Lead with Mission: A look to the future with Larry Benz

With 2020 finally behind us and signs that the pandemic is fading, we thought that now might be a good time to look ahead into the future.

As part of our recent outreach to PT leaders to get their thoughts on the profession’s emerging trends (p.s., you can read all of our conversations and get the full guide here), we spoke with Dr. Larry Benz, PT, DPT, OCS, MBA, MAPP, Chief Executive Officer and President at Confluent Health. His family of physical therapy and occupational therapy companies operates in four  areas, Benz told us. First and foremost, Confluent Health partners with independent practices, providing them with support and economies of scale. Separately, it has an occupational health and safety division offering PT and OT services directly to employers, and it runs a business called “Evidence In Motion,” Confluent’s reimagined health care education model which integrates evidence-based practice, top faculty from across the country, and a leading curriculum that combines online learning and collaboration with intensive hands-on lab experiences. Recently Confluent also partnered with PTPN, America’s largest network for rehabilitation private practice professionals.

Keet: What’s your take on how physical therapy has handled what most agree has been an exceptionally difficult stretch?

Benz: I think that all things considered, PTs have done well over the last year. As a profession, we’re climbing back. We’ve learned to do more with less and to be more innovative in several ways. At Confluent Health, we believe in leading with a mission and a culture of strong values, and it’s the same in practicing physical therapy. What we do in physical therapy is incredibly meaningful, impactful work. We’re fortunate that we get to help people get back to doing the things they love every day, and particularly during a time of national crisis where healthcare providers are the pandemic’s heroes.

Keet: Musculoskeletal disorders cost U.S. employers more than $800 billion per year in medical expenses and lost productivity. With the growing emphasis on value-based care, how can PTs bring this number down?

Benz: It is my view that our best value-add in the healthcare system as PTs is as frontline musculoskeletal screeners—and we can provide that service directly to employers. When you do physical therapy first, there is less surgery, less injections, and less imaging, and that’s how you reduce expenses. Outpatient PT is a low-cost-provider business. If you can be low cost, you can be high value-add, and during a time of great change and economic headwinds, that is the right place to be– in the position of helping businesses and people. However, our industry is only reaching around 10% of the approximate 127 million annual musculoskeletal injuries in the United States. The best way to reduce costs is to increase that number to much higher than 10%. 

Keet: It’s been an exciting time for physical therapy—COVID-19, the move to value-based care, adapting to new technologies like telehealth. Where do we go from here?

Benz: One thing everyone should be thinking about is MIPS [the Merit-based Incentive Payment System]. You don’t have to like MIPS, you just have to understand that it’s mandated. So if you are required to submit data and patient-reported outcomes measures, why not use the program to your advantage? Leverage it for your practice. Use it to keep your own therapists accountable via care delivery while also keeping your entire practice accountable to those that are paying for it.

Keet: Are there any aspects of care you think will be particularly important once the pandemic is over?

Benz: Behavioral health is going to be a huge piece. We’re all going to be treating patients post-COVID who are more overweight, are more addicted, and have more anxiety, depression and fear, and that combination is going to be tricky. You won’t just be treating patients for garden-variety low-back pain; it’s going to be low-back pain with apprehension, panic, metabolic disease, and other comorbidities. We’re going to need to be better about aligning with other providers for this—cognitive behavioral therapists, for example. If you ignore the behavioral health component, you’re not going to be able to do the best for your patient.

Keet: It sounds like the kind of physical therapy most PTs are interested in practicing anyway.

Benz: I think it is. In years past, we’ve wanted to take PT in the direction of fitness and wellness. While that is still laudable, the greater impact will be to incorporate behavioral health interventions. I like to refer to this as “PT-plus.”