Why Direct Care is the Future of PT

Why Direct Care is the Future of Rehab Therapy

In the debut episode of The Direct Path, hosts Scott Hebert and Ryan Klepps tackle a problem every practice owner knows too well: the business of physical therapy is broken.

Margins are shrinking. Reimbursement rates have flatlined (or declined). Administrative burdens are climbing. And the response from much of the industry has been to do more—see more patients, fill more hours, add more services—without solving the core problem: payment.

Scott and Ryan make the case that it’s time to stop playing defense and start building something better. That “something” is direct care—a model built around alignment, not volume. It’s about contracting directly with those who value the service and are willing to pay for it: employers, patients, and other partners who are fed up with the status quo.

They outline how today’s problems—margin compression, burnout, lack of leverage—are all symptoms of an outdated model that relies too heavily on third-party reimbursement. Then they shift to the opportunity:

• Why self-insured employers are the most important payer you’re not contracting with
• What makes MSK care so critical to employer healthcare spend
• How digital MSK companies like Hinge Health proved the demand—but missed the mark
• What PT practices can offer that virtual solutions can’t
• How even 5–10% of revenue from direct care can shift a practice’s entire strategy
  

“We’ve officially reached insanity levels with physical therapy reimbursement. It’s finally time to find another path.” — Scott Hebert

Whether you’re just starting to explore alternatives or already testing new models, this episode lays the foundation for everything to come. It’s not just a diagnosis—it’s a call to action.

If you’re ready to stop waiting on insurance to save you, this is where to begin.