Are Cash-Based or Insurance-Based Providers "Better"?

There’s been a recent flare-up in the pelvic rehab world around cash-based versus insurance-based care. And while emotions are running high, we wanted to pause the noise and add something that feels increasingly rare: context.

In this episode, we start with what we all agree on:

• Every pelvic PT and OT is doing their best for their patients
• We all want clinicians to be paid fairly and sustainably
• More practice models = more options for both clinicians and patients
• Patients benefit from having real choices
• We should be referring to one another, not competing against the field itself
• The current medical system requires both insurance and cash-based care — in every country we’ve seen

From there, we address the two biggest areas of disagreement head-on.

First, the claim that cash-based practices reduce access to care. We walk through the data around deductibles, waitlists, and real-world barriers to care — and why more options actually increase access, not reduce it.

Second, the idea that one model inherently produces better care. We’re very clear here: you can get excellent or poor care in any setting. But when you take the same caliber clinician, the environment matters — and we explain why time, autonomy, documentation burden, and feedback loops change outcomes.

This episode isn’t about picking sides.
It’s about understanding incentives.
And it’s about recognizing that the growth of pelvic rehab depends on all of us moving forward together.

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 800+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email ([e-mail]).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!