2 Different Paths of Healthcare
“Do you take my insurance?“ This is one of the most common questions we get. At MOTION RX, we intentionally chooses to be an out of network provider with insurance companies. This allows us to base our treatment towards your performance goals instead of the goals set by insurance. For a lot of people, this is actually a really good thing as it allows us (the provider) to make decisions that are best suited for the patient (you) and YOUR goals instead of having an insurance company dictate the treatment plan. For a lot of people, this actually can save them a lot of time and money as well!
Let’s compare the same path to recovery for two 35-year-old men recovering from a torn rotator cuff. Jake chooses to go the private-pay route with MOTION RX Health & Performance, while Mike sticks with the traditional third-party reimbursement track.
Before we dive into the breakdown, we will assume one crucial thing: both Jake and Mike have met their annual deductible and have chosen conservative over surgery (which has better long-term outcomes according to the latest medical research) so Mike qualifies for reimbursement from his insurance, which typically looks like 20% out-of-pocket or $40 co-pays per session.
If we take the “standard” protocol in a insurance-based PT model for a torn rotator cuff in a healthy individual (25-45), the patient will typically need 3-4 months of rehab requiring passive and active PT (~2x per week) according to the US National Library of Medicine.
In our model we typically see the patient 1x every 1-2 weeks and give them a comprehensive performance rehab program so they can begin working on this stuff at home. We also see our patient on overage 6-10x during a plan of care and quickly go from rehabilitation to working on performance and prevention.
At the end of 3 months, Jake has spent $160 out of pocket more than his buddy Mike. Although both men were recovering from the same similar injury, Jake invests less than a third of the time (13.5 hrs vs 31.5 hrs) for a fuller recovery that got him back to the active lifestyle he loved sooner. This outcome also doesn’t account for the intangibles around enjoying a dynamic, individualized care and relationship built with the MOTION RX Health & Performance team.
Furthermore, had Mike NOT met his deductible, this care path through traditional insurance based PT would have cost him $1,500 ($100 for the initial evaluation + 16 sessions at $70/ea) out of pocket, which would have him spending $400 more in less-effective care than if he had gone through MOTION RX.
Jake was able to spend 100% of his time with his Doctor of Physical Therapy who was a sports performance specialist which aligned with his active goals and active lifestyle and was able to completely get back to his goals (Crossfit & Golfing) completely pain free WHILE spending LESS time in physical therapy (13.5hrs vs. 31.5hrs).
Which path of care will you take for your own health in order to get back to your peak performance as an athlete and active adult?