APTA supports physical therapist efforts to lead employer-based health promotion and population health initiatives that improve outcomes for individuals and communities.

Policy Support

At the 2024 APTA House of Delegates meeting, RC 10-24 was adopted to support entry-point and periodic fitness and health risk assessments by PTs for employer safety and wellness programs.

This aligns with APTA’s broader support for:

• Direct-to-employer (D2E) services to increase access, improve quality, and reduce health care costs (HOD P08-22-13-15)
• Unrestricted access to PTs as entry-point practitioners for activity participation, wellness, and disability determination (HOD P08-22-12-14)
• Prevention, wellness, and disease management as key health priorities for populations and individuals (HOD P06-19-41-15)

Why Focus on Employer-based Health Promotion?

Employers provide a natural setting for reaching large groups of people, making them an effective entry point for delivering preventive care and advancing population health. PTs can contribute directly by providing:

• Fitness and risk assessments
• Ergonomic evaluations and injury prevention
• Workplace wellness and chronic disease prevention programs
• Strategies for improving return to work and participation after injury or illness

Occupational health and ergonomics are examples of an emerging area where PTs are expanding their roles and impact. A growing demand for improvements in worker health and organizational productivity reflects the increasing value of these services across settings.

What Is Direct-to-Employer?

Direct-to-employer, or D2E, physical therapy refers to PTs contracting directly with employers, outside of traditional insurance networks, to provide workplace-based services.

Common D2E offerings include the following:

• On-site or near-site care
• Injury prevention and risk screening
• Early intervention and musculoskeletal care
• Wellness programs and coaching

The D2E model delivers:

• Greater access to PT services
• Early identification of musculoskeletal and chronic disease risk factors
• Reduced overall health care costs and administrative burden
• Improved productivity and employee well-being

Explore the resources below to build your skills and launch effective D2E partnerships and employer-based health promotion programs.

Why Work With Employers?

Direct-to-Employer Services: Why PTs Should Work With Employers to Manage Population Health

• Learn how partnering directly with employers can help PTs provide fitness and health risk assessments, expand into population health services, and position themselves as key contributors to workforce health and cost reduction.

Perspective on Direct-to-Employer Population Health Services by Physical Therapists

• Explore how expanding beyond traditional patient care into employer-based preventive services enables PTs to help improve workforce health, reduce costs, and strengthen their role in the direct-to-employer market.

How PTs Can Cut Your Employee Health Care Costs and Improve Well-Being

• See how delivering fitness and risk assessments and preventive services positions PTs to help employers lower health care costs and improve employee well-being, while opening new market opportunities for PT-led workplace health programs.

Advocacy

Direct Access in Practice

• Understand where PTs can currently provide direct access services and how APTA is advocating for full, unrestricted access

The Model Practice Act for Physical Therapy

• The FSBPT Model Practice Act defines physical therapy to include injury prevention and the promotion of fitness, health, and wellness through participation-focused physical examinations, supporting the role of PTs in providing fitness and risk assessments in employer settings.
• View the full Model Practice Act language to help PTs, chapters, and advocates advance or expand PT involvement in employer-based fitness and risk assessment programs.

Health Priorities for Populations and Individuals (HOD P06‐19‐41‐15)

• This APTA position highlights PT roles in prevention, wellness, and disease management, including injury prevention and active living in the workplace. Use it to support your advocacy for PT involvement in employer wellness programs.

Where Do I Start?

Ready to explore direct-to-employer services? These resources will help you understand the market opportunity, build partnerships with employers, and position your services to compete effectively in this growing space.

Before You Begin

Direct-to-Employer Services: Why PTs Should Work With Employers to Manage Population Health

• Learn why self-insured employers are seeking direct contracts for injury prevention and wellness services and how PTs can compete in this growing market.

Establishing the Program

Direct-to-Employer Services: How to Engage in Employer Outreach

• A step-by-step guide to help PTs launch direct-to-employer services, from identifying employer needs to designing customized injury prevention and wellness programs that compete with offerings from other provider types.

How PTs Can Cut Your Employee Health Care Costs and Improve Well-Being

• Use this resource to prepare for employer meetings. It offers key talking points to help PTs advocate for direct access, early intervention, and population health programs.

Tools for Establishing Direct-to-Employer Relationships

• A practical checklist to help PTs looking to enter or expand in the D2E market. This resource helps you assess readiness, design competitive service models, and implement effective strategies to build and sustain employer partnerships.
• Deeper Dive: Self-Insured Health Plans and Physical Therapist Services
  • Understand how working with self-insured employers, who cover over half of U.S. workers, can open direct contracting opportunities for PTs.

Enhancing Your Skills as a PT

Physical therapists already bring valuable expertise to employer-based services. These programs and certificates provide opportunities to further expand your skills in population health, occupational wellness, and business development, helping you deliver even greater value to employer partners.

Direct-to-Employer Services Designation Program

• Brought to you by APTA Private Practice. This virtual three-module program builds PTs' skills in launching and managing D2E services, from proposal writing and contracting to legal considerations and demonstrating value to employers.

Occupational Health Practitioner Certificate

• Brought to you by the Academy of Orthopaedic Physical Therapy. This three-course certificate prepares PTs to deliver fitness and risk assessments and occupational health services, including ergonomics, job analysis, workplace wellness, and Total Worker Health strategies.

Clinical Guidance to Optimize Work Participation After Injury or Illness: The Role of Physical Therapists (CPG+)

• Brought to you by the Academy of Orthopaedic Physical Therapy. This guideline provides evidence-based recommendations to help PTs support work participation and deliver effective prevention and early intervention services for employees.

Other Key Resources

Stay informed on APTA initiatives that support PT-led workplace health promotion. These additional resources highlight opportunities to further elevate the role of PTs in improving worker safety, health, and well-being.

APTA Named a Total Worker Health Affiliate

• APTA’s official affiliation with the Centers for Disease Control and Prevention’s Total Worker Health program reinforces PTs’ leadership in promoting worker health, safety, and wellness through fitness and risk assessments.

Additional Resources

Workers' Comp Research Group Sees Advantages in Early Manual Therapy for LBP

• A study of 2 million workers' compensation claims shows that early physical therapy and manual therapy for LBP improve outcomes and reduce costs, providing valuable evidence to support early PT involvement in workplace health strategies.

APTA Student Social: Prevention, Health Promotion, and Wellness

• Hear from PT leaders and students on how to advance prevention and wellness, including promoting workplace health and addressing social drivers of health.