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Fee-for-service PT reimbursement isn't viable. It's just math. In this episode, we bring our second physician guest to the Future Proof PT studio to explain. For Episode 22, we are joined by sports medicine surgeon and Protera Health co-founder Dr. Eric Makhni, MD, MBA, who also explains what physical therapists can do about our "math problem."
We explore the economics of MSK care, who actually bears financial risk in healthcare, why your clinical reasoning matters more than your manual therapy skills, and how digital health (when done right) can extend your reach without replacing your value. Eric shares stories from 20 years studying and practicing value-based care in orthopedics, including how patient-reported outcome measures changed a surgical decision in real-time and why the 2020 telehealth pivot separated true clinical experts from customer service providers.
We hope this conversation challenges how you think about your career, your compensation, and your profession's future.
Key Topics:
- PTs' effectiveness in treating MSK conditions
- The "Healthcare Factory" metaphor for fee-for-service physical therapy
- Using patient-reported outcome measures (PROMs) as a clinical GPS tool for shared decision-making, not just compliance
- The 2020 telehealth pivot that separated clinical experts from customer service providers in digital health
- The difference between tech companies and true clinical integration in digital MSK care platforms
- The shift from "hands to brains" - why clinical reasoning and movement expertise is more valuable than manual techniques
- Understanding who bears financial risk in healthcare and why PTs should align with and target employers directly
- How to pitch directly to employers instead of chasing insurance panels
- Patient case study as an example of a functional use of PROMs: How patient-reported outcomes changed a surgical decision and prevented an unnecessary procedure
More about our guest, Dr. Eric Mahkni, MD, MBA:
Dr. Eric Makhni is a sports medicine orthopedic surgeon and Associate Professor at Henry Ford Health, with nearly 20 years experience in value-based orthopedic care. He has taken that experience and co-founded Protera Health, which helps health plans improve quality and costs of MSK care for their populations.
He is also the team physician for the Detroit Lions.
We asked him what PTs, and other healthcare professionals need to hear. Here's what he shared:
"Lot of organizations doing MSK VBC that are welcoming PT's with open arms. Really great opportunity to shift gears from the clinic grind to thinking - and practicing - more holistically!"
Here's why he thinks this episode is important to tune into:
"Digital MSK is one of the hottest spaces for health tech. With so many players in the space, it's important to learn how to untangle the web and see how each solution fits in the spectrum of delivery options."
Here's a "hot take" from Dr. Makhni:
"Health plan leaders have very little to lose by trying out new innovation solutions, provided these solutions use high quality clinical delivery models and pass the "sniff test." There is much more to gain by trying to improve quality of care as opposed to being scared that it might not work out."
Resources:
Protera Health - proterahealth.com
Henry Ford Health - henryford.com
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Here's the YouTube version of Episode 22
