Dropping an insurance contract can be a difficult decision for a PT owner, as it may feel like they’re going against their purpose and commitment to the community. However, maintaining those contracts can be financially untenable and negatively influence our profit, limiting the ability to expand, progress, or better compensate your team members. In this episode, Trace Kennemore shares his experience of dropping a nationally recognized insurance carrier, how he dealt with the concerns above, and the difficulties that ensued. He added that PTs should know what their contracts are and identify the effects they would cause before they decide to drop them. If you want to increase your profit, what are you waiting for? Tune in and gather more insights from Trace’s experience!
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Drop Your Lowest Paying Insurances With Trace Kennemore, DPT
In this episode, I’ve got a coaching client and good friend, Trace Kennemore, Owner and Founder of Southern Rehab PT outside of Chattanooga, Tennessee, who’s coming to share his experience of dropping a low insurance payer. First of all, Trace, thanks for joining me. I appreciate it.
I appreciate the opportunity to come on and speak about this topic. It’s a big topic and something that’s very viable for everyone’s ability to continue in outpatient physical therapy.
If you look at any of the surveys, WebPT does their surveys, and I’m sure there are other surveys that are out there on an annual basis. One of the general concerns is declining reimbursements. It’s not getting worse, especially with the current issue regarding inflation in the country. Here we are in early 2023, it’s getting into the 8s, 9s, and even double digits in inflation.
The added expense puts pressure on the PT owner to squeeze out a smaller and smaller profit margin when we continue with these contracted rates that are so low. I’m excited to bring you on because you’ve gone through this before. If there was one thing that I would love to share with the PT owner world out there, it is how to get rid of these low-payer contracts.
It has been a journey. I hope that’s what we will bring out to some others and will resonate with some people. Quite frankly, it may resonate most with small mom-and-pop shops such as mine. A lot of times when you have 1 foot in patient care and 1 foot on the administrative side, that’s the reality that a lot of us are dealing with that are in the private practice world.
Before we get into it, we’re going to share your experience in dropping a low-payer here in a second. Share with everybody a little bit about you and where you’re coming from.
This is a second career for me. I was originally a high school teacher and coach. I had a short stand in the military. I couldn’t decide what I wanted to do when I grew up, so I started investigating other avenues. Fortunately, in the military, I was exposed to the medical side of things. I landed in PT, and it’s been a blessing. I started out working for someone else and did that for six years to learn the ropes.
I dove into the administrative side because as everyone knows, as a PT, we learn absolutely zero about being a business person in PT school, and what most of us strive to do on a business. It doesn’t make a whole lot of sense. After working for someone for a while, I was encouraged by a local orthopedic physician to open my own practice.
My practice is in a small rural community, as you mentioned, outside of Chattanooga, Tennessee. It happens to be the place where I grew up. It’s been good because the community gave me an opportunity. As I said, I’ve been blessed beyond measure to serve my community. As we’ll talk about in a moment, that’s one of the things that makes it so difficult to drop insurance.
This being your hometown, especially in small towns, you want to serve the community. You want to be all things to all people. As an industry, we as physical therapists are people pleasers, and we want to serve. We have this altruistic nature about ourselves. We’re compassionate. We’re willing to sacrifice ourselves in the name of doing the greater good, but how far do we go? How far are we willing to take it to serve that greater purpose?
At what point are we being a detriment to our community, our employees, and to ourselves where the sacrifice isn’t necessarily appropriate? We’ve been doing some one-on-one coaching for some time. Do you recall a time when I brought up the idea of dropping a low-payer and your initial emotions regarding that?
I do, yes. I had contemplated that as I became more and more business-minded. I’ve had this business for seventeen years, so it’s about time I learned how to run the darn thing efficiently and effectively. I’ve always made excuses not to drop the lowest payer. For example, every time I would contemplate dropping one of my lowest payers, then I would get one of my local high school athletes that I take care of that would have an ACL surgery, and he would have that particular insurance. That was something that hit home.
There’s a pull on the heartstrings there.
Quite frankly, in a rural community, healthcare is not easily accessible. Sometimes, as PTs, we can serve a pretty valid role in taking care of members of our community regardless of their insurance. That was my thought process of, “I need to help anyone and everyone.” To directly answer your question, as we went through some analytics and looked at the future of my practice along with physical therapy in general, I started to realize that, “Maybe I’m taking good care of the community by taking care of everyone, but am I taking good care of my coworkers that I love and care about so much?”
We went through the pandemic together, and I told them initially that was a litmus test to see how much the company cared about them, as well as how much they cared about the company. They demonstrated to me that they care about the company that they work for. I got to thinking that one of the things that prohibited me from taking better care of them financially, benefits, compensation package, etc. is that I’m not being a good steward of the business.
I had to weigh the options of, “I want to serve my community and everyone in the community, but not at the sacrifice of my coworkers.” The final straw was when I saw that a particular insurance company posted a $24 billion profit that I am subsidizing by seeing their clients for substantially less than it costs me.
We can say that’s UnitedHealthcare. Let’s let the cat out of the bag. When we’re talking, nationally, everyone understands. When you say UnitedHealthcare, everyone’s going to be like, “I know what you’re talking about.”
That was it. It was that realization of looking at the big picture. “Was it fair for me to make the decision for my coworkers that I’m going to not be able to progress them in terms of financial compensation, etc.?”
If I’m not mistaken, probably for well over a year, you guys have been running red-hot. When I say that, you guys are full, your utilization numbers are great, you’re adding team members, the schedule is full, you guys are packed, and they’re running around fully scheduled. Did it come to mind that maybe maintaining this lowest payer was a detriment to the care that they were providing as well as losing money?
Yes, sir. It was a combination of two factors. It was potentially a detriment because I was asking them to, in good Southern terms, push the wagon uphill every day. Also, like many small rural areas, I have staffing issues to compete with the hospitals and the reimbursement plan which is difficult to do. I found myself putting more and more on my staff.
Not only was I concerned about the quality of care, but I was also concerned about the burnout of my staff because we pride ourselves in our culture. I’ve established what I call a system of reciprocity from a business perspective between myself and my coworkers. It’s give and take on both parts, not just take on the business side. I felt like that’s what I was getting to, which is being unfair to them.
It’s asking them to see many patients because you took all comers. “We’re going to take them all, and you’re going to see them all.” Was there ever any kickback from the team in any regard, verbal or non-verbal that, “Maybe you’re pushing us too hard,” or, “I’m not providing the quality care that I want to provide?”
Initially non-verbal, but I still have a small caseload. I’m out in the gym with boots on the ground, and that’s my way of gauging the climate like gauging the culture. I could tell that there were some frustrations from time to time, so I started having some direct one-on-one conversations. I have almost zero turnovers from a staff perspective on the treatment side. I’ve got staff that’s been with me since 2008, 2010, and 2012.
We’ve established mutual respect with an open relationship. I was asking them their very thoughts on this. There was some definite frustration, yet they didn’t want to let the company down or the clients we’re serving, so they were digging deeper and working harder. How long can I ask them to do that? That was a huge factor. That was the tipping point.
That was going to be my next question. When I talk to owners about dropping in insurance, there are a few concerns that come through their minds. I want to ask you what your tipping point was, but what are some of the other concerns that you had? You wanted to be a servant to the community, and you had these patients that you wanted to serve. You wanted to be all things to all people. Were there any other concerns that you had going through your mind?
Those are the primary ones. You have to weigh the business side that we alluded to of making sure that you can post a reasonable profit so that you can give to your coworkers, etc. You also have to balance that with the PTs, the natural altruistic nature of wanting to be everything to everyone.You have to weigh the business side of ensuring that you can post a reasonable profit to give to your coworkers, etc. You also have to balance that with the PT's natural altruistic nature of wanting to be everything to everyone. Click To Tweet
Dropping the lowest payer and maybe filling those spots with a higher payer, having people come in 2 and 3 times a week instead of maybe 1 or 2 times a week, financially is a no-brainer. It’s obvious that if you have open spots and people aren’t able to reschedule and get in, you should be doing this all day long. The other concern that comes up as I’m talking to owners, and you went through this as well because you have an orthopedic group nearby you, is how is that going to affect your reputation. How are you going to be seen by your referral sources? Did you have some of that concern as well?
I did a little bit, but I’ll be honest with you about that. Since I’m in my community, and I’ve established a good work-family around me that’s just super skilled, and they make me look darn good. We have a good reputation in the community. I was less concerned about that because most of our clients come to us, not through the physician. This is a point I’d like to make. If you’re earlier in your career, you’re not fortunate enough to be serving the community where you grew up, then that’s a real issue.
Those relationships got to be strong.
That’s a huge factor in that sense of, “Do I do this or do I not do this?” Early on, I had the same sense of number one, when I started the business, when you start out, you take a loan that’s much more than you ever thought you would borrow, and then you contemplate whether or not you’re going to have to give up at least one kidney to make things work in those early days. You have that realization that you have to take everyone and keep all doctors happy, of, “My business is going to collapse if this one particular doc decides that it’s too much trouble to figure out which insurances they take at Southern Rehab versus the other ones in this own.”
From my experience talking to other owners, that’s a pretty common one. You’ve been around long enough in your community that you could have those conversations with the doctors, and they’d understand, I’m sure. I don’t want to speak for you, but you’re going to provide opportunities for those people who come in who are out of network to still potentially see you, so you’re not going cold turkey. You also have a relationship with the referral sources to work that out.
Overall, in this climate, most doctors out there in the nation understand that when you’re dropping in insurance because many of their groups have. They’re not necessarily all things to all comers either. They’re not taking all the payers, so they can understand when there are financial things in play. You had this idea that, “Financially, this would be better for me.” Also, you’ve discussed it with your teams. What was the eventual tipping point? What psychologically turned you and made you committed, “I’m going to do this?”
It goes back again to some conversations that we had. It’s advantageous to talk through these things with a coach or peer-to-peer group. That was my other conversation after you and I would discuss these things to go through and work through that psychologically because it’s not just objective. That’s the point that some people miss when they think, “Why doesn’t everyone drop this?” There is a business objective side to it, but there’s a psychological component.
It’s similar to retiring. You may have a number and will be financially set, but you better be emotionally set. This is akin to that. You have to be willing to turn that young kid away that’s had an ACL surgery, that’s a high school kid on the football team that you stand on the sidelines with on Friday nights. That’s tough. The other side of it is that to give up this insurance, I’m not giving up my altruistic nature in taking care of my community.You may have a number and will be financially set. But you better be emotionally set. Click To Tweet
It’s like you mentioned a moment ago. I’m going to take better care of the patient population that I’ll have because we were in that cycle that if someone cancels, there was not a chance of getting them back in on the schedule in a timely manner. I’m still going to do some pro bono stuff. I’ll still be on the football field on Friday nights and doing courtesy assessments of the injured athletes. The community members offer free courtesy visits that I’m taking up quite frequently. You do not have to give up your altruistic nature and your compassion.
I’m glad you pointed that out. You said, “I’m going to drop UnitedHealthcare. Here I go.” You then sent in the letter, and 90 days later, it was all done.
It was so easy. I increased the stock of bourbon initially and decreased it quite substantially over this process. This is one of those processes that would make a preacher curse. What happened was, first of all, since I started my practice back in 2005, I couldn’t even find a copy of my original contract. I thought, “I’m wanting to drop UnitedHealthcare. How did I go about this?” I thought the smart thing to do was to go on the UHC provider portal and get the appropriate contact.
Maybe there’s a, “Fax it to this number or email it to this address, etc.” I’ll receive a confirmation, and they’ve received my notice. I’ve got 90 days. I’ll script my plan for what I’m going to tell patients and doctors. It’s smooth sailing. That could not be further from the truth. I’ll shorten this, and I’ll keep the foul language out of it. When I was contacting UHC directly online, I had to make two phone calls to people.
I found some numbers trying to get some, through an investigative approach, “Where do I start?” I was given two different email addresses like, “No problem. Email it to this address and this address. This will take care of UHC. This will take care of Optum.” I crafted what I thought was a professional letter to let them know of my change of network status in 90 days with the appropriate effective date and things like that. I sent those and received almost immediate auto responses saying, “This is not the right place to send these.”
I’m a member of PTPN. It’s Physical Therapy Providers Network national organization. My next step was I reached out to PTPN to someone in the leadership role and said, “Please help me. How do I get out of UHC?” It was like, “No problem. Send your resignation to this email.” This is email address number three. Not long after that, I was excited because I thought, “This is it.” I even sent you an email saying, “I finally bit the bullet. I’m on my way. I’m starting to script what I’m going to tell everyone.” A week later, I received this email, and I’m going to read this for a second.
The email says, “Thank you for contacting the UnitedHealthcare network management resource team. We are not the correct contact to answer your questions.” To make a long story short, there were at least three other email addresses given to me, and none were correct. These are either emails or verbal conversations or me responding and saying, “You’ve given me the wrong one. Where do I go next?” I started this process in August.
In October, I finally spoke to a human. I spoke to the vice president of provider relations and thought, “I have hit the jackpot.” What I asked her was, “Do I at least have a provider rep, someone that I can speak to to help me through this process, or can you tell me where to send it?” She was not sure. She would investigate it. I sent her all my information about whom I’d contacted so far, and we got absolutely nowhere. She finally had someone contact me from Optum.
She is the contract manager of network development Optum. We’re over six weeks into this thing. I’m now getting to the person that I thought was the one. She investigated it for me and said, “I can’t find anything in our systems that indicate that you have turned in a letter of resignation of going to out-of-network status.” I asked her, “Where do I go from here? What’s next?” She said, “Do you want to renegotiate?”
I thought, “I’m six weeks into it. I’m still taking some UHC patients because I had post-op patients reach out to me. I have not clearly delineated my exit strategy with my patients, so what the heck?” She sent me original copies of all my contracts. I reviewed them and told them which ones I was interested in attempting to get increased reimbursement for. She submitted that. Here I am on pause again with about six weeks to go.
Don’t skip this step because, at this point, you have finally recognized it. This is something that for people who are reading, maybe that’s the verbiage you need to use as you’re communicating with Optum/UHC. Find a contract manager. Maybe if you knew that vocabulary, to begin with, maybe you would’ve gotten there faster. For others, you could learn from this. Look for the contract manager over provider relations. You said you found contracts, so there wasn’t just one. This might be particular to your region, but it might be nationwide also. Tell the readers why there are multiple contracts with UnitedHealthcare.
To speak to your point about the contract manager, first of all, it is by the state. For instance, the one that I spoke to covers nine states in the Southeast. You will have to find your region contract manager through Optum, by the way, not UnitedHealthcare. I received different contracts. I was thinking, “I want to drop UnitedHealthcare,” but it turns out that UnitedHealthcare has a couple of buckets of insurance.
One would be UnitedHealthcare Medicaid, and then you would have UnitedHealthcare Commercial and then UnitedHealthcare Medicare, but here’s the caveat. With my conversations with the contract manager, if I drop the UnitedHealthcare Commercial and Medicare, I may also have to drop the Optum VA contract as well. That threw up a red flag to me because that was another intrinsic struggle through the umbrella.
UnitedHealth Group is the owner, and the subsidiaries under that are Optum and UnitedHealthcare in my understanding, but Optum handles all the contract negotiations for Optum and UnitedHealthcare. There’s where they get intertwined. If I dropped certain UnitedHealthcare contracts, it was going to kick me out of certain Optum contracts that I did not want to get out of. The primary one, as I indicated, was the VA because that was near and dear to my heart to make sure that if reasonably financially responsible and had the ability to do so, then I wanted to stay in the VA contracts.
It turned out that it’s a bit of a pick and choose, and you have to be careful. To make a long story short, I could drop UnitedHealthcare Medicaid and still stay in the commercial and the Medicare as well as the Optum contracts of VA and the worker’s comp. If I dropped UnitedHealthcare Commercial and Medicare, it was going to kick me out of the Optum contracts.
You ultimately dropped the Medicaid contract. Is that what I’m understanding?
I did because they renegotiated the Commercial and Medicare contracts. By the way, those are lumped together. You cannot separate those.
You can’t drop one and not the other. You’re going to have to stick with Medicare and the Commercial. You dropped Medicaid because they weren’t willing to negotiate on the reimbursement for Medicaid, and that was a very low percentage of your clientele anyway, from what I remember. You negotiate with the other. Can I ask you the numbers? Is that okay?
Sure. I don’t mind.
What were you able to negotiate with them?
They increased the $15 per visit for both of those. It allowed me to stay in it a little while longer while I construct a better plan. Mind you, this is taking place on the 89th day of my 90-day notice. I got the new rates on the 89th day. It was from a phone call from the contract manager because I had reached out to her multiple times by email, phone calls, etc. “What’s going on?” She finally reached out and said, “I finally got the new rates. Here they are.”
It was one of those things of I either had to say no because they still had not received my official notification by the way. I didn’t want to start the whole process over, and it was a win temporarily. I could live with the rate temporarily. If you’re from UnitedHealthcare and you’re reading this, that doesn’t mean I’m going to take this forever.
Congratulations. How long have you been dealing with this flat rate payment with UnitedHealthcare? How long has it been going on?
We’re talking many years, you’re getting the same payment, not adjusted for inflation by the way. A lot of people assume that rate is that rate and it’s non-negotiable. When they hear stories like yours, and I’ve heard others as well, they bump it up. People will say, “You can do that?” I’m assuming. The fact that no one knew where to guide you tells me that not enough physical therapists are pushing this avenue or they’re not asking enough questions and pushing it to the right people. If more therapy owners were out there pushing for negotiated rates, there would be a quick and easy, “We get these calls all the time. Talk to so-and-so the contract manager.” I’m assuming that the contract manager is twiddling her thumbs because the PT owners aren’t reaching out.
You’re probably right. It was quite a confusing process. A takeaway on this whole thing is to start with the contract manager like you indicated earlier for your particular region and dive in and ask those specific questions of, “If I drop one, how does it affect the others?” First of all, request your contract. She’s the one that sent me. I was surprised she sent me 15 contracts, and 5 of them I didn’t even know I was a participating provider, but they were managing them. There were some workman’s comp contracts in there that I was familiar with. It’s about finding out the game is not as simple as saying, “I’m going to drop the Commercial UHC.” You need to know the effects of that and make that decision if you do so.
One thing that I’ve seen owners have a hard time with is requesting contracts. They’ll drag their feet on that and slowly walk those contracts back to you even if they were able to find it because that’s labor on their end to find a contract and get it to you. If we’re being responsible business owners, we should have those contracts on file.
That doesn’t necessarily need to be the owner’s responsibility. If they have some admin support, maybe that could be something that they delegate, but it would be good to have those on file, so you can see exactly what they are covering. I’m assuming you got those fifteen contracts, and you’re thinking, “I didn’t even know I signed up for this.”
The person that handles my billing was well aware of the different contracts, but I was a bit out of the loop, and I’m the decision-maker in these circumstances.
One thing that I didn’t bring up, and I’m embarrassed that we didn’t talk about is simply your numbers. We recognize that UnitedHealthcare patients made up 15% of your patient load.
At one point, UnitedHealthcare made up 14.8% of my visits, yet it accounted for 2.6% of my reimbursement. The disparity there was another thing that I had calculated. When you and I were speaking at one point, that was another shocking statistic that made me think about the effects, not only from a business perspective but to me as an individual and also as I indicated to my coworkers. That’s where you have to start looking at it much more carefully.
That 2% doesn’t account for the headaches that they give you, like the acquisitions and all that stuff. It doesn’t account. They’re one of the worst pairs, but they give you some of the most headaches.
At one point, they let me know I’d switched to a different tier. They have different tiers. The different tiers mean additional administrative burdens. Out of frustration, I called one time and said, “Why am I going to another tier?” The person on the other end of the phone, who should have been able to adequately tell me, this is a UHC worker by the way, could not explain to me why I had shifted to another tier. It was my turn to go to that tier, so they could frustrate me for a year or something.
They spun the roulette wheel in your name popping. I get it. How long has it been now that you’ve been out of network?
October of 2022.
Tell me about your experience since then. Anything you can share?
I haven’t had one issue, to be honest with you. I’m still in the UHC Commercial and Medicare.
Talk about the increased reimbursement rates.
What I did drop was the Medicaid side. The ones that have contacted me, I’ve been steering them in the right direction, giving them some advice. I’ve done a couple of courtesy checks. I communicated back with the doctor to still make sure that number one, “Did they need physical therapy services and communicate with the doctor?”
You have to understand that in a small community, I get a lot of eval and treats from the PCPs. We also have the name and number of someone to send them to from a physical therapy perspective at the front. We don’t just say, “Sorry, good luck to you.” We help them take the next step and get where they need to be and adequately explain to them what’s going on.
That still serves your purpose of wanting to be a part of the community. You’re not going to leave them cold turkey. You’re going to say, “We’re not unfortunately taking that insurance, but here is a provider who will and treat you.” It’s only been a few months. Have you been able to compare those numbers? It was 15% and then 2% of your revenues. Are you far enough along that you’ve seen a difference in that at all?
Honestly, I haven’t gone back and reinvestigated that, but I feel pretty confident that everything’s moving in the right direction. I can tell you one thing I have been able to increase patient visits. I feel like I’m taking better care of the patients that we have. A small decrease, it’s opened up the avenues that you mentioned. My therapist feels better about the care they’re given because we’ve always prided ourselves on that like everybody else. It’s frustrating when you even feel remotely like that might be slipping slightly, and you can’t let that occur.
The results are going to be better if you see them more frequently. It’s better to treat somebody 2 times a week for 4 weeks instead of 1 time a week for 8 weeks.
That’s part of the conversation I had with the staff because I’m very transparent. We talk about decisions. It’s not a dictatorship. I have the final say, but I attempt to get buy-in on most major decisions, and we had the conversation of, “If patients need to be here three times a week, and we see them once or twice every other week because of the inability to get them in a timely manner, we’re not doing them justice.” That’s the bottom line. It’s not fair to that patient.If patients need to be in the clinic three times a week, and we see them once or twice every other week because of the inability to get them in a timely manner, we're not doing them justice. Click To Tweet
Anything more you want to add to the experience that you shared?
I don’t think so, but I would encourage everyone to take a hard look at it. You have to find the time, reach out to someone, coach, and discuss it. Often the other thing about being a rural physical therapist is that you don’t often have that peer network of people that are walking in your shoes. It’s very advantageous to discuss that and walk through the objective numbers as well as the psychological things that you’re dealing with. A takeaway is by dropping in insurance, you’re not giving away your altruistic nature. You can still take pro bono cases and limit the percentage. There are other ways of serving your community better by doing a better service to the patients that you are taking.
For those who have read a couple of episodes ago, I spoke with another owner in Vegas who’s dropped a few low-paying insurances by this point. He was at a negative profit margin, but now he has a profit margin. The ability to take care of his team is dramatically different and the possibilities that he sees before himself in terms of what he can do for his team and expansion.
Will Humphrey coined the term, “Profitability unlocks possibility,” and the possibilities now are there. He’s able to move forward with greater confidence as a business owner and knows his numbers a little bit better. Having gone through that process successfully gives him confidence in maybe being a little bit more investigative into the other contracts that he has that he might want to drop as well.
You said something there that sparked a thought as well. Another reason I had my head in the sand for so long about not dropping UHC, in particular, is that we were still doing fine financially. I justified that there are a million excuses when you’re doing something that you shouldn’t, but it came to the point in time because as you well know with the Medicare cuts, what if we had 10% over the last few years maybe in Medicare alone and everyone else follows suit? You see that profit margin shrinking, and we’re still fine, but I feel like I’m almost plateaued where I can’t do more for my staff. You asked me about a tipping point, so to speak.
Do you have any other insurances that you have a target on by chance?
Absolutely, and I don’t mind saying Cigna. They’re next.
You’ve already got them on your sites.
That’s another one that’s been at the same rate since the beginning of time, and I’ve got to make some decisions about that one as well.
Having gone through the experience with UnitedHealthcare, does that give you a little bit more confidence in approaching Cigna and what to do next?
It’s a game-changer, absolutely. I was like everybody else. You hear that they’re not going to negotiate, and you never know. If you need to negotiate, reach out and see what they tell you. I will tell you, no matter what region of the country you’re in, they’re probably not going to go above $75 a visit. That’s my takeaway from conversations, etc. It doesn’t matter who you are or where you are. That’s probably their limit. That will decrease their profit from $24 billion to $23.5 billion if they go above $75.
As an owner, you’ve got to be clear with yourself, “Am I okay with that, or do I need to stand firm at my number,” and be clear about what your number is and say maybe $75 is your max, “I’m sorry. I can’t do that.” That’s the proper way to negotiate. Know what your number is. If you’re not willing to cut off, then you’re not in a powerful position to negotiate. That’s good to know.
One thing about the negotiation part is that when you submit your official letter to the contract manager that you want to renegotiate, it goes to a board. The board looks at it, and it looks at what tier you’re in, what other providers, the number of visits you have, etc. They then come back to you and look at it relatively and objectively. You never know.
Ask and see if you want to at least go that step first. I don’t want everyone to get complacent and stay in, even if there is still a substantially low paying rate below your cost. Once it gets to the portion of your business, I’d say 14.6% or somewhere in that neighborhood, that’s a pretty substantial amount of your total visits. That was for a year, by the way. That’s a huge portion because initially, it was 2.4% for years and years.
That was the other reason that I didn’t worry about it so much. If you ever investigate UnitedHealth Group, it was a few years ago, they’ve had a massive proliferation in the number of clients they’ve brought in. UnitedHealthcare is gaining more and more of the market share it seems over the last few years. I don’t have my source in front of me or anything, but I ran across some data indicating that the UnitedHealth Group has had a huge proliferation in terms of the number of clients. This is a real issue that we’ve got to continue to look at and address. As we have more and more companies that switch to UnitedHealthcare in particular for their company benefit plans, then we have to take a strong look at this.
Unknowingly, we’re going to be taking more UnitedHealthcare plans simply because they have acquired other insurance companies over time.
Yes, sir. As I mentioned, it’s the fact that originally for years and years, it was less than 3% of my total patient population in a given year, and it’s gone up to almost 15%. The demographics in my area haven’t changed that much. It’s just that the industries have been lured into UnitedHealthcare insurance for their companies.
They’re a significantly greater player as evidenced by their $24 billion profit.
I helped facilitate for them.
I’m sure they appreciate you. Thank you so much for taking your time and being willing to share your experience, Trace. I hope it was valuable to those who are reading because you went through not just the process but also took some effort beforehand to get over that hump to make the commitment. If people wanted to talk to you about your experience or have questions for you, are you willing to share how people get ahold of you?
I’d appreciate the opportunity. If anyone has any questions, there’s never any such thing as a dumb question. If you want to reach out and talk about how to start or anything like that, I’m more than happy to share because what helped me so many times is talking to you as my business coach and to other members of my peer-to-peer group. You can reach me. I’m on LinkedIn. My name is @TraceKennemore. Also, if you want to reach out, shoot me a text at (423) 605-7779. The last best place to reach me would be by email. It’s Trace10@SRAPT.org.
Thanks for sharing. Thanks for taking the time. Hopefully, others in the industry have taken courage off of your experience itself and are looking at some of their peers sideways and looking forward to making a commitment to do better.
I hope so.
Yes, sir. Thank you.
- Southern Rehab PT
- @TraceKennemore – LinkedIn
About Trace Kennemore
Trace obtained his BS in Secondary Education in 1992, followed by his BS in Physical Therapy in 1999, both from the University of TN at Chattanooga. He later received his Doctorate in Physical Therapy Degree in 2013. He enjoys working as a sports therapist with the athletic population, including those returning to sports and post-surgical shoulder and knee patients.
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