,000 for individuals and $6,000 for families. And prices are continuing to rise: According to this CNN article (which cites analysis performed by consulting firm Avalere), in 2018, premiums for silver plans “will rise an average of 34% in the more than three dozen states that use the federal exchange.” Additionally, “gold plan premiums are rising by 16% on average, while the prices for bronze plans, which have lower rates but higher deductibles, are increasing by an average of 18%.” With those kinds of rate hikes, it’s no surprise that many patients who opt for exchange plans will experience increased financial burden.

And that will encourage even more consumer-like behaviors.

So, what does this mean for providers? Well, the more financial responsibility patients take on, the more consumer-like behaviors they exhibit—for example:

  1. doing significantly more online research about provider and treatment options prior to making a decision regarding their care, and
  2. prioritizing value (in terms of great service, positive outcomes, and efficiency of care) as they make those decisions.

Thus, savvy providers will devote time early in the year to not only ensuring that they’re providing high-value care (which requires leveraging impactful touchpoints throughout a patient’s course of care and beyond), but also optimizing their online presence by:

  • Developing a professionally branded website;
  • Being transparent with pricing and the cost of care;
  • Creating (and disseminating) excellent educational content;
  • Maintaining active social media channels; and
  • Cultivating positive online reviews.

2. Patients will have greater access to rehab therapy.

Access to rehab therapy is continuing to grow in the US. For example, every state now has at least some form of direct access to physical therapy. As a result, patients are finding it easier to reap the benefits of much-needed rehab therapy care. But, therapy providers have yet to take full advantage of this change—despite the fact that they fought so hard to bring it to fruition. This year, the onus will be on rehab therapy providers to further expand their marketing efforts to account for patient-consumers and better communicate their value to patients and other healthcare providers alike. After all, as it stands now, only 9.58% of all patients who could benefit from seeing a physical therapist ever do (based on data from this source and this one). That means 90.42% of those patients are missing out on the extremely valuable care that we are uniquely able to provide. Now that we’ve overcome the access blocker, it’s time for us to face down the perception one. To make the positive impact we want to make on a global scale—and ensure our ability to continue providing care to patients in 2018 and beyond—we must do a better job of communicating our value. To put it simply, more people must understand the benefits we, as rehab therapists, are able to deliver.

Pending legislation could improve access even more.

Additionally, depending on the outcome of the pending telehealth proposals and the PT licensure compact, patients may have even more access to rehab therapists—and providers should start preparing for these changes now. With that in mind, we can expect to see a lot more regulations on the table designed to ensure that this improved access isn’t abused or exploited.

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3. There will be a continued emphasis on collaboration.

I’ve been writing about this one for several years now, but I simply can’t emphasize enough the need for collaboration with other providers in 2018. While regulations and mandates aimed at cost reduction will make collaboration a necessity—and private partnerships can certainly bring about opportunities for increased revenue—there are also huge benefits associated with asserting your role as a primary care provider. Now that direct access is available in every state, rehab therapists have an opportunity to serve as a healthcare entry point—and use their clinical expertise to determine whether or not a patient would benefit from rehab therapy. And if not, a therapist can then refer the patient out to receive the appropriate care from someone else in that therapist’s network—thereby strengthening the therapist’s relationship with external providers as well as ensuring the patient achieves the best possible outcome. We aren’t ancillary providers anymore—and I’d argue that we never were—so it’s about time we stopped acting like it. This will be the year we step out of the physician shadow and firmly establish ourselves as care coordinators for patients with neuromusculoskeletal conditions. That means we must know our own value first and foremost—and then confidently share it with the world.

Patients want collaborative care.

Patients also are beginning to demand collaborative care—and for good reason. According to this HBR article (which we wrote about here), “It’s a common patient complaint about the people involved in their care: ‘Sometimes the left hand doesn’t seem to know what the right hand is doing. I don’t feel everyone is working together.’” That’s concerning on many levels: for starters, it can be downright dangerous for the patient, and even if no physical harm comes from the lack of collaboration, it can still hinder the patient experience and his or her ability to achieve positive clinical outcomes. As I wrote here, health care is rapidly becoming patient-centric (as it should be). And as a result, many PTs, OTs, and SLPs will soon be in the position to partner with other practitioners (or teams) with complementary skills to enhance clinical care and the patient experience—“thereby minimizing the patient’s chances of experiencing further injuries and conditions that would require future clinical intervention.”

Providers need interoperable technology.

It should come as no surprise, then, that this type of collaboration is only effective when all providers involved are using interoperable (i.e., connected) technology. Now, that doesn’t mean you should adopt a hospital’s behemoth EHR in order to remain connected; rather, PTs, OTs, and SLPs should embrace niche software options that are designed to enhance their workflow—and help them stay compliant—while also integrating with larger-scale systems. That’s the way to have your cake and eat it, too.

4. Patients will be at the center of their care.

In 2018, we can expect an even greater focus on patient-centered care delivery, patient empowerment, and the patient as the driver of his or care journey. Thus, providers would be wise to implement strategies specifically designed to enhance the patient experience—things like improving communication, customer service, care efficiency, and outcomes. Before you can enhance the patient experience, though, you’ll need to better understand its current state. That’s precisely why tools like Net Promoter Score® (NPS®) tracking can be so invaluable. By asking your patients—at various times throughout the care journey—how likely they are to refer your services to a friend or family member, you’ll be able to:

  • quantify the patient experience,
  • determine who’s loyal to your practice (and who’s not), and
  • identify what changes you need to make to your clinic and your company culture in order to please more patients.

From there, you can also ask the patients who already love your practice to write glowing online reviews, thereby widening your reach and helping you serve more patients. (While you could certainly track your NPS manually, there’s integrated technology designed specifically to help PTs, OTs, and SLPs automate the entire process, which is crucial if you’re looking to scale.)

Women make most of the healthcare decisions for their families.

And speaking of widening your reach, in 2018, providers may want to consider upping their marketing budget to reach more patients directly—specifically, the aforementioned 90.42% of patients who could benefit from rehab therapy but aren’t receiving it. In addition to optimizing your online presence, you should also be considering your audience. According to this resource, “women make approximately 80 percent of the health care decisions in their families.” This means that—in more cases than not—your marketing campaigns should be patient-centered and tailored to women.


With all of this in mind, it’s clear that 2018 will bring even greater opportunities for PTs, OTs, and SLPs to showcase their value. We know the results our patients are able to achieve. We know that first-line PT, OT, and SLP intervention often produces significantly better outcomes—at a significantly lower cost point—than many more invasive treatment options. And now, we finally have the tools and technology necessary to quantify that knowledge in an objective way (hello, data analytics and dashboards) and share it with the rest of the world.

Instead of anecdotes, let’s use outcomes data and standardized metrics. Instead of siloing ourselves, let’s collaborate with other providers to improve the quality of care across the board. This coming year, let’s embrace data collection for what it can do for our industry. Let’s get excited about our findings and share them—with patients, fellow therapists, other providers, and payers. And let’s adopt technology that enables us to better connect across the entire care continuum.

2018 can be the year of the PT, OT, and SLP—if we’re ready to own our value and stand up for it. That means no more accepting lowball insurance contracts or payments; instead, let’s rise together—as a profession. Let’s continue advocating for ourselves, our peers, and our patients. We’ve already seen how powerful we can be when we unite behind a worthy cause. Let’s unleash that power again to improve the state of our industry.

Who’s with me? Who’s ready for the best year yet?