Let me tell you about the corporate underbelly of healthcare. I feel like someone who escaped the system and is now free and liberated.
One of my favorite films is The Matrix, starring Keanu Reeves. After watching it a couple hundred times, I finally understood the premise: humans are trapped in a fake reality, working for a system that doesn’t favor us but favors the machine. But there are a few freedom fighters looking to break out and do things the right way.
The system I’m referring to is the insurance-driven physical therapy clinic. Why do you think healthcare is such a polarizing topic in today’s world? Because it’s littered with problems.
Problem #1: Insurance Benefits Are Not Easy To Understand.
Plain and simple, we don’t understand our benefits. Insurances can provide you with an “explanation-of-benefits”, but how many of you are still confused after reading that? Coinsurances, deductibles, co-pays, in-networks, out-of-networks…. I’m in healthcare and I still find it confusing. A majority of you come to physical therapy because your doctor told you to. They didn’t really explain what PT does or what we cost. Hell, your health insurance barely explains it either.
Example: David has a commercial healthcare insurance plan through his job. He was told that he gets 30 visits of physical therapy a year. David goes to PT for knee pain, and after 4 weeks, he receives a bill of $1,400. David is perplexed. Turns out he was still responsible for a copay of $75 a visit, PLUS 20% cost-sharing (co-insurance) because of his high deductible insurance plan.
Problem #2: Insurance Companies Serve Their Own Self-interests, Not You.
So I found out that Aetna releases their quarterly earnings each year. Check out the 2018 statement:
I love how transparent they are with their earnings, almost like they’re bragging. $3.4 billion. And that’s only in 9 months!! Commercial insurance payers don’t make billions each year by spending. They make it by saving.
Think about it… What’s their goal? To give YOU the best possible chance at making a full recovery? Or to trim and bleed healthcare costs so they can turn a profit?
Commercial payers realized that they can save a bunch more money if they limited what PTs can do for their patients. They tell their PTs, “Only work on functional stuff at home… standing, walking, stairs, and getting off the toilet. Anything other than that, we won’t reimburse you.” Basically, do just the bare-minimum. It’s complete crap. Someone behind a computer desk in Idaho is deciding what your goals are and what you should be working on.
Example: David begrudgingly pays the bill. He sees that PT has been helping, but it hasn’t fully fixed his issues. David tells his physical therapist his goal is to return to trail running. His therapist informs David that she cannot work on that because his insurance won’t pay for it. She asks if they can work on stairs instead. David says he doesn’t have any issues with stairs anymore. David grows frustrated. He’s worried he’ll never run again.
Problem #3: We Are Paying For More, But Receiving Less!!
Here is some simple math:
Example: Here’s David again. Except this time, he comes to see me. He says his insurance plan is highway robbery. He said he would be less frustrated with the bills if the PT was actually working. I told him that he can’t expect to succeed in THAT system. It’s not designed to favor the patient. David won’t get the best results possible if he’s sharing his PT appointment with another patient, the therapist’s attention is split between two people, and if the therapist can’t even work on his goals of running.
So I work with David. One-on-one visits, no pressure from insurance companies telling us what to do, and no handing him off to aides or assistants. We get David back to running the Dipsea Trail in 2 weeks. David saved time AND money in the long run. David is happy.
This blog post grew longer than anticipated… I can gripe about this topic for hours. Thank you for taking the time to read it, and I’ll leave you with this:
Insurance companies and insurance-based clinics will fail you, because they are set up to fail you. Being a PT of this system for 3 years, I grew more and more frustrated that I wasn’t allowed to work on the things my patients wanted most. So I basically “unplugged myself from the Matrix”, and decided to create a system that favors YOU.
Bottom Line: If you are curious why you are spending all this money and you aren’t getting the results you’d hoped for, don’t put the blame on yourself. You’re still plugged into a system that isn’t designed for your success. Find the system that is.
Jet Physiotherapy is a cash-based practice aimed at achieving the patient’s goals, not what the insurance companies want. We are 100% satisfaction guaranteed. We are transparent with our costs. No hidden fees, coinsurances, or deductibles. Buy your 6 visits, the price doesn’t change. You won’t be slapped with any unexpected bills or fees. Best of all, will have the freedom to work on YOUR goals, in a system that is set up for YOUR success.