We brought Practice Independence offline for one night (PIN #24)

A dinner with independent practice leaders—founders and CEOs managing anywhere from 3 to 70+ locations–works when the focus isn't about the scale of it. 

When the room is small, the conversation can openly focus on what's working, what's breaking, and where we're headed in the independent practice space..why getting the hierarchy right matters more than any tech upgrade.

The First Supper 🔦 

On November 12th, Dan Vapne, DPT (Owner @ Advantage PT) hosted an invite-only dinner with the Practice Independence community here at Indie Health, bringing together 22 of the most forward-thinking leaders in independent healthcare.

Founders, CEOs, MSO operators, and practice owners managing anywhere from 3 to 70+ locations across New York, New Jersey, Connecticut, Georgia, and Florida, as well as APTA's incoming President joined us. 

Intimacy is what allows a night like this to work. 

Introductions covering business details and 2026 goals flowed into organic conversation over exceptional food. 

What stood out most was the honesty at the table. 

No vendor pitches. No sanitized presentations. Just real conversation about what's working, what's breaking, and where independent practices are headed.

Some of our guests shared:

• How their practice shifted to out-of-network status

• How their IPA structure helped 39 independently owned clinics negotiate better rates under one tax ID

• How they achieved the first reimbursement increase they’ve seen in 16 years through careful IPA selection

• How they’ve moved verification and billing to offshore teams for their 25-year practice

The conversation kept circling back to core challenges. 

→ Reimbursement keeps sliding while costs rise. United and Cigna came up repeatedly as particularly low payers.
→ PT school costs have jumped from $25,000 to $60,000 per year.
→ Staffing pressure is hitting everyone. Hospitals are competing harder for the same talent pool.

Operations everywhere are strained under growing volume and administrative work.

There’s an appetite for innovative technology that can help mitigate these challenges and deliver measurable EBITDA improvement, but several owners mentioned feeling burned by AI vendors who over-promise and under-deliver. They’re skeptical of the noise.

MSO formation emerged as a clear trend, with multiple groups actively building management structures to increase negotiating power while maintaining PT ownership. 

It’s clear that everyone is focused on keeping practices independent rather than selling to corporate buyers.

These were the high-signal conversations we were having. A practice owner in Miami managing Brooklyn operations remotely comparing notes with someone running eight Syracuse locations, both walking away with specific ideas worth testing. And we want to keep having these conversations.

It's a reminder of how powerful community becomes when the right people are in the right room.

We hope you join us, because what became obvious that night is that profit and quality care are not at odds. Stronger margins enable better hiring, better patient experience, and more sustainable practices. 

That's the next chapter we're writing together.

Take care,
Indie

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If you’d like to host a dinner in your city with us, reply directly to this email. We can’t wait for the next one.

Pulse Check ❤️

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