Diversify revenues with a private-pay program
Rehab facility teams with arthritis foundation
Administrators at Danbury (CT) Hospital knew in the early 1990s that managed care one day would be a big force in their region. So they began to plan an expansion into private pay that would provide some insulation from the capriciousness of insurers and Medicare.
The hospital’s timing worked well because there already were plans to build a new outpatient physical/occupational/speech therapy practice, which also could house a fitness and wellness center for private-pay clients, says Kathy Halek, MS, CCC-SP, manager of outpatient physical rehabilitation services at Danbury Hospital.
The private-pay program has become very popular within the local community and given the rehab facility an opportunity to offer affordable services to clients who no longer qualify for outpatient rehab reimbursement from their insurer, Halek says. While the hospital’s goal is for the program to make a profit, that hasn’t been the chief priority, she adds.
The outpatient rehab center consists of 36,000 square feet and contains the traditional rehab gym as well as a fitness gym and a therapeutic heated pool that can be used by rehab clients as well as private-pay clients. One of the private-pay programs involves aquatic exercises, and it was formed in collaboration with the local Arthritis Foundation.
"When we put together the concept for the wellness program, we didn’t know if companies would pay for it or not," Halek says. "After we investigated it, we found that for the most part, it is not reimbursable."
Prior to building the new facility and its pool, the hospital had rented use of a local YMCA and used that organization’s heated pool for therapy services, Halek says. "We felt we had enough patients who we had seen in the past who could benefit from pool therapy."
The private-pay wellness program charges modest fees for use of the gym and for pool programs, and it has become popular among people who have arthritis, as well as with people of all ages, Halek says. Because the heated pool also is used for rehab therapy, rehab reimbursement helps support the costs of operating the pool, she adds.
Halek provides this glimpse at how the facility’s private-pay programs work:
• Arthritis aquatics program: This program provides activities in flexibility, range of motion, muscle strengthening, and endurance. An exercise physiologist trained and certified by the Arthritis Foundation leads the classes, which have a maximum enrollment of 15 people. Participants either have arthritis or simply could benefit from the program’s water exercises.
The program has been full with 14 classes each week. Since the beginning, the program has grown due to demand, and classes are offered during the day and in the evening. The pool, which is 4.5 feet at its deepest level, is large enough for a full class to exercise at one time. Clients sign up for a month of classes, paying about $60. They may attend two or three times a week.
"This is an exercise class and not therapy, which is a very big distinction," Halek says.
• Aquatic exercise program: This program is suggested to rehab patients who have completed their therapy and wouldn’t be able to handle the type of group training offered through the arthritis program, Halek says.
"These are individuals who need close supervision to improve their strength, range of motion, flexibility, and endurance through exercises," Halek says. "They gradually are encouraged to become more independent, but they’ll first work one-on-one with an exercise physiologist."
People who have musculoskeletal problems could benefit from this program because water provides a safe environment in which gravity isn’t making exercise more difficult, she says.
The program, which costs $80 per month, appeals to patients who had been receiving physical therapy in the pool and now are discharged from rehab services, she says.
• Water-walking program: This is a new program that has not yet built up a large clientele, Halek says. "An area physician said he had a patient who could benefit from being in a warm pool environment and just walking," Halek explains. "So we designed this for the individual who needs the warm water environment and can do this independently."
Patients simply walk around the inside edge of the pool for a half hour or longer, which they can do while the pool is being used for one of the other water programs. "These people don’t need a lot of instruction, and the program wouldn’t be for somebody who has a very debilitating illness," she says. While a physician prescription isn’t required, a waiver is needed to show that the patient will be safe in a warm pool.
• Fitness program: The facility’s fitness area includes treadmills, exercise bikes, semi-recumbent cycles, a stair climber, strengthening equipment, and special equipment that can be used by people with spinal cord injuries or people in a wheelchair.
"Another unique feature you won’t find in a regular gym is that the treadmills start at zero miles per hour," Halek says. "We carefully evaluated the type of equipment we’d need that would be patient-friendly for people who may not have fully recovered from whatever illness they have."
The fitness program costs $60 per month, and clients may attend three times a week and work out with an exercise physiologist, who develops a personalized exercise program for them. The rehab facility has found the fitness program is a great benefit to patients discharged from physical therapy or occupational therapy who still need some ongoing exercise training. It serves as a carry-over program, Halek says.
"Many times, people who had orthopedic or neurologic problems are not comfortable going to the regular private gym because some equipment won’t be as conducive to them," she says. "And we feel we’re able to give them better one-on-one personal care and guidance in our program."
Rehab administrators envisioned the fitness program as a short-term offering clients would attend for a few months after their discharge and then quit once they had regained strength and fitness. Instead, some clients have attended the program for years and plan to attend indefinitely, Halek says. "They’re comfortable in our environment because the attention is better, and we have more staff to assist them and provide care."
Need More Information?
Kathy Halek, MS, CCC-SP, Manager of Outpatient Physical Rehabilitation Services, Danbury Hospital, 235 Main St., Danbury, CT 06810. Telephone: (203) 730-5954. Fax: (203) 730-5905. E-mail: [email protected]. Web site: www.danhosp.org.
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