As a physical therapist, you have to jump through commercial insurance hoops and keep up with Medicare’s ever-changing regulations—all while dealing with the pain of falling reimbursement rates. But what if you could expand your practice offerings to generate more cash in the present and potentially ditch commercial insurances in the future?

The rise of cash-based care appears to be inevitable; it’s flexible, comprehensive, and tailored to the patient’s wants and needs—with no insurance strings attached. According to Jonathan Bassett from the Advance Healthcare Network, “The rise of consumer power, health savings accounts (HSAs), consumer-driven health plans, and an aging population with discretionary income and an unwillingness to become sedentary, all point to the viability of cash pay practices in the years ahead.” Cash pay care could be the answer to PT reimbursement woes.

If you’ve been following our blog for a while, you’re probably familiar with Ann Wendel and her successful cash-based practice. But maybe you aren’t quite ready to dive in like Ann did—and that’s OK. Here are a few tips for dipping a toe into the cash-based market pool:

Examine Your Current Patient Base

I’m sure you’ve researched your area’s demographics, but don’t forget to take a look at the patients you currently treat (and have treated in the past). By starting your research close to home, you can get a better idea of what cash-pay services would generate the most interest for your clinic. As Michael Weinper, PT, DPT, MPH, founder and president of PTPN explains, “Most experts see a natural fit between their offerings and their existing patient mix. For example, Susan Layfield says her patient population includes a large proportion of Medicare patients, and the practice offers a senior program called Fit for Life.”

A senior program worked for Susan Layfield, but that doesn’t mean it will work for your practice. Do you see a lot of kids from a nearby high school? Maybe your office treats a lot of back-pain patients whose jobs require sitting at a desk all day. Think of something unique and valuable to offer—something for which your patients would be willing to pay out-of-pocket.

Start the Conversation

As you prepare to expand into cash-pay, your current patients provide an excellent sounding board—so don’t skimp on conversations. Take advantage of the time you have with each patient to learn about his or her therapy goals beyond the prescription. And don’t wait for your patients to open up this discussion. Instead, ask questions.

In an Advance Healthcare Network article, Paul Gaspar, DPT, CCS, and owner of Gaspar Doctors of Physical Therapy, says that PT “customers are more willing to pay cash for our services, than we as therapists are to ask about it.” In the article, Dr. Gaspar estimates that 90% of his current cash-pay clientele have received traditional physical therapy at his practice, so “your current patients may be your most lucrative client base.”   

Once you’ve gotten the conversation going, align your practice’s strengths with your patients’ goals. Communicate to them the value of your expertise and how it relates to their needs.

Personalize Your Offer

Cash-pay patients will expect high-level service, and they’re not bound to therapy by prescription. So, to attract—and keep—them, you’ll need to think outside the box and stay flexible in your cash-based offerings. There’s endless cash-pay potential. To unlock yours, ask yourself,  

  • Would my patients benefit from payment plans?
  • Can I bundle multiple sessions and apply a discount to reduce costs and increase perceived value?
  • Would my patients prefer an entire hour of myofascial release, or would they rather work solely on their golf swing?

These are just a few questions you can start asking yourself. You might be surprised where the answers lead you.

Expanding into the cash-based realm involves researching your current patient base and market conditions, asking educated questions, and using the information you compile to diversify your practice’s offerings in a thoughtful manner. Remember, expanding your practice doesn’t mean you have to take on the whole cash-based enchilada (shout out to last week’s lunch); a few metaphorical tortilla chips should do the trick.


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