Randy Boldt, Chief Financial Officer, Rock Valley Physical Therapy

Transcript:

My name is Randy Boldt, I'm by trade a physical therapist. I went to the University of Iowa and graduated in 1994, and I started at Rock Valley the next year in 1995 and I've been here ever since. Over time, I started as a therapist, became a manager, and worked my way into the Chief Financial Officer position. I've been overseeing the billing office, the administrative division, and human resources.

I've been really involved on the payment side, getting involved with APTA committees such as the RUC and a payment committee currently working on the future of national payment for physical therapy. I am the co-chair of the Iowa Physical Therapy Association for payment and also the president of Midwest Therapy Network, which is a local network of private practices that we're trying to help support.

It's definitely my life's work. What I see across the board is that our biggest, number one issue is that we've had a pretty stagnant payment system. We've seen decreases with Medicare for the last five years or so, and this is the first year we've had a very small increase. At the same time, inflation across the United States has gone up significantly.

In a recent presentation for University of Iowa students, I showed that if your company's revenue hasn't changed for five years, a small clinic would go from making $100,000 to losing $131,000. We've been challenged by having to be more efficient and productive with our time, figuring out different ways to make money outside of the normal fee schedule for Medicare. As we all know, our Medicare population is growing; for us, it represents about 45% of our business. If we just look at Medicare, it's a losing proposition, making a large percentage of patients very difficult to take care of financially. We're all challenged by that, especially in places like Iowa with rural communities where the Medicare population is growing as a percentage of the total population.

I think that's the biggest issue, and that leads to new opportunities like our partnership with Athellis as our EMR. We are looking to find ways to make therapists more productive to meet payment challenges. All of us desire to be more efficient. Many small practices have owners working evenings and weekends to handle the business side of things. We'd like to provide resources that allow them to be more efficient. When they can go home at the end of the day with their notes completed, they are better able to manage their business.

Most practice owners are seeing patients; in small practices, the primary owner often sees the most patients. If we can help these small practices complete their notes by the end of the day and supply an excellent RCM to collect money for them so they don't have to do all the back-end work, I think that will really help. Through our partnership with Athellis, we're trying to offer those resources to smaller practices that normally wouldn't get them.

Providing a different level of software and service will allow them to be more successful and continue to stay in business. We are about legacy providers and physical therapists owning businesses. When administrative burdens and costs get too high, people decide to sell their practice or leave the profession. We want the tools to allow them to stay in the profession and succeed. That applies to us as well—we need to be more efficient and have more resources—but for small practices especially, we feel an obligation to help take care of them.

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