Skip to main content

Should you tap the market? Some points to consider.

Have you ever considered contracting directly with self-insured health plans for treatment of musculoskeletal conditions and/or wellness provision? Perhaps you should. It's a vast market that's full of opportunities for enterprising physical therapists (PTs). First, though, it's important to gain some background knowledge.

Definition and Prevalence

Healthcare.gov defines "self-insured plan" as a "type of plan usually present in larger companies [in which] the employer itself collects premiums and takes on the responsibility of paying employees' and dependents' medical claims. These employers," the site adds, "can contract for insurance services such as enrollment, claims processing, and provider networks with a third-party administrator, or they can be self-administered."

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.

  1. Employee Benefit Research Institute. Self-insured health plans: state variation and recent trends by firm size. EBRI.org Notes. http://www.ebri.org/pdf/notespdf/EBRI_Notes_11_Nov-12.Slf-Insrd1.pdf. Accessed March 22, 2016.
  2. Henry J. Kaiser Family Foundation. 2015 Employer Self Benefits Survey. http://kff.org/report-section/ehbs-2015-section-ten-plan-funding/. Accessed March 22, 2016.
  3. Herman B. Self-service insurance: insurers forced to compete for self-insured customers. Modern Healthcare. January 3, 2015. http://www.modernhealthcare.com/article/20150103/MAGAZINE/301039980. Accessed March 22, 2016.
  4. Aon Hewitt. 2014 Health Care Survey. http://www.aon.com/attachments/human-capital-consulting/2014-Aon-Health-Care-Survey.pdf. Accessed March 22, 2016.
  5. Society for Human Resource Management. SHRM Survey Findings—2015 Strategic Benefits: Wellness Initiatives. https://shrm.org/Research/SurveyFindings/Documents/SHRM_Survey_Findings-Strategic-Benefits-Wellness-Initiatives.pdf. Accessed March 22, 2016.

You Might Also Like...

News

UHC Says Treatment Time Can Be Used in Lieu of Start and Stop Time

Nov 29, 2023

The latest clarification from the mega-insurer comes after it released a set of burdensome policy expansions earlier this year.

News

Win (for Now, at Least): Aetna Backs Away From PTA Differential

Nov 1, 2023

Aetna put its decision on hold, giving APTA time to press for a permanent shift. Other news from the insurer isn't as good.

News

Aetna Will Adopt PTA Pay Differential

Sep 12, 2023

The 15% reduction, set to begin Dec. 1, would mimic CMS cuts adopted in 2022. APTA is pressing Aetna to reconsider.