Private Practice Owners Club

Most private practice owners assume insurance companies won't negotiate. But what if you could increase your reimbursement rates with the right strategy, the right argument, and the right person?

In this episode of the Private Practice Owners Club, Nathan Shields sits down with David O'Hara of Brace Health to break down how private practice owners can negotiate better payer rates and stop leaving money on the table.

David shares what they've learned from hundreds of payer negotiations, including what payers actually care about, how to build leverage, how AI can identify opportunities, and why finding the right person inside an insurance company can make all the difference.

In this episode, you'll learn:

• Why some practices are successfully getting 5–10%+ rate increases
• How an additional $5 per visit can translate into significant annual revenue
• Why the highest-paying payers may actually be more willing to negotiate
• What insurance companies actually care about when negotiating rates
• Why network adequacy can give practices leverage
• How to use local market data to strengthen your negotiation
• How AI can identify geographic and specialty-specific opportunities
• Why simply telling payers that your costs have increased may not be enough
• Why you should focus your negotiation on specific rate increases
• How to determine what to ask for in a payer negotiation
• Why asking for a larger increase can sometimes be more effective
• How to find the right network or contracting manager
• Why some negotiations require persistent follow-up
• What happened after one practice sent 11 follow-up emails
• How building relationships with payer representatives can improve negotiations
• How successful negotiations can create immediate improvements to your bottom line
• Why negotiating reimbursement rates can also be a form of advocacy for the PT industry
• What practice owners should know before starting the negotiation process

Payer negotiations don't have to be complicated or adversarial. With the right strategy, preparation, and persistence, practice owners can create more leverage and potentially improve reimbursement.

If you're a private practice owner who wants to stop accepting low reimbursement rates and learn how to approach payer negotiations strategically, this episode is for you.

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

A profitable practice doesn’t automatically become a great place to work; great culture has to be intentionally built, protected, and reinforced by leadership.

In this episode of the Private Practice Owners Club, Adam and Nathan dive into what it really takes to create a practice culture that people actually want to be part of and one that helps attract, develop, and retain great talent.

They talk about the difficult side of leadership: bringing energy every day, protecting your values, holding people accountable, having uncomfortable conversations, and making hard decisions when someone is no longer aligned with the culture.

In this episode, you'll learn:

• Why owners can end up hating the practice they created
• How a leader’s energy influences the culture of an organization
• Why purpose and values need to be more than words on a wall
• Why protecting your culture sometimes requires difficult decisions
• Why highly productive employees may still be a poor cultural fit
• How accountability conversations can strengthen your team
• Why ignoring problems can slowly erode your culture
• How uncomfortable conversations can create stronger teams
• How to create an environment where people can truly be themselves
• How culture can become part of your recruiting strategy
• Why compensation and financial growth still matter to employee experience
• How career development can give employees reasons to stay
• Practical ways to operationalize culture through meetings, recognition, activities, and team events
• How to establish clear expectations around gossip, rumors, and workplace drama
• Why protecting the standard is part of the leader’s job

Culture isn't built through one meeting or one company event. It's built through the daily behaviors, decisions, standards, and conversations that leaders consistently reinforce.

If you're a private practice owner trying to build a business that attracts great people, retains talent, and gives you a team you can actually trust—this conversation is for you.

Join us at the High-Performance Practice Conference to learn proven systems for growing a stronger private practice.

If you enjoyed this episode, subscribe, leave a review, and share it with another private practice owner.

Explore more resources from the Private Practice Owners Club:

https://linktr.ee/ppoclub

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Variable Compensation Models: A Better Way to Recruit, Retain & Motivate Therapists

How do you compensate therapists in a way that supports productivity, retention, recruitment, autonomy, and practice profitability?

In this episode of the Private Practice Owners Club, Nathan Shields sits down with Jason Wanold, VP of Prompt Compensation and former co-founder of Onus One, to revisit variable compensation models and discuss what Jason has learned from years of helping practices implement them.

They break down how variable compensation works, why it shouldn't be treated like a bonus or incentive program, and how practices can create compensation structures that give therapists more autonomy and control while still protecting the financial health of the practice.

In this episode, you'll learn:

• What variable compensation actually means
• The difference between base pay and variable pay
• Why variable compensation is different from bonuses and incentives
• Why units-based compensation can work better than visit-based models
• How to frame compensation changes so therapists understand the purpose
• How to protect quality of care while using variable compensation
• The KPIs that can improve under these models
• Why you can't simply “bonus your way” into better behaviors
• How variable compensation can create more autonomy and flexibility for therapists
• The biggest concerns owners have when introducing these models
• The most common concerns therapists have about changing compensation
• How historical data can reduce fear and uncertainty
• Why practices should consider a 6–12 month transition period
• How compensation models can improve recruitment and retention
• Why standardizing compensation plans can create more transparency
• How therapists can create a path to earning more within the same practice
• Why owners should use financial projections and historical data before implementing a model
• The biggest mistakes practices make when rolling out variable compensation

One of the biggest takeaways from this conversation is that compensation doesn't have to be a battle between what the therapist wants and what the practice can afford. With the right structure, data, transparency, and implementation strategy, it can become a true win-win.

The goal isn't simply to pay therapists more. It's to create a compensation model that rewards contribution, gives providers autonomy, supports quality care, and strengthens the practice.

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Staffing Ratios: How to Build a Leaner, More Profitable Practice

Payroll is one of the biggest expenses in a private practice and when staffing gets out of control, profitability can disappear quickly.

In Episode 6 of the High-Performance Practice Series, Nathan Shields and Adam Robin break down how practice owners can properly calibrate their clinical and administrative teams to maximize performance, efficiency, and profit.

Instead of simply hiring another person whenever the team feels overwhelmed, they discuss how to use financial benchmarks, productivity metrics, technology, AI, and virtual assistants to build a more efficient practice.

In this episode, you'll learn:

• Why employee compensation can be your practice's biggest expense
• How to keep total employee compensation within a healthy revenue ratio
• The 2.5–3.5x compensation-to-revenue productivity benchmark
• Why hiring another person isn't always the solution
• How to create and manage an admin staffing budget
• Why every practice needs to be evaluated based on its own financials
• How technology and virtual assistants can reduce administrative costs
• How to simplify and eliminate unnecessary processes
• Why constraints can create innovation
• How AI can improve patient communication and scheduling
• How virtual assistants can support your front desk
• How to determine when your front desk needs additional support
• Why keeping operations lean can improve profitability
• How technology can help practices maintain a cleaner revenue cycle
• Why practice owners need to continuously test, measure, and improve their systems

The goal isn't simply to have fewer employees. It's to build a high-performing team with the right people doing the right work at the right cost.

If you want to build a practice that is more efficient, profitable, and scalable, this episode is for you.

Don't just hire more people. Build better systems.

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Dropping Low-Paying Insurance & Maximizing Revenue

Private practice owners are under more pressure than ever to maximize revenue and protect their profit margins. In this episode, we break down the practical steps owners can take to improve profitability before making major decisions about insurance contracts.

From knowing your numbers to improving front-desk collections, managing billing, optimizing provider billing, and evaluating insurance payers, this conversation gives you a framework for making smarter financial decisions in your practice.

In this episode, you'll learn:

• Why simply breaking even isn't enough for a healthy private practice
• The key financial numbers every practice owner should know
• How to calculate and understand your average reimbursement
• Why cost per visit matters when evaluating payers
• How your front desk can become a major revenue driver
• Why collecting copays, deductibles, and coinsurance matters
• How to better manage your billing and collections team
• Ways to optimize provider billing and revenue per visit
• How to use data and AI tools to improve financial decision-making
• How to evaluate insurance companies using a scorecard
• When it may make sense to negotiate or drop a low-paying payer
• Why practice owners need to stop being afraid of demanding profit

The goal isn't simply to generate more revenue. It's to build a practice that is financially strong enough to support your team, your family, and your long-term goals.

Demand profit from your practice. Know your numbers. Make decisions based on data.

And if you're ready to take your practice to the next level, join us in San Antonio for the upcoming conference.

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

The 4 Marketing Buckets Every Private Practice Owner Needs to Know

When private practice owners think about marketing, the first thing that usually comes to mind is getting more new patients.

But what if more patients aren't actually your biggest constraint?

In this episode of the Private Practice Owners Club Podcast, Nathan Shields and Adam Robin take a deeper look at what marketing really means for a physical therapy practice and why thinking beyond physician referrals and paid ads can completely change the way you grow.

They break down the four marketing buckets every private practice owner should understand: current patients, past patients, physicians, and the broader community.

The conversation goes beyond simply “getting more patients.” They explore how marketing can help you fill a new provider's schedule, launch a new specialty, recruit better team members, build referral relationships, and create consistent lead flow.

You'll also hear why simple, consistent action beats complicated marketing strategies and how tracking the right numbers can turn marketing from something you occasionally remember to do into a repeatable system.

In this episode, you'll learn:

• Why “I need more new patients” isn't always the real problem
• The 4 buckets of marketing every private practice owner should consider
• Why current and past patients are often your cheapest and most reliable marketing channels
• How to use enrollment conversations to generate new opportunities
• How role-playing can help your team become more comfortable asking for referrals
• Why marketing should become an SOP, not a random activity
• How volume and consistency create momentum and lead flow
• How to identify the key influencers in your community
• Why your ideal patient avatar should determine your marketing strategy
• How physicians, chiropractors, trainers, gyms, pastors, and other community leaders can become influencers
• How social media can help you reach your ideal patients directly
• Why knowing who you're trying to help makes marketing dramatically easier
• How to use simple messaging that actually resonates with patients
• Why consistency and calendaring are critical to successful marketing
• How to use video, AI, CRM systems, and social media tools without overcomplicating your strategy
• What to do when hospital systems control a large portion of physician referrals
• Why private practices need to pivot instead of making excuses
• How developing marketing skills can help with recruiting, launching programs, and growing new locations
• Why the owner's ability to learn, adapt, and develop new skills is critical for long-term growth

The biggest takeaway?

Marketing doesn't have to be complicated.

Know who you want to help. Know where they are. Start conversations. Create value. Show up consistently. Track what works—and keep doing it.

Because when the market changes, those who know how to pivot will survive.

Learn more about the Private Practice Owners Club

Build a practice with more profit, freedom, and purpose without relying on one single source of referrals.

Love the show? Subscribe, rate, review, and share the Private Practice Owners Club Podcast!

#PrivatePractice #PhysicalTherapy #PracticeManagement #HealthcareMarketing #PhysicalTherapist #PrivatePracticeOwner #PTBusiness #MedicalMarketing

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

How to Prepare Your Physical Therapy Practice for a Successful Exit

What is happening in the physical therapy M&A market right now, and what does it mean for practice owners thinking about selling?

In this episode of the Private Practice Owners Club, Nathan Shields sits down with Paul Martin of Martin Healthcare Advisors, who has spent 27 years helping physical therapy practice owners navigate mergers, acquisitions, valuations, and exit strategies.

Paul breaks down what is happening in the current M&A market, why buyers are becoming more selective, and why practice owners need to start preparing well before they are ready to sell.

They also discuss what actually increases the value of a practice, how EBITDA affects valuation, why clean financials matter, the importance of leadership teams and documented systems, and why owners should think carefully about culture and deal structure before accepting an offer.

In this episode, you'll learn:

• What the current physical therapy M&A market looks like
• Why there may be more sellers than buyers over the next few years
• How EBITDA and valuation multiples affect your potential sale price
• Why owners should know the value of their business today
• How charge capture, schedule management, and provider productivity can increase value
• Why clean and credible financials matter to acquirers
• How leadership teams can make a practice more attractive to buyers
• Why owner-dependent practices can be harder to sell
• How documented systems reduce dependence on individual employees
• How long owners may be expected to stay after a transaction
• Why culture fit should come before structure and price
• Why structure can matter more than the headline sale price
• How multiple offers can give sellers more leverage
• The two questions every owner should answer before preparing for an exit

The biggest takeaway: you don't want to wait until you're ready to sell before you start building a valuable business.

Know where you are today. Know what you want from a transaction. Then build the roadmap that gets you there.

Connect with Paul Martin

Learn more about Martin Healthcare Advisors and their work with physical therapy practice owners at martinhealthcareadvisors.com.

Paul also hosts The Next Level Owner podcast for physical therapy business owners.

Connect with the Private Practice Owners Club

Learn more about the Private Practice Owners Club and explore additional resources for growing and improving your practice.

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Building a productive clinic isn't about pushing your providers to work harder, it's about creating the systems, expectations, and culture that allow great teams to thrive.

In this Facebook Live, Nathan Shields and Adam Robin discuss one of the biggest challenges facing private practice owners: improving provider productivity while maintaining healthy team communication. They explain why clear metrics alone aren't enough, and how leadership, accountability, and hiring the right people are what truly drive long-term performance.

Whether you're struggling with team buy-in, accountability conversations, or simply don't know which metrics matter most, this discussion offers practical leadership insights that every clinic owner can apply.

In this session, you'll learn:

• The essential metrics every practice owner should know
• How to set realistic productivity expectations for providers
• Why systems must come before accountability
• The relationship between culture and clinic performance
• How to identify when you have the wrong people on your team
• Tips for leading difficult accountability conversations
• Why production is the foundation of team morale
• Books and leadership resources that improved their management skills
• What aligned teams naturally outperform misaligned organizations

If you're serious about building a high-performing practice with a strong team culture, this conversation is packed with actionable leadership lessons.

Join us at the High-Performance Practice Conference

Learn proven systems for improving leadership, profitability, productivity, and practice growth.

Explore more Private Practice Owners Club resources:

https://linktr.ee/ppoclub

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Most private practice owners know they need a good billing department but very few know how to actually manage one.

In this episode of the Private Practice Owners Club, Nathan Shields and Adam Robin break down one of the biggest hidden profit leaks in private practice: poor billing oversight. Whether your billing is handled in-house or outsourced, simply trusting your biller isn't enough. As an owner, you need to understand the numbers, ask better questions, and establish accountability.

Nathan and Adam share hard-earned lessons from years of losing—and eventually recovering—hundreds of thousands of dollars by learning how to manage the revenue cycle more effectively.

In this episode, you'll learn:

• Why billing is one of the biggest hidden profit leaks in private practice
• The costly mistake of relying solely on your billing company
• The essential reports every owner should review every month
• How to run productive billing accountability meetings
• The KPIs that actually matter collections, denial rates, and AR aging
• Benchmarks every billing department should be hitting
• Why denial rates are the leading indicator of billing performance
• How front desk processes directly impact your revenue cycle
• What separates average billers from truly exceptional ones
• How to build stronger communication between your front desk and billing team
• The leadership mindset required to take ownership of your clinic's financial health

If you've ever wondered whether your billing department is leaving money on the table, this episode provides a practical framework to take back control of your revenue cycle and protect your clinic's profitability.

Join us at the High-Performance Practice Conference and learn proven systems to build a more profitable, efficient private practice.

Love the show? Subscribe, leave a review, and share this episode with another private practice owner.

Explore more resources from the Private Practice Owners Club:

https://linktr.ee/ppoclub

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/

Do bonus programs actually improve performance, or do they simply reward behaviors your team should already be doing?

In this episode of the Private Practice Owners Club, Nathan Shields and Adam Robin explore how private practice owners can design bonus and incentive programs that drive productivity without hurting profitability.

They discuss why culture must come before compensation, how to determine the right baseline metrics, and why simple incentive structures often outperform complicated formulas. They also share real-world examples of provider bonuses, front desk incentives, alternative compensation models, and profit-sharing strategies.

In this episode, you'll learn:

• Why strong culture matters more than bonus programs
• The difference between intrinsic and extrinsic motivation
• The financial metrics you must know before offering incentives
• How to build simple provider bonus structures
• Why bonuses should reward performance beyond baseline expectations
• Creative team-based incentives that don't always involve cash
• Alternative compensation models that increase earning potential
• Front desk bonus ideas that improve productivity
• Common mistakes practice owners make with incentive programs
• How higher revenue per visit creates better compensation opportunities for your team

Whether you're building your first incentive program or improving an existing compensation model, this episode provides practical ideas to motivate your team while protecting your clinic's profitability.

Join us at the High-Performance Practice Conference to learn proven strategies for building a more profitable, high-performing private practice.

If you enjoyed this episode, subscribe, leave a review, and share it with another private practice owner.

Explore more resources from the Private Practice Owners Club:

https://linktr.ee/ppoclub

Want to talk about how we can help you with your PT business, or have a question you want to ask? Book a call with Nathan - https://calendly.com/ptoclub/discoverycall

Love the show? Subscribe, rate, review, and share! https://ptoclub.com/