Healthcare spending has always been a touchy subject—and that might be truer now than ever before. Despite the fact that the United States spends more money on health care than any other country, that massive expenditure hasn’t necessarily translated into better health outcomes. Clearly, something needs to change, which is why many healthcare providers—including physical therapists—are fundamentally shifting the way health care is managed. Specifically, they are starting to explore care delivery models that allow them to affect entire populations of patients, thus preventing widespread health issues. And that’s great news, because as physical therapist Mike Eisenhart said during his population health session at last year’s PPS conference, “If [PTs] don’t claim to be part of the solution, then that makes us part of the problem.”

As it turns out, PTs are ideal champions for this movement. A 2013 study published in the Journal of the American Medical Association found that the top five conditions that contribute to US healthcare spending are:

  1. Diabetes mellitus ($101.4 billion)
  2. Ischemic heart disease ($88.1 billion)
  3. Low back and neck pain ($87.6 billion)
  4. High blood pressure ($83.9 billion)
  5. Fall-related injuries ($76.3 billion)

Therapists can significantly reduce the incidence of all five conditions with preventive or restorative physical therapy treatment. But, to PTs who are used to providing mainly rehabilitative (i.e., reactive) care, venturing into wide-scale population health efforts can seem pretty overwhelming. That’s why the APTA recommends starting small—by creating partnerships with local employers and developing employer-based wellness programs, for example.

Employers have a vested interest in lowering healthcare costs, maintaining a productive workforce, and reducing workers’ compensation cases—making them an ideal starting point for providers looking to expand beyond the individual patient level of treatment. Securing employer buy-in might seem like a challenge, but with the right approach—and a little research—getting employers on board could be easier than you think. Here are some tips for getting the ball rolling:

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Identify your target audience.

Before you go out and start pitching your idea to employers, figure out which ones are the most likely to be responsive. Think about the demographics in your area and research the health risks associated with prevalent industries in your region. Once you’ve determined where your efforts would be most effective, create a set of talking points tailored to the employers you’ve chosen.

During the same PPS session with Mike Eisenhart, Holly Johnson, PT, DPT, Cert. MDT, discussed her practice’s experience with worker wellness programs in Appalachia. She noted the grim health and socio-economic statistics for her region—specifically, the staggering prevalence of prescription drug abuse and some of the highest poverty rates in the US. She also found that the region has high mortality rates associated with seven of the nation’s leading causes of death, including heart disease, injury, stroke, and diabetes. So, her practice began partnering with major area employers—such as local coal mining and manufacturing companies—to deliver pre-work screenings, early physical therapy intervention opportunities, and WorkWell programs.

Talk to employers.

Some of the more health conscious, forward-thinking companies may jump at the chance to implement a preventive, health-focused program. After all, healthier employees equal a smaller price tag on employer health insurance—not to mention a more productive team. But, more traditional employers may need a little convincing. That’s why it’s important that you’re prepared to back up your pitch with cold, hard ROI data. During her talk at last year’s PPS conference, Dr. Heidi Ojha, PT, DOPT, spoke about her experiences with convincing employers to focus on employee health and wellness. She stressed the importance of providing relevant data to employers to support your argument. Here are some examples:

  • Nearly 40% of deaths in the US can be avoided with preventive care.
  • More than half of American adults have some kind of chronic condition—and many have more than one.
  • Employers are taking on a larger financial burden as a result of increasing insurance premiums. According to estimates from the 2017 Milliman Medical Index, “coverage for a family of 4 will cost nearly $27,000 per year, with employers contributing about 56% and employees paying the other 44%.”

Generate and maintain interest.

Of course, providers will only remain interested as long as your efforts are effective. That’s why it’s crucial to prove the efficacy of your preventive services by sharing your successes and communicating them in an engaging manner. That means avoiding overly technical language and providing real-life examples. One way to do this is to leverage the data you collect through outcomes tracking. Specifically, you can show employers how the overall health of their employees improved after those employees participated in your wellness initiative. This data is also crucial for generating buy-in from additional employers. By tracking outcomes data and building your own case studies, you can effectively communicate the benefits of your services to prospective participants.

Market your efforts with patient health in mind.

It’s also important to come up with a marketing strategy for your direct-to-employer services. For example, if you offer free wellness screenings to employees, it could inspire those individuals to start thinking about their health and seek out additional services—or even encourage them to make positive lifestyle changes on their own. The team at Johnson’s practice found success with marketing their direct-to-employer services in a number of ways, such as:

  • hosting free “Workers Compensation Symposiums” at different clinic locations,
  • participating in employee health fairs, and
  • offering free early intervention screenings to injured workers.

Johnson found that direct-to-employer services have significantly impacted the workforce in her region, which is largely comprised of workers in the coal mining and manufacturing industries. And that impact extends beyond merely preventing injury and getting injured employees back to work more quickly. In Johnson’s words, “As a result of the changing local employer landscape, [WorkWell] programs now significantly impact our efforts to successfully manage the unique concerns of aging workers and to assist employers in safely transitioning displaced employees into alternative work.”


If we want to create real change in American health care, we have to start considering the health of the whole population—not just individuals. After all, lasting widespread change doesn’t happen at the individual level. Have you enacted population health initiatives in your area? Share your experiences with us in the comment section below.

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