Amid an ongoing political scuffle, the exact details of how the nation’s health care system will change in the coming years remains unclear. But instead of sitting around and waiting to see what happens, local business owner Blaine Stimac is taking a proactive approach and adapting to the evolving medical marketplace.
Stimac owns Professional Therapy Associates, a physical therapy company based in Kalispell and with additional offices in Whitefish and Columbia Falls. Stimac has kept a close eye on the recent development of health care reform. Instead of solely focusing on potential drawbacks and challenges, Stimac has been adjusting his business model and vision in a big way. This includes adding new clinics across the state and reshaping the role of physical therapy in people’s lives.
“There’s an enormous amount of change coming and we want to be on the front end of that change,” Stimac said. “There’s a lot of things we can do to prepare for that instead of hanging onto this old (health care) model. If we don’t embrace change and if we don’t prepare to be able to change, then it’s going to be a tough go.”
The U.S. Supreme Court upheld most of the Affordable Care Act (ACA) in June, allowing for a comprehensive overhaul of the nation’s health care system. The act plans to guarantee insurance to more than 30 million people and expand Medicaid and lower- and middle-income assistance for private coverage.
Changes are already rolling out and the ACA should become fully realized by 2014. In the meantime many states, like Montana, are still developing the exact nature of their systems for patients, providers and insurance companies.
Stimac, who has been a certified physical therapist for 11 years, has his concerns, primarily that if a government-based system emerges as the lone option health care services could possibly become watered down and stagnate.
However, he does believe reform is absolutely necessary. Over the last 10 years, the environment of the health care industry has made it increasingly difficult for small, private practices to succeed, he said. Reimbursements from insurance companies have continued to shrink while the cost of running a private practice has risen drastically, he said, and this scenario hurts small businesses most. At the same time patients should also be able to access care that is affordable and high quality, Stimac said.
“The health care system needs to reform. That’s 100 percent true,” he said. “What we have going on right now is not sustainable. Do I think the Affordable Care Act is going to fix that? I have my doubts. But I am completely in support of reform.”
Stimac sees a significant opportunity for change involving how insurance companies incentivize wellness. In the current formula, insurance companies are hesitant to pay for preemptive measures. It’s not until a procedure or need arises, like surgery or rehabilitation, that insurance companies deliver coverage payments.
With millions more Americans adding insurance in the near future this could lead to a massive influx of large payments. What if insurance companies paid customers to enroll in programs aimed at combating issues like obesity or other health concerns that can lead to further, costlier ailments?
Traditional physical therapy has remained focused on helping someone regain his or her normal health status. But what if it evolved to include an emphasis on being healthy in the first place through a variety of wellness programs?
These are the questions at the heart of Stimac’s vision for the future.
He recently partnered with Ryan Robinson and founded Health and Rehab Solutions in July. The company will oversee the growing number of Physical Therapy Associates clinics and staff. Two new clinics joined the PTA family just last week, in Somers and Polson. There are plans to add another eight clinics across the state.
Despite much uncertainty, Stimac is certain his clinics and staff will be ready to adapt to the changing landscape.
“Our goal is to improve people’s lives through physical therapy,” he said. “We believe that (physical therapy) has a place in helping people.”
Professional Therapy Associates in Kalispell is located at 1234 Whitefish Stage Road. For more information call 756-7878.