Part 9 of 9: From Insight to Action: Why the Future of Outpatient Rehab Runs Through Clinically Integrated Networks

Eight Days of Clarity, One Path Forward

Over the past eight days, we’ve uncovered the underlying forces shaping the chiropractic and physical therapy landscape—forces that providers feel every day but rarely see clearly defined:

• Flat and fragmented reimbursement

• System design that favors gatekeepers and intermediaries

• Erosion of clinical scope through reimbursement strategy

• Administrative burdens fueled by disorganization and outdated tech

• A complex and siphoned healthcare dollar pipeline

• Ineffective research strategies that fail to capture real-world value

• Underleveraged utilization and disconnected system access

These aren't isolated issues—they're symptoms of fragmentation. And fragmentation is not just inefficient. It’s unsustainable.

The solution? Organization. At scale. Built around value.

The Arete Network: The Future, Already in Motion

Arete (pron: 'areet') means to reach one’s full potential—to express excellence through action.

For chiropractic and physical therapy, that means delivering care at the top of our training, integrated into modern healthcare systems, and properly valued for the outcomes we deliver. The Arete Network is the leading clinically integrated network (CIN) purpose-built for independently owned chiropractic and physical therapy clinics. With over 12 years of development, data aggregation, and proven operations, Arete offers a tested, scalable, and transformative model that addresses every barrier uncovered in this series.

Arete is more than a network. It’s a platform for economic power, administrative relief, data-driven contracting, and clinical impact.

Over the first eight parts of this series, we’ve uncovered the most critical barriers holding these professions back: underutilization, invisibility, administrative burden, and systemic misalignment.

Arete Network exists to solve these challenges. Not in theory—but in practice.

How Arete Solves the Problems of Days 1–8

Day 1 & 2: Utilization, Outcomes & First-Provider Advantage

Challenge: DCs and PTs deliver top-performing MSK care but are rarely the first provider seen. Consumers are often routed into inefficient, high-cost pathways.

Arete Solution: Arete repositions chiropractic and physical therapy as frontline providers through payer partnerships, care navigation tools, and technology infrastructure that enables direct referrals from medical groups and employer health programs.

• Contracts that reward efficient episode closure and guideline-concordant care

• Population health reporting to highlight resolution rates and patient outcomes

• A structure designed to channel patients to the right provider—first

Day 3: Technology & Interoperability

Challenge: DCs and PTs are digitally invisible—excluded from referral directories, feedback loops, and health data registries due to outdated or closed EHR systems.

Arete Solution: Arete enables full technology integration, including:

• Interoperable EHRs that connect to Health Information Exchanges (HIEs)

• Provider directories and direct messaging tools enable “easy-button” referrals

• Population health data feeds for outcomes reporting

• AI-readiness through open APIs and connected infrastructure

• Tens of thousands of referrals flow through Arete from primary care groups

• Feedback loops close the gap between MDs and MSK specialists

Arete transforms “invisible” clinics into visible, referral-ready partners in value-based care where DCs and PTs are positioned not as alternatives—but as primary entry points.

Day 4: Intermediaries & Exploitation

Challenge: Third-party intermediaries siphon resources, suppress rates, and impose administrative chaos—while providing no clinical value.

Arete Solution: Arete bypasses intermediaries altogether, offering direct contracts and full administrative infrastructure:

• Delegated status with major commercial payers

• Contracts designed by providers, not middlemen

• Outcomes-driven reimbursement that reflects true value

Same efficiency for the payer. Better transparency and control for the provider.

Day 5: Scope Suppression & Reimbursement Limitations

Challenge: Providers are trained to deliver comprehensive MSK care but are reimbursed as limited-scope technicians. Scope is suppressed by reimbursement design, not regulation.

Arete Solution: Arete contracts align with top-of-license practice:

• Evaluation and management codes are covered

• Manual therapy and active care are included

• Direct access and autonomy are prioritized

This empowers providers to practice how they were trained, not how legacy policies dictate.

Day 6: Administrative Burden & Duplication

Challenge: Clinics face redundant work, from prior auths to credentialing, without scale or support—draining time, staff, and resources.

Arete Solution: Arete Services, the provider-built MSO, centralizes:

• Credentialing and payer enrollment

• Prior authorization workflows

• Revenue cycle management

• EHR, scheduling, and data reporting

• Employee benefits and staffing support

Clinics focus on care. The network handles the rest.

Day 7: Financial Flow & Payment Suppression

Challenge: Most revenue is siphoned away before it reaches the provider. Reimbursement is flat, unpredictable, and disconnected from outcomes.

Arete Solution: Arete realigns the flow of funds:

• Participation fees fund member services, not corporate profits

• Value-based contracts reward efficiency and outcomes

• Ownership returns to providers when market thresholds are met

You generate the value. Arete ensures you keep more of it.

Day 8: Research, Evidence & Policy Influence

Challenge: RCTs don’t reflect the real-world impact of DCs and PTs. Claims data misrepresents value. The result: limited influence in payer decisions.

Arete Solution: Arete is already generating real-world, practice-based data through:

• EHR-integrated outcome tracking

• Patient-reported experience and resolution metrics

• Functional outcome and time-to-resolution reporting

• Population-level analysis to support policy and contracting

This is research from practice, not theory. The kind that payers, employers, and policymakers are demanding.

The Policy Shift: The Moment Is Now

The industry is catching up with what Arete has built:

• Medicare's expanded focus on low back pain and non-pharmacologic care signals that conservative care will increasingly be built into value-based frameworks.

• Arete recently announced one of the most innovative collaborations ever in MSK management, a value-based partnership with one of the country’s largest primary care entities. This is a model for all value-based primary care groups and the Arete Network.

• Commercial insurers are rapidly developing value-based payment programs for MSK, many of which Arete is already engaged in or piloting.

These policy and payer shifts aren’t hypothetical. They are happening now—and Arete is already positioned at the table.

Clinically Integrated Networks: The Inevitable Future

Across healthcare, CINs have become the standard for organizing care around value. In primary care, cardiology, and orthopedics, CINs have:

• Improved access

• Reduced cost

• Increased revenue per visit through shared savings

• Enabled providers to negotiate from strength, not isolation

Outpatient rehab is no different. Chiropractors and physical therapists must organize or be organized. There is no sustainable future in remaining fragmented.

Why Arete Is the Leader

• Proven model: Over a decade of network development and success, with expanding payer contracts and referral partnerships

• Built by providers: Governed and managed by member clinics—not outside capital

• High-impact contracts: Already driving revenue growth across multiple states

• MSO-backed: Arete Services supports every operational need, from claims to credentialing

• Data-first strategy: Built to publish the outcomes payers and policymakers are now prioritizing

Arete isn’t waiting for the system to change. Arete is the system creating change.

Conclusion: Time to Act

Every insight from this 9-Day Challenge points to a single conclusion:

Independently owned chiropractic and physical therapy clinics must organize to survive and thrive.

Clinically integrated networks are the path forward. And Arete is the blueprint.

• If you want fair reimbursement—join Arete.

• If you want referrals and direct contracts—join Arete.

• If you want relief from admin overload—join Arete.

• If you want a say in your profession’s future—join Arete.

This isn’t just a network. This is a movement. And it’s already working.