Dana Strauss (00:16) Welcome back everybody. This is episode 19. We have with us today Dr. Marc Gruner. Dr. Gruner is a Mayo Clinic trained sports medicine physician dedicated to enhancing patient outcomes and healthcare system efficiency through innovative solutions and value-based care models. He maintains a part-time clinical practice in orthopedic care at Aligned Orthopedic Partners while also leading Limber Health, a digital MSK platform he founded.

Limber Health offers a comprehensive suite of services, including home exercise programs, remote therapeutic monitoring, patient reported outcome collection, and care navigation for MSK conditions, building a hybrid model of care. So he has these clinical and entrepreneurial endeavors, but Dr. Gruner also serves as a consultant for various organizations, including the state of Maryland for the Equip program, the PACE's model.

and Rubicon founders. In this capacity, he focuses on developing and evaluating specialty value-based care models. He also represents the American Academy of Physical Medicine Rehabilitation on Value-Based Care Model Development and participates in the Partnership for Quality Measurements Pre-Rulemaking Measure Review Hospital Committee developed by CMS on quality measures. Dr. Gruner's diverse experience includes a brief period at the Center for Medicare and Medicaid Innovation where he focused on alternative payment models.

He also holds an MBA with a specialization in value-based healthcare. His expertise lies in FDA regulatory pathways, CPT code development, remote monitoring, and value-based care model development. He is a dynamic leader at the forefront of clinical practice, digital health innovation, and healthcare policy. And Alex and I are proud to call him a friend. So, little intro to episode 19 now. We're facing a significant access problem in physical therapy. Patients need our care.

the traditional model effectively limits how many people we can reach. In our conversation, Marc discusses two practical paths forward for building sustainable income while expanding access. First is leveraging teams more effectively, and the second is participating in episodes of care and value-based care arrangements. Marc defines value-based care as a way to provide better care across the continuum.

doesn't just define it as a payment model and he's definitely right in that. He frames this shift as an opportunity to evolve our intellectual capacity and be challenged in new ways. Our profession is really uniquely invested in taking care of patients over a continuum, which positions us perfectly to be quarterbacks in the management of care within value-based care arrangements. This is the future we really need to embrace.

We're also diving into remote therapeutic monitoring and how it brings technology and care navigation to physical therapists who are naturally skilled at these things. emphasizes that the more touch points with patients means better chances of engagement and adherence. And at the heart of all of this is what really matters, which is quality and outcomes. The data shows what we're accomplishing and that's how we'll demonstrate our value moving forward.

So for those of you that subscribe to the Future Proof PT newsletter, this week's article covers the role of RTM for PTs. Don't miss it. Sign up for our newsletter to access the full library of episodes, including this one.

Dana Strauss (03:47) Hello everybody and welcome back. We are here for episode 19 with Dr. Marc Gruner, And we wanted to bring Marc in because he is first of all, a great friend of the physical therapy community and has done a lot to actually help our profession, He is a physician and a physiatrist, sports medicine doc.

Take it away Marc. We'd love to hear a little bit about you

Marc Gruner (04:11) Yeah, well, thank you so much. First, I want to say thank you both to Dana and Alex for having me on the show. I I've been following both you guys for a while, and I have the highest regard for both you guys when it comes to quality, outcome measures, innovation, and value-based care, which I know we're all passionate about. But quick background myself. So I'm a sports medicine physician, a co-founded Limber Health.

Alex Bendersky (04:23) you

Marc Gruner (04:34) with my brother and Limber Health is a digital health company that works with physical therapists across the country. We have five different products where we work with brick and mortar physical therapy clinics. We work with 8,000 clinics now across 85 million different patients in the United States. And we focus on five products. One is home exercise programs.

Two is remote therapeutic monitoring, which we help create the CPT codes for. Three is helping them on a glide path towards value-based care. Four is outcomes. And then five is we also help with the staffing of care navigators. So thank you for having me.

Alex Bendersky (05:14) Thanks for being part of this process.

Dana Strauss (05:16) We'd love to hear first just what drew you to value-based care and then what were your early experiences with it like and then why have you stuck with it?

Marc Gruner (05:25) Yeah, so I did a medical degree and MBA right when the Affordable Care Act came out. Ended up working briefly at the Center for Medicare and Medicaid Innovation Center. And there I learned about episodes of care like a bundle for like a knee replacement and several other value-based care models. And was really interested in not just what was happening in the clinic.

but what was happening across the continuum of care for a patient over a period of time. And it was there, and I did Michael Porter's Value-Based Healthcare course and kind of drank some of the Kool-Aid. I met a lot of great people, Patrick Conway, who's now the CEO of Optum, and Kevin Bozic, who leads UT Austin.

One of the things that I was really interested about was how to provide better care for a patient, not just after a surgery or a visit, but across a continuum.

Alex Bendersky (06:17) That is awesome. And I think you were definitely one of the first to to merge some of the missing links in allied health, with the pillars of value-based proposition in traditional allied health