In this timely episode of What's Best For The Patient Is Best For Business, host Jerry Durham is joined by two powerhouse voices in healthcare: Angela Diaz, PT, VP of Market Development at TailorCare, and Dana Strauss, PT, DPT, a physical therapist turned health policy strategist.
Recorded in the wake of CMS's monumental 2025 Physician Fee Schedule proposed rule, this conversation is a masterclass in translating complex policy into actionable business strategy. Jerry, Angela, and Dana dissect the new regulations and mandatory models, moving beyond the headlines of reimbursement cuts to uncover the significant opportunities hidden within for forward-thinking physical therapy practices.
They break down the new ambulatory specialty model for low back pain, the WISER model aimed at reducing wasteful spending, and the TEAM model holding hospitals accountable for 30-day post-discharge care. The discussion provides a clear roadmap for PTs to pivot from being siloed service providers to becoming indispensable, collaborative partners in a value-based care system.
Key Takeaways:
• Why the conversion factor is only a small piece of the reimbursement puzzle and how PTs/OTs were inadvertently grouped with specialists, leading to a potential negative impact.
• How to leverage data to demonstrate your value to physicians and health systems participating in new mandatory models (like the ambulatory specialty model for low back pain), making you a sought-after partner instead of an ancillary service.
• The critical difference between capitation and true value-based care, and why attaching your payment to quality outcomes is the only sustainable path forward.
• A practical strategy for engaging referring physicians by focusing on their pain points and asking, "What can I do to help you be successful in this new model?"
• Why the future of PT isn't about doing less but about providing the right care at the right time—including phone calls, remote monitoring, and self-care guidance—to improve outcomes and reduce the total cost of care for a population.
Tune in for an empowering conversation that will change your perspective from one of uncertainty to one of opportunity, proving that by focusing on collaboration and patient outcomes, you can future-proof your practice and thrive in the new landscape of healthcare.