Start up practice stats: I need to know what to expect....

Start up practice stats: I need to know what to expect.... (Full Version)

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bhenchodh -> Start up practice stats: I need to know what to expect.... (April 10, 2006 5:14:00 AM)
I started my private practice in July 2004. I want to know how I am performing compared to other private practices when they were nearly 2 years old. Anybody willing to share any information? From 7/04 to 12/04 we only saw 5 visits a week, with nothing in July. From 1/05 - 12/05 we only saw an average of 14 visits a week. I need to know what to expect. How long did it take you to get a relatively full case load?

bhenchodh -> Re: Start up practice stats: I need to know what to expect.... (April 13, 2006 3:33:00 AM)
Nobody wants to share any info regarding how many patients they were seeing in first year compared to second? Please I need your input. If you don't want to publicly state it you can email me at faaompt@gmail.com. Please reply, because where else can I get this comparison info? I don't want to pay some hot shot private firm for business analysis, and frankly I can't afford it.

winegirl -> Re: Start up practice stats: I need to know what to expect.... (April 13, 2006 6:21:00 AM)
My clinic started in April of 2005. We've definitely struggled with patients and are now averaging 10-12 a week in a market which is fairly competitive and in which it is difficult to actually get face time with doctors to explain how our clinic is unique. I don't think what you're seeing is that unusual if you are in a competitive market with long-established clinics.

pt2005 -> Re: Start up practice stats: I need to know what to expect.... (April 13, 2006 12:51:00 PM)
I started june of '04, cant really even count that month. July, probably saw 15-20 per week; was like that for a few weeks/2-3months. january of 05 started seeing 30 40 per week. Now I see from a low of 30-35 up to 55 per week plus an fce on tue/thu. My situation is unique in that my partners are well established therapists so I had almost instant caseload; however I still had to prove myself to the docs. What I have seen is that pt. load ebbs and flows, high tide and low tide. Keep getting your name out and look for innovative ways to market yourself. Check out guerilla marketing by JC levinson. Good ideas for those on a budget. good luck

SJBird55 -> Re: Start up practice stats: I need to know what to expect.... (April 13, 2006 12:56:00 PM)
I began treating patients in June 2005. Small outpatient, predominantly orthopaedic practice. Main competition = hospital outpatient satellite 1/2 mile up the road. I also worked for that hospital at their satellite for 6 years before breaking out on my own. My statistics are not by week, but by month. The definition of my stats: visit = a patient coming in for session and billed for the session. Oh, and I'm also only clinically treating patients 3 eight hour days a week. (This was in my business plan and what I want.) I also am not sure if our small community has enough of a population for 2 outpatient clinics providing 40 hours of PT/week at each facility. 06/05-12/05 New patients: 54 Office visits: 354 01/06 - 04/06 New patients: 26 Office visits: 315 February sucked (it was really, really bad...)... If I toss out February, I've been basically at about 9 patients a day since December. I refuse to participate with some insurance plans, so I technically could have 3-4 extra new patients a month. I wanted to be at my break even by December and I was... now I'm trying to grow the business just a bit. My goal is 14-17 patients a day and I'm almost there. If you check out [URL=http://www.ptmanager.com]www.ptmanager.com[/URL] there is valuable information there. If you are a member of the APTA, I'm sure they would also be able to assist you. The Health Policy and Administration Section and/or the Private Practice Sections would probably have helpful information for you.

Sean Weatherston -> Re: Start up practice stats: I need to know what to expect.... (April 14, 2006 1:17:00 PM)
Ahhh the ebb and flow, feast or famine, whatever you want to call it... I started with a partner at the end of July '05. We both worked at a hospital outpatient clinic 2 blocks away from our current location for several years. August- avg 40 pts. (visits) each per week September avg 50 pts. /wk October- 60 pts./wk Nov- hired another therapist- average since then around 80 pts./wk I guess it took us about 2-3 months to get a reasonably full case load and knocking on wood it stays that way.

SJBird55 -> Re: Start up practice stats: I need to know what to expect.... (April 14, 2006 2:12:00 PM)
If I had the glass crystal ball, hindsight... it would have been wiser for me to have left the hospital and right away opened my own clinic right down the road from them. I was out of the area for a little over a year - I worked for surgeons and that didn't work out and then I worked for another crap company that I wouldn't send my dog to... The hospital owned physician practice ended up closing its doors (which was in the same building as the physical therapy clinic)... the physicians broke off, stayed in the same building and own their own family practice. I would have been tons better off if I would have just bailed and opened my own clinic. I could have taken my patients with me and I wouldn't have had to "spread the word" as hard as I have been. And, the hospital is a big threat for me in the sense that there are physicians right in their building, so patients may choose the hospital site because of that. I am loving the challenge and loving the fact that for every patient I treat that means one less patient being treated at the hospital site. LOL I don't believe that I would ever choose to work for anyone again. LOL I don't have anyone breathing down my neck about productivity, no one enforcing stupid decisions upon me, no one with an attitude that just a hot body is needed to do the job... Sean, you guys are kicking butt... good job! You know though... technically, when it comes to "visits" and number of patients and those kinds of numbers... the most simple reality is that all you need is a patient in every 15 minute slot in your day, combined with the simple fact that you get paid for what you billed out during that time with the patient. What the patient needs to achieve the desired outcomes is what should determine the amount of time allotted them. And you also need to know your payer mix and how the payer pays and the type of contract you have with the payer. You also have to know your preferred way of practicing and compare that to how well it meshes with your payer mix. IF you had a contract that only paid $45/visit and you have a lot of patients with that type of contract and your style of practice is to spend 1 hour with each patient, you'll be screwed because your salary and overhead won't be met. So, technically, Hawk, volume of patients isn't the only thing to look at in the big picture.

drbuddy -> Re: Start up practice stats: I need to know what to expect.... (April 16, 2006 8:30:00 AM)
I have a chiro practice, but the situation is probably very similar to a PT practice (except with no MD referrals!). I opened in May of 2005. For 2005, I saw 110 unique patients for a total of just over 1000 visits. From May to July '05 I avg about 15 visits per week. From Aug to Sept I was at around 25 visits per week. In Nov and half of December I was up around 45 visits per week. The holidays brought a slow down to 20 per week, but then in mid Jan '06 it moved back up to 45 per week and has been there since. I just can't seem to break that 50 mark. I do very little advertising and almost all of my patients are through referrals. I also have a great location, which does help by getting me 3-5 new patients per month. By the way, I work by myself with one assistant. She helps me with front desk duties, paitent set up, and it also the massage therapist. I perform all exams, modalities, exercise supervision, manual therapy, and manipulation myself. If I feel a patient needs more muscle work than I have time to provide, I send them over with the MT. I outsource my billing, which helps lower the stress level tremendously. Like I mentioned, I have had viturally zero MD referrals. If I can crack that nut, it will help me grow a little faster. I've had lunch with many MDs, but no dice thus far.

bhenchodh -> Re: Start up practice stats: I need to know what to expect.... (April 19, 2006 1:16:00 PM)
Hey folks I want to thank you all for your input. It seems like you all are doing way better than I am. I think I have to reevaluate my location choice. My lease is up next year so I have some serious thinking to do. Our projections are really bad. With nocap on Medicare I was doing well last year and projections were looking great. Currently because now I must inform every Medicare patient coming in that there is a cap and that hospitals don't have a cap they are selecting hospitals. Event though in most cases I might never reach the cap and can help them in under ten visits as soon as the pt. hears that there is a cap and that they are responsible for 20% of 1740 and that hospital outpatient clinic has no cap they just do not want to be bothered with any possible financial problems. Can I blame them? If I had Medicare I would just go to the hospital because who wants to ask the PT every week, "Are we there yet? (maxed out the cap?)" My demographics are heavy on Medicare population. I might have to move. But I have to stay that yes I love having my own practice and would prefer never to be employed.

Sean Weatherston -> Re: Start up practice stats: I need to know what to expect.... (April 20, 2006 12:00:00 PM)
AHA, Please tell me you aren't implying that they won't be responsible for their 20% portion if they go to a hospital outpatient department....that's what it sounds like to me as I read your post. If that's how it was presented to me, I might go to another clinic as well. That's bad for you obviously, but bad for the patient as well when they get a bill for the 20% from the hospital. To Everyone: How many of your Medicare folks don't have a secondary insurer anyway? I would guesstimate it's only around 5% that don't. We also see quite a few folks that have opted for a Medicare HMO that has a co-pay with every visit.

bhenchodh -> Re: Start up practice stats: I need to know what to expect.... (April 21, 2006 12:27:00 PM)
I do mention that to the patients but they don't seem to retain that little piece of information. So far 2 percent of my past patients did not have secondary.

drbuddy -> Re: Start up practice stats: I need to know what to expect.... (April 21, 2006 12:53:00 PM)
Can you tell them they can stay with you until you near the cap, then you can transfer them to the hospital PT clinic for more care if they need it?

SJBird55 -> Re: Start up practice stats: I need to know what to expect.... (April 21, 2006 2:06:00 PM)
Yes, Buddy... that is one way to handle the situation. The other thing... I have the exempted ICD-9 Dx and comorbidities posted right at the front desk. A lot of my patients ARE exempted, so I don't even mention the cap - why confuse them? Knock on wood, but so far, I haven't exceeded the cap with any Medicare patient. The other thing that I think I have going for me is that I am a geriatric clinical specialist (with no one in a 90 mile radius with my qualifications) - many of the geriatric patients already know of me and were told by their friends not to go to anyone but me. They are a pretty loyal group of customers. Not a single patient has batted their eye at the $1740 and just ask me if I keep track of their account. I answer yes and tell them that I promise I will alert them as to when they would need to make different arrangements for care if they chose not to fully pay for services. Sean, it used to be with the secondary insurance policies that they picked up the 20%... oh, there are differences this year. In Michigan some BCBS policy - Medicare Blues Option 3? I'm terrible with names, but the policy that I saw for a secondary had a $10/visit copay. I don't know, but the particular policy I saw sure looked like they might be paying more out per month than the savings they would acquire. For $60, with $12 being the 20% left over, the secondary insurance is only paying $2. Physician office visits were either $20 or $10, I can't remember. I just remember wondering if in the end the subscriber ended up losing money because they were paying monthly and getting crap that would never even come close to adding up to being a benefit. I guess it all depends on how unhealthy one is...

Sean Weatherston -> Re: Start up practice stats: I need to know what to expect.... (April 24, 2006 6:22:00 AM)
SJ, Is that one of the Medicare HMO plans or a true secondary insurer? The big one here is called "True Blue" offered by Blue Cross. When someone joins that plan, he or she opts out of traditional Medicare and does have to pay co-pays of $10-20 per visit, but also get dental, vision, prescriptions, etc. There is also a monthly premium subscribers pay similar to what a secondary insurer would charge. Humana also began offering a Medicare HMO policy in this area that's getting a lot of people involved- by offering a plan that doesn't have a premium. However, I don't think they do a very good job of telling people their co-pays for MD, PT, etc. are $30 a pop--per visit. I've lost a few potential patients because of that one.

FL_PT -> Re: Start up practice stats: I need to know what to expect.... (August 1, 2006 6:08:00 PM)
This is a great post. I will look up our numbers from the first couple years and email them to you. We have been in practice 5 years now, but I know the first year or two were lean times. One thing I did last month was put together a spreadsheet with financial benchmarks from USPT's annual report. It is public info and gives me a chance to compare our practice stats to the "big guys". I can email that sheet to you also if you like.

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