Top 5 Things You Must Consider When Choosing Between In-House and Contracted Physio Services

Traditionally the demand for physio services in residential aged care has been low and has mainly been focused on meeting accreditation standards with regards to regular monitoring and assessing the mobility needs of residents. However, since the introduction of the pain management program under the current ACFI business model, having physiotherapists on a more regular basis has become a necessity for aged care providers. But with this increased demand for service has come the tricky decision as to whether to opt to employer your own physio’s or go for an external contractor arrangement. Inevitably there are risks and rewards for every decision we make in life, but some are more costly than others. So this blog is about delving in the 5 TOP THINGS TO CONSIDER when making that elusive decision…

No.1. Outsourcing, it’s more cost effective than you think!

Many companies swear by it and others despise it, some businesses shy away from it but countless entrepreneurs and large corporations depend on it. Regardless of what side you take, there is no denying that there are plenty of things to love about contracting key services to an external provider.

One significant advantage for using an external physio contractor is that it can cost less than hiring one or more full time employees. Not only can you save money by avoiding the cost of paying out employee benefits and recruitment costs, but with the aged care physio service market so hotly contended a well negotiated service agreement that offers a reasonable per consult or hourly rate and services just the hours you need per week, can prove to be more cost effective than paying out for one or more 40hr/week employee/s.

The elephant in the room when it comes to aged care physio is the potential scrapping of the pain management supplement and the fall out for all those providers that have chosen to go in-house. In the event that the pain management supplement suffers the similar fate of the now defunct dementia supplement, then the cost of redundancy could be high!

No.2. Reliability and continuity is key!

Whether you are a small independent or a large multi-national aged care provider, having ready access to Physiotherapy services that are reliable and continuous, we all know, is imperative when it comes to ensuring and maintaining the validity of certain components of an ACFI claim. With this firmly branded in the minds of key decision makers, the temptation to lean towards employing your own physio staff is ever present. Whilst this may be a viable option for organisations that are large enough to carry excess staff to cover, for many smaller to medium providers the financial burden of additional staff can place a significant strain on the budget.

In addition to the costs associated with employing in-house staff, there are significant recruitment issues when it comes to employing suitably qualified physiotherapist within aged care. This shortage of physio’s is partly owing to the lack of interest by experienced and new graduate physiotherapists to enter the aged care sector, the high churn rate and burn out of those already in the industry and the very short life span of those now entering becoming Physiotherapist, which has fallen to only 3-5 years following graduation. Outside of this there are challenges both financially and logistically aged care providers face, particularly those regionally or located in outer suburban areas, when recruiting their own physio staff, such as the need to offer incentives to attract high quality and experienced city based employees, relocation and recruitment fees. Some of these additional costs and headaches can quite often be avoided by using a reputable high quality external physio provider.

No.3. Experience and expertise

We all know that you can’t put an old head on young shoulders and when it comes to working in aged care there is a certain level of clinical skills and experience you want your physiotherapist to have. Let’s face it, with the introduction of in-home care, older adults are entering residential care much later and they are presenting with multiple co-morbidities and complex care needs, so opting for a new graduate probably isn’t your best option unless you have other more senior staff that have the necessary skills and experience that they can mentor more junior staff.  When it comes to directly employing a physio with experience in the aged care sector, it can come at a hefty price, often $10,000 more than the standard equivalent pay rate within the acute or rehab sectors, due to the high demand and relative scarcity of physiotherapist available. For those facilities that are independents or are have below 5 facilities, being able to recruit the right skill mix and enough experience can be a real challenge.

One of the great things about an outsourced service is that you are more likely to get a bigger skill mix and all the good aged care physio companies tend to have a dedicated clinical educator that provides ongoing support and upskilling for staff, which takes the pressure off you having to source and offer relevant external professional development at an additional expense.

No.4. Efficiency and accountability

The fact is that as a facility manager or aged care provider there is a million and one things that require your focus at any one time and monitoring the quality and productivity of your employed physio staff and physio programs can easily fall by the way side, as can the quality of the physio service you provide. It can be equally as challenging to find the time to try to develop new and innovative programs to keep up with the ever changing best practices within the physio world and offer services that give you a marketing edge over other local aged care competitors.

An outsourced physio provider model does just that, outsource the responsibility and accountability of providing high quality evidence based care, monitoring and supplying best practice and innovation. This service model allows you to sit in the driver’s seat when it comes to making them accountable for producing the care outcomes that you desire. Gone are the days of big physio external providers getting away with providing a tick and flick service. With so many new players in the aged care physio service market looking to get their piece of the aged care pie, there is most certainly great benefits to be had for astute aged care providers who spend a bit of time checking out some of the newer physio companies in the market who are giving the big names a run for their money and offering significant ‘Bang for your Buck’.

No.5. Exit strategy – for when things just don’t go to plan!

Last but not least, we must always have an exit plan just in case. Let’s face it when you work with people things don’t always go to plan. Having a contractor arrangement in place provides you with all the power and offers a much easier platform to change service providers and saves you the hassle of having to go down what can be a long and protracted performance management process. Whilst we appreciate that it’s important to have continuity in therapist for a number of clinical reasons, but in the same vein it is equally important to be able to cut ties with those who are just not performing.


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