Another look at payment, let me go on…

My last post on how our approach to increasing payment may be completely broken or, maybe, just about to work out caught quite a bit of attention. I’d like to take this opportunity to expand on a few thoughts that didn’t make the first cut.

Contrary to popular belief, I believe PT pay has increased greatly in recent years. Here’s my evidence:
-I work in the mountains of Colorado, one of the lowest paying regions of the entire country (Forbes lists it as the 10th least paying state for PTs). I make about 60% more than I did when I graduated in the Boston area 14 years ago – or about a 4% raise per year. Average wage increase over that same time frame has been about 3%

-I personally know of at least one former class mate working as a staff hospital PT in one of the top 10 states making numbers approaching double my pay – he makes about 300% of what we made when we graduated in 2006.

-I hear routinely of PTs make $80, $100, or more per hour under different models. Certainly not myself, and certainly not most staff PTs.

It is a fact our reimbursements are going down – a 9% cut is currently approved by CMS for 2021. But, in my experience, our pay is, in fact, going up. So what gives? In my mind, this confirms that PT insurance payment is only tangentially responsible for actual PT pay.

It is my assertion that in much of health care, practitioner pay is so far departed from practitioner billing that the two are not related – at least not like we think they are. In many facilities, there is a large budget that has nothing to do with the performance of individual pieces of that budget. If the whole budget works, it works – we must get a larger piece of that very sloppily-arranged budget.

Is it possible that our salaries and pay drive insurance rate and not the other way around? That as a PT costs more to hire and furnish, that an insurer must pay our employers more for our services? Is it possible that we have the whole cause and effect relationship backwards!?

Perhaps WE need to determine our value and insurances will follow. I do not know if this is the case, but it needs a good hard consideration by those that are experts in the value of PT Services.

What I’m getting at in this piece is that even though we have done a poor job at affecting insurance payment, actual PT pay is on the rise. Our sell to insurers is losing, but other techniques are somehow paying off somewhere else in the system. We need to identify what has been the successful factor(s) in raising our pay.

Healthcare payment is extraordinarily complicated. Anyone who claims to fully understand all the factors is a fool. I think I understand some pieces. I have some ideas about other parts. But, I know this for certain: If you complain about PT pay and have not yet reached out to your Congressional Representatives about next year’s 9% cut, you are a part of the problem. We have power in our numbers and everyone with a dog in this fight must be fighting their employers, their insurers, and their Congress for a bigger piece of the pie.

Thanks for your additional time.

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