When Mark Kaufman, PT, opened a small therapy space in Chicago's "Gold Coast" historic district in 1991, he had one employee and just two athletic training contracts with a high school and a local rugby team.
His father Larry, a carpenter by trade, fashioned the company's first treatment table by hand.
Now, almost 22 years later, Athletico is an established Midwest powerhouse with 69 locations across three states and more than 1,200 clinical and administrative staff. Corporate partners include the Chicago Bears, White Sox, Cubs, Bulls and Blackhawks, U.S. Soccer and the Joffrey Ballet. It's one of the most instantly recognizable rehabilitation brands in the nation.
And yet when Athletico held a ribbon-cutting ceremony last month at its 69th location in South Chicago, Larry Kaufman loaded several handmade treatment tables into his van, made the four-hour drive from his hometown of Olds, IA (population 200), and set it up in the new clinic's therapy room.
The younger Kaufman stresses this point to illustrate that no matter how big his operation expands, and no matter how thick his portfolio of affiliations and partnerships grows, the company will never stray from its founding values of hometown service, patient-driven relationships, and above all, evidence-based rehabilitative care.
"[Dad] has made over 800 tables, plus balance boards, beams, step-up blocks, thera-tube trees and customized items since our inception," Kaufman said of his 74-year-old father. "Both of my parents have been very supportive. They instilled in me the principles I carry to this day. I like to think this is still very much a family-run business."
What's Their Secret?
Kaufman got his start the way many physical therapists do-an interest in sports during high school (where he wrestled and played football) led to college studies in athletic training at the University of Iowa, followed by graduate work at the University of Arizona and a master's of physical therapy at Northwestern.
His first job out of college at an orthopedic clinic in Chicago led to him launching an outreach program and, before long, the call of independent entrepreneurship took hold. "Everyone kept saying, 'you should go out and do your own thing,'" recalled Kaufman. "Initially I just wanted to open one center. But community relationships have a funny way of building on themselves." As his referral base and network of contracts expanded, so did his patient base, and soon other clinics began to open.
Today, the company is a full-service rehab operation spanning the entire Chicago region. Pick any subspecialty, and chances are Athletico is already there-work/industrial therapy, hand therapy, golf rehabilitation, aquatic therapy, video gait analysis and women's health rehabilitation only scratch the surface.
"This year's winner has been able to show astonishing growth with real diversification, while maintaining a balanced approach to patient care and PT job satisfaction," said Brian Gallagher, PT, owner of Cypress Creek Therapy Associates in Severna Park, MD, the winner of ADVANCE's Practice of the Year Contest in 2011. "This is a major success for any group in healthcare today."
"Customer service is at the forefront of their practice model, indicated by their accommodating hours (including weekends and nontraditional hours), transportation reimbursement, and internal checks and balances on quality management, compliance and ability to pay online," said Dale Boren Jr., MPT, OCS, another of this year's judges and clinic director and partner at Physical Therapy Central, the Oklahoma-based practice that won ADVANCE's Practice of the Year award in 2010. "They have taken a very unpredictable healthcare system and aligned their model to incorporate a multi-disciplinary approach that can meet any potential client's needs."
"Athletico prides itself on offering a warm, friendly and caring environment at all our facilities," said Colin Crawford, PT, MSPT, OCS, corporate director. "What distinguishes our atmosphere from others is the open, safe, collaborative environment." Clinic spaces average around 3500 square feet and patients are cared for by a primary clinician in partnership along with a team of PTs, OTs, athletic trainers, massage therapists, performance enhancement specialists and rehab aides.
"My experience of therapy was clearly enhanced by the spirit of the entire staff at Athletico," said Barbara Ann Bosch, a Catholic nun who underwent double knee replacement in May 2010. "It was obvious to me that the staff members worked as a team, got along and were friendly and helpful not only to clients but to one another as well. For me, the positive tone seen in the staff was a great supportive background as I was going through the rigors of therapy. Coming in for my sessions, I was always greeted like an old friend."
Partners in Practice
Kaufman learned early on that having his leadership team invested in the company's success-not just in the philosophical sense, but the financial one as well-was the best way to keep Athletico moving forward. Partners in the company examine potential sites for new clinics and approach the leadership team with a business plan.
With this corporate structure, each partner has a vested interest in the company's success and each brings unique skill sets, treatment philosophies and ideas for doing business in the community.
"I respect my leadership team and trust their instincts immensely," said Kaufman. "They understand the value of community relationships and strategic partnerships." If a given area has a large performing arts component, a heavy concentration of schools or sports teams, or a large industrial population, Athletico tailors its services accordingly.
The formula is a proven winner. Athletico reported an 18 percent growth in revenue from 2007 to 2008, said Crawford. Even through the worst years of the recession, the company's revenue grew an average of 11 percent per year. Crawford cites the company's strict policy of remaining abreast of local and national coverage determinations and acting proactively.
When CMS's multiple procedure payment reduction (MPPR) resulted in reimbursement decreases, Athletico reacted by implementing an EMR system to automate claim submissions and avoid costly delays and errors, verifying real-time benefits eligibility prior to care, and collecting co-pays at the front end (which resulted in an over-90 percent co-pay collection rate). Online bill-pay makes it easier for patients to settle their accounts. Cash services for personal training, Pilates, massage, sports performance and golf fitness augment third-party revenue streams. They contract with PPO, POS and select HMO plans in addition to large physical groups to keep referrals generating.
"Downward pressures on reimbursement are having an impact on the profession, no question," said Kaufman. "It requires you more than ever to differentiate yourself through your service and your outcomes."
Money Where Their Mouth Is
Owning any business can be fraught with company-speak about exceeding expectations and providing client-centered service. But objectively tracking performance and measuring yourself against competition is another matter.
About five years ago, Daphne Scott, PT, DSc, regional manager in charge of three Athletico locations and the company's director of leadership development-overseeing the clinical and management skills development of Athletico's leadership team-sought to impartially evaluate their business plans to see how they stacked up to the competition.
"I got curious about what we're doing to develop our leaders, both as managers and clinicians," Scott said. "It was a case of, 'what are we doing with our culture?' We had to have a model of getting all this to the front lines. We brought on a formal leadership piece, clinical measurement tool and formal residency program."
A key differentiator was a partnership with Focus on Therapeutic Outcomes (FOTO), an external database for rehabilitation that measures patient satisfaction and functional outcomes for muscuoloskeletal, industrial, neuromuscular, cardiopulmonary and pediatric patients. All Athletico patients complete a health status questionnaire using an iPad mobile digital device at admission, during a midway session and at discharge.
Data provided rates the patient's ability to perform usual activities. FOTO provides a comparative database and reporting service, allowing Athletico to identify areas of strengths and weakness. According to their data, over 98 percent of patients would recommend Athletico to a friend or family member.
The FOTO partnership is a business generator. "It becomes part of every conversation we have with our payers," Kaufman said.
"Only through extreme attention to detail in the areas of structure, personnel, and management systems can you achieve such success as this group has done," said Gallagher. "It's evident in their statistical tracking system, which allows them to know what every element of their company is doing at any given moment."
Getting recognizable corporate partners on your team lends instant credibility to potential consumers making their way to physical therapy for the first time, and is a proven way to show off your talents, said Kaufman. Athletico is the official provider of physical therapy for the Chicago Bears, Bulls, Fire, Cubs, White Sox and Blackhawks.
Recently the company was named a Major League Baseball Center for Excellence, a new program whereby local practices are certified by Concussion Health to provide rehabilitation to Major League umpires who sustain a head injury during games.
"I cannot say enough good things about the Athletico therapists and athletic trainers," said Hughie O'Malley, manager of sports medicine administration for the U.S. Soccer Federation, the national governing body of soccer in America. "The therapists there have the unique qualifications and expertise to work with athletes at the highest level."
O'Malley oversees the medical needs of the U.S. men's and women's soccer teams in addition to the multiple age-specific developmental teams under the purview of the federation. About 10 years ago, O'Malley sought to forge a formal partnership with a physical therapy company whereby therapists would travel with the teams to matches, staff the federation's full-time training facility in Florida, and work with injured and rehabilitating athletes in the company's own clinic. Athletico was a natural fit.
"The company is very approachable, they have a tremendous grasp of their profession, and they go above and beyond to ensure that our needs are met," said O'Malley, who places strong emphasis on having physical therapists in charge of his athletes. "They've formed an incredible operation."
Athletico provides therapy services to area performing arts companies such as the Chicago-based Joffrey Ballet, which holds performances at the Auditorium Theatre in Downtown Chicago, in addition to traveling performances both nationally and overseas. The partnership dates to 1994 and arose from Kaufman personally treating several Joffrey performers.
"Having physical therapy on site is crucial to keeping our bodies in optimal shape," said dancer April Daly, who spent two seasons with the Washington Ballet before joining the Joffrey in 2003. Daly, who has battled a severe hamstring strain since February, credits the consistent attention of Athletico therapists in her being able to continue dancing and finish the season. Her day starts at 9:45 a.m., when she attends a 90-minute ballet class. Following that is six full hours of rehearsal. This is in addition to actual show times, which can number several per week.
"Unfortunately, we don't have the luxury of taking time off during the season," Daly said. "The physical therapists are able to help us maintain a tolerable level so that we can get on stage."
Building for the Future
The final piece of the puzzle putting Athletico over the top, according to this year's judging panel, is an unselfish promotion of the physical therapy profession beyond the company's territories.
One pillar is student education. Athletico provides clinical affiliation opportunities for PT students from 75 programs nationwide, and has been an orthopedic residency site for Evidence in Motion since 2008.
Upward employee mobility is another corporate pillar. For its employees, Athletico offers a formal development program including mentorships, new employee orientation, residencies and a generous compensation plan with tuition reimbursement and performance bonuses. Therapists interested in leading a clinic or a company-wide initiative have ample opportunities at the growing organization. Scott, now the company's regional manager and director of leadership development, began as a staff therapist 13 years ago when Athletico had just 11 clinics, and she interviewed for the job with Kaufman personally.
"Athletico excels at opening doors and opportunities for their clinicians to pursue what they're most passionate about," said Brendan Yorke, PT, MHS, OCS, who began as a staff PT 10 years ago, became co-manager of the company's Endurance Sports Program (he's an avid runner and triathlete), and is now facility director of the company's Bloomingdale, IL location.
Continuing education is another mainstay. Athletico University is the company's internal CE platform that conducts 150 hours of state-approved clinical instruction per year on wide-reaching topics from dance medicine to video analysis to surgical interventions. Athletico University also hosts outside experts in its 60-person conference and learning center equipped with treatment tables, rolling stools and AV technology. They outsource locations for larger group training.
Finally, a full slate of charitable giving initiatives and outreach lectures-including sessions on concussion, overhead athlete injury, balance and arthritis-get the word out to the community at large. The Athletico blog, e-newsletter, "Ask the Expert" portal and a strong Facebook and Twitter campaign keep patients engaged.
"It's rare in physical therapy for a practice to truly contribute more than locally to the profession," said Boren. "This company has taken the physical therapy profession into the national spotlight through their partnership with EIM and their time on national TV, which can influence the masses. [They're] a truly customer service-based company, innovative and adaptive to an ever changing healthcare system, and promoting physical therapy on a global scale."
But far from resting on its laurels, the company is forever looking forward. "I predict that the Athletico you'll see in five years will be staggeringly different than the one you see today," said Scott. "What makes us different is that we're developing a culture."
"I've never forgotten my roots," said Kaufman. "I pay attention. I take things personally. We have a platform now and we can take things as far as we'd like to go."
Jonathan Bassett is on staff at ADVANCE, and can be reached at firstname.lastname@example.org