Skip to main content

Among the reasons for becoming a physical therapist (PT), the chance to work with self-insured employers likely is near the bottom of the list. After all, says Mike Horsfield, PT, MBA, ATC, the average PT in an outpatient clinic or typical owner of a physical therapy private practice "doesn't even know when a patient's employer is self-funded, because it doesn't change the way that person is billed."

Feature Self Insurance

Self-insured plans are those in which employers use their own funds to cover associated costs and financial risks related to their employees' health care. Such plans require the employer to, for example, write a check to its employees' providers for all of their health care up to a certain point (minus any deductible and copays owed by the worker). Above that dollar amount—say $100,000—most employers turn to stop-loss coverage from a commercial carrier that protects them against expenses exceeding their budget.

That patient's insurance card likely will look the same as any other, with the corporate logo of Blue Cross Blue Shield, UnitedHealthcare, or another major carrier on its face, notes Horsfield. The reason: self-funded companies often turn to health plans to act as third-party administrators. Furthermore, most patients have no idea where their employer-provided insurance comes from. "If you asked them," he says, "they probably couldn't tell you, because for them it doesn't make a difference." Horsfield is the chief executive officer (CEO) and 1 of 10 PT owners of Rock Valley Physical Therapy, with clinics in Iowa and Illinois.

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.

  1. Fronstin P. Self-insured Health Plans: Recent Trends by Firm Size, 1996-2015. Employee Benefit Insurance Institute. July 2016:37(7). https://www.ebri.org/pdf/notespdf/EBRI_Notes_07-no7-July16.Self-Ins.pdf. Accessed March 24, 2017.
  2. Pozen RC, Vinjamoori A. Incentives for Small Firms to Self-Fund Their Healthcare Plans. Brookings Institution. November 19, 2014. https://www.brookings.edu/research/incentives-for-small-firms-to-self-fund-their-healthcare-plans/. Accessed March 24, 2017.

You Might Also Like...

Feature

Social Responsibility Finds a Home in the House

Feb 01, 2020

The APTA House of Delegates increasingly is taking stances on societal matters. But members of the policymaking body still are getting comfortable with

Feature

Providing Onsite Physical Therapist Services

Jul 01, 2019

These PTs work everywhere their patients are, from industrial sites and touring shows to naval ships and universities.

Feature

PTs and the Consumerism Movement

Mar 01, 2019

As physical therapy patients increasingly seek to become more involved in their own care, PTs and PTAs face both challenges and opportunities.