The Better Outcomes Show

Rafael E. Salazar II, MHS, OTR/L
  • 5.0 (4)
  • Medicine
  • Updated Biweekly

Exploring the possibilities of a new healthcare. Let’s get real: Healthcare is broken. You know it. I know it. Every clinician who came into this field from a desire to care for others, knows this to be undeniably true. We feel it everyday when we enter our clinics, hospitals, and practices. We feel the burden of time-based productivity metrics, utilization rates, and the expectation to behave like cogs in a giant, soul-crushing machine aimed at extracting revenue from our patients in exchange for “units” of treatment. Healthcare should be about one thing: PEOPLE! Yet how many clinics, organizations, or healthcare professionals live their lives by the numbers? Metrics & spreadsheets drive most of our healthcare decision makers and administrators. That leaves patients -the people we serve- lost in the mix. Patient’s feel lost, forgotten, and ignored by a system that prioritizes efficiency & productivity over their own personal experiences, priorities, or goals. It’s time for clinicians to finally stand up and say what we’ve all been thinking for so long: enough is enough! It’s time for healthcare organizations to commit to serving the individual needs of each unique patient that they are charged with serving. Join Rafael E. Salazar II, MHS, OTR/L (Rafi), principal of Rehab U Practice Solutions and host of The Better Outcomes Show as he explores the possibilities of a new healthcare. Guests range from clinicians trying new techniques and treatments to executives and entrepreneurs exploring new service delivery methods, business models, and organizational structures.

  1. 169: The Medicare Fraud Case Every Outpatient Therapist Should Study

    4d ago

    169: The Medicare Fraud Case Every Outpatient Therapist Should Study

    The Medicare Fraud Case Every Therapist Should StudyA recent Medicare fraud case involving an outpatient therapy organization has resulted in prison sentences for clinic owners, convictions for multiple staff members, and hundreds of thousands of dollars in restitution orders. While the allegations included intentional fraud and manipulation of patient schedules, the case also shines a light on operational practices that many therapists have encountered throughout their careers. In this episode, we discuss what happened, why it matters to every clinician and clinic owner, and the uncomfortable reality that some common outpatient therapy business models can create significant legal and ethical risk. Because when it comes to Medicare billing, the question isn't what your employer told you to do.The question is whether the services billed accurately reflect the care that was actually provided. What We Cover in This Episode:The Medicare Fraud Case That Has Been Years in the MakingWe review the details of a high-profile outpatient therapy fraud case involving allegations of unlicensed personnel providing treatment, manipulation of patient schedules, and billing practices that misrepresented the care delivered. Why Common Operational Practices Can Create Serious Legal RiskMany therapists have worked in environments with concurrent scheduling, heavy productivity demands, and extensive use of aides or technicians. We discuss why these systems can increase the likelihood of billing inaccuracies and compliance problems—even when fraud is not the intent. Your License, NPI, and Signature MatterOne of the most important lessons from this case is that liability does not always stop with ownership. Clinicians, directors, and managers can also be held accountable when documentation and billing fail to accurately reflect patient care. How Payers Are Becoming More Aggressive in Auditing Therapy ServicesInsurance companies and government payers have more tools than ever to identify billing irregularities. From data analytics to direct patient interviews, healthcare organizations should expect increased scrutiny regarding treatment delivery and documentation practices. Why "Everyone Does It" Is Not a Compliance StrategyMany questionable practices become normalized over time. We explore the dangers of relying on industry norms rather than payer regulations, compliance standards, and ethical clinical decision-making. Building a Sustainable Practice Without Compliance ShortcutsFor clinic owners and leaders, the lesson extends beyond fraud prevention. We discuss how operational systems, scheduling models, documentation expectations, and organizational culture all contribute to long-term sustainability and risk management. Key Takeaways:-Medicare fraud cases often begin with operational practices that become normalized over time.-Clinicians can face consequences alongside owners and executives when documentation and billing are inaccurate.-Concurrent scheduling and productivity pressure can increase the risk of billing errors and compliance violations.-Payers are increasingly using audits, analytics, and patient interviews to verify services rendered.-Your license, NPI number, and signature carry legal responsibility.-Ethical clinical practice and accurate documentation remain the strongest forms of professional protection. Resources & ReferencesU.S. Department of Justice Sentencing Announcement: Full episode note Podcast: https://www.betteroutcomes.showGet a Book:  "Better Outcomes: A Guide to Humanizing Healthcare": https://amzn.to/3M2UZ6x"From Clinician to Something More": https://amzn.to/4fpx69T"From Clinician to Owner": https://amzn.to/4u7fFOZBook a call with me: https://calendly.com/rehabu/discoveryConnect with Me: https://www.rafisalazar.com If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    42 min
  2. 168: Career Advice For Healthcare Professionals

    Jun 3

    168: Career Advice For Healthcare Professionals

    Full episode note: https://rehabupracticesolutions.com/better-outcomes-168 Podcast: https://www.betteroutcomes.showGet a Book:  "Better Outcomes: A Guide to Humanizing Healthcare": https://amzn.to/3M2UZ6x"From Clinician to Something More": https://amzn.to/4fpx69T"From Clinician to Owner": https://amzn.to/4u7fFOZBook a call with me: https://calendly.com/rehabu/discoveryConnect with Me: https://www.rafisalazar.com 168: Don’t Let Go of the Vine Too EarlyPatience, Career Pivots, & Strategic Transitions in Healthcare What do you do when the career you worked so hard for turns out to be nothing like you expected? In this episode of The Better Outcomes Show, I share a story from early in my career that completely changed how I think about work, leadership, career transitions, and difficult seasons. Only weeks into my first “real” clinical job after graduation, I found myself trapped in an unhealthy work environment, questioning my career choice, and seriously considering walking away entirely. Then my dad asked me a strange question in a Dunkin’ Donuts parking lot:“Do you know why Tarzan never fell out of the sky when he was swinging through the trees?” That conversation became one of the most important professional lessons I’ve ever learned. In this episode, we explore the difference between being stuck and being strategic, why emotional decisions can derail long-term growth, and how patience—when used correctly—is not weakness, but positioning. In This Episode, We Discuss:-The reality shock many healthcare professionals experience early in their careers-How toxic environments can distort your perception of an entire profession-Ethical pressure, workplace culture, and maintaining professional integrity-Why emotional career decisions often create unnecessary instability-The difference between patience and passivity-Strategic career pivots vs reactive exits-How difficult seasons can unexpectedly prepare you for future opportunities-Why some of the most important career growth happens quietly behind the scenes Key Takeaway:Not every hard situation needs an immediate escape plan.Sometimes the better move is enduring it long enough to position yourself for something better. If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    39 min
  3. 167: What Clinical Education Didn't Teach You (And Why IT Matters More Than You Think)

    May 13

    167: What Clinical Education Didn't Teach You (And Why IT Matters More Than You Think)

    What's one thing that you think was missing from your clinical education? That's the question I got asked on a recent speaking engagement. We were covering the topics of clinical education, professional development, and growth into leadership roles within healthcare. Most clinicians graduate knowing how to treat patients. Very few graduate understanding the business systems that make patient care possible. After speaking with students and faculty at Bowling Green State University, one question kept surfacing: “What do you wish you had known coming out of school?” The answer wasn’t another certification, clinical framework, or specialty area. It was business literacy. In this episode, we explore the hidden curriculum of healthcare — the financial, operational, and strategic realities that shape modern clinical practice but are rarely taught in OT or healthcare programs. Because whether you plan to own a practice, lead a team, negotiate compensation, or simply understand why healthcare organizations make the decisions they do, understanding the business side of healthcare changes everything. The clinicians who advance aren’t just clinically skilled.They understand the system they operate inside of. What we cover in this episode: -Why clinical excellence is not enough-The gap between clinical education and real-world practices-Why business literacy matters even if you never plan to own a practice-The financial engine driving the healthcare industry (in the US)-The future of healthcare reimbursement and delivery-Viewing your clinical education as the foundation, not the ceiling.  Full episode note: https://rehabupracticesolutions.com/better-outcomes-167 Podcast: https://www.betteroutcomes.showGet the Book: https://amzn.to/3M2UZ6xBook a call with me: https://calendly.com/rehabu/discoveryConnect with Me: https://www.rafisalazar.com If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    48 min
  4. 166: Why MSK is the Next Healthcare Battleground

    Apr 1

    166: Why MSK is the Next Healthcare Battleground

    The Battle for MSK Care Is Already UnderwayMusculoskeletal care is quietly becoming one of the most important battlegrounds in healthcare.MSK conditions affect over 120 million Americans, account for roughly $420 billion in annual healthcare spending, and remain the leading cause of disability worldwide.And because of that, nearly every major stakeholder in healthcare is moving into this space.Digital health companies.Employers.Payers.Orthopedic groups.Health systems.Wearable tech companies.They’re all competing for one thing:Control of the musculoskeletal patient relationship.Because whoever controls the entry point into MSK care often controls everything that follows—from imaging and therapy to injections, surgery, and long-term outcomes.In this episode, we take a step back and look at what’s really happening in the MSK space—and why this moment represents more than just innovation. It represents a fundamental shift in how care is delivered. What we cover in this Episode:-Why Musculoskeletal Care Has Become a $420B Healthcare CategoryMSK is one of the largest drivers of healthcare spending, disability, and lost productivity in the United States.-Why the Current MSK System Is So FragmentedHow disconnected care pathways create inefficiencies—and opportunities for disruption.-The 4 Competing Models of MSK CareProcedure-centric, therapy-centric, digital-first, and hybrid care models—and how they’re competing for control of the patient journey.-Why Policy and Payment Models Are Beginning to ShiftHow CMS initiatives like the ACCESS model and the expansion of RTM are beginning to support more coordinated, longitudinal care.-Why Technology Alone Won’t Solve the ProblemThe role of clinicians in guiding movement, behavior change, and long-term capacity building.-Why the Future of MSK Care Will Likely Be HybridHow digital tools and clinical expertise are coming together to reshape care delivery. Full episode note: https://rehabupracticesolutions.com/better-outcomes-166 Podcast: https://www.betteroutcomes.showGet the Book: https://amzn.to/3M2UZ6xBook a call with me: https://calendly.com/rehabu/discoveryConnect with Me: https://www.rafisalazar.com If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    48 min
  5. 165: The Affordability Crisis of Healthcare Education

    Feb 18

    165: The Affordability Crisis of Healthcare Education

    The Department of Education’s proposed loan cap changes have sparked strong reactions across healthcare, including within occupational therapy and physical therapy circles. Much of the conversation has focused on whether these degrees should be classified as “professional degrees” versus “graduate programs.”But that may be the wrong fight. In this episode, we zoom out and ask three deeper questions about the economics of certain healthcare education programs— questions that matter far more than federal loan labels. Whether the DOE calls us “professional” or not doesn’t change the structural issues facing our professions. What we cover in this episode:-Why Has the Cost of Healthcare Education Become So Disconnected from Salary?-The gap between education cost and earning power continues to widen.-Why Have Clinical Salaries Been Flat (or Declining) in Real Terms?-How tightening margins have forced productivity demands higher in clinical settings. -Why we need to focus on making healthcare degrees a valuable financial investment, rather than career fields with negative ROIs  Full episode note: https://rehabupracticesolutions.com/better-outcomes-165 Podcast: https://www.betteroutcomes.showGet the Book: https://amzn.to/3M2UZ6xBook a call with me: https://calendly.com/rehabu/discoveryConnect with Me: https://www.rafisalazar.com If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    35 min
  6. 164: The Future of Healthcare Delivery

    Feb 11

    164: The Future of Healthcare Delivery

    RTM & Virtual Service Delivery Isn’t a Billing Add-On — It’s the Future of Healthcare Delivery In this episode, I break down one of the biggest misconceptions in modern rehab: the idea that Remote Therapeutic Monitoring (RTM) and virtual service delivery is just a billing perk, a revenue booster, or a marketing gimmick. It’s not. RTM and virtual services represent the next era of healthcare delivery— a shift toward hybrid, patient-centered, digitally augmented care that extends the clinician’s impact far beyond the clinic walls. In this episode, I explain why RTM and virtual matters, how it’s changing the role of clinicians, why patients now expect hybrid models, and why CMS is actively incentivizing it. If you’re a clinician, clinic owner, healthcare leader, or digital health innovator, this episode will challenge the way you think about care delivery. What we cover in this Episode: -Why RTM is NOT just a revenue strategy-The shift towards hybrid care-What today's patients expect from their care-How virtual healthcare & RTM elevate clinicians into their highest-value roles-Why CMS is incentivizing services like RTM and what it signals Full episode note: https://rehabupracticesolutions.com/better-outcomes-164 Podcast: https://www.betteroutcomes.showGet the Book: https://amzn.to/3M2UZ6xBook a call with me: https://calendly.com/rehabu/discoveryConnect with Me: https://www.rafisalazar.com If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    37 min
  7. 163: Why Clinical Decision-Making & Business Growth Are All About Reps

    11/05/2025

    163: Why Clinical Decision-Making & Business Growth Are All About Reps

    How do you actually get better — as a clinician, a business owner, or a leader? It’s not more school, another certification, or reading one more article. It’s reps. In this episode, I break down the single biggest piece of advice I give new clinicians (and anyone moving into leadership or entrepreneurship): your education is just your ticket to play — expertise comes from getting reps. We’ll explore: Why formal education is only the starting line, not the finish line How repeated exposure to patient cases sharpens pattern recognition and clinical decision-making What it really means to turn experience into wisdom through reflection Why this “reps + reflection” framework applies equally to business and leadership — hiring, marketing, launching new services Practical ways to accelerate growth in any career path without waiting years for confidence to catch up Why This Matters Confidence isn’t built in a classroom — it’s built in the field, one decision at a time. Business & leadership skills develop the same way as clinical ones — through lived experience and iteration. If you’re feeling “stuck” or unsure, the solution isn’t another credential — it’s getting in the game and stacking reps. Listen to the Episode to Hear … How to intentionally extract lessons from each patient, project, or business challenge Personal stories from my early days as a clinician and later as an entrepreneur Simple strategies to speed up growth without burning out — journaling, mentorship, and deliberate practice Encouragement to stop waiting for perfection and just start doing the work Full episode note: https://rehabupracticesolutions.com/better-outcomes-163 Podcast: https://www.betteroutcomes.showGet the Book: https://amzn.to/3M2UZ6xBook a call with me: https://calendly.com/rehabu/discoveryConnect with Me: https://www.rafisalazar.com If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    42 min
  8. 162: Why PT & OT Programs Are Struggling to Attract Applicants

    10/01/2025

    162: Why PT & OT Programs Are Struggling to Attract Applicants

    In this episode of the Better Outcomes Show, we take a look at a recent conversation on LinkedIn about the steep decline in occupational therapy (and physical therapy) school applications. A post by Sarah Lyon raised an important question: Why are fewer students choosing OT, and what does that mean for the future of the profession? In response, Rafi shared several factors that may be contributing to the decline — and in this episode, he unpacks those ideas in more detail. What we cover in this episode:- Why confusion about OT entry-level requirements (Master’s vs. OTD) is discouraging prospective applicants.- How rising tuition and questionable ROI impact PT/OT’s attractiveness compared to other health professions.- The role of corporate healthcare and private equity in fueling burnout — and how that shapes the profession’s reputation.- Why other clinical degrees often carry higher compensation ceilings and broader leadership opportunities.- What these trends mean for the future — and why this might actually be a unique opportunity for new students entering PT/OT now. If you'd like to learn more about Strata EMR & RCM and achieving a 99.99% reimbursement rate for your PT, OT, or SLP Clinic head over to stratapt.com and book a demo with their team!

    30 min
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Ratings & Reviews

5
out of 5
4 Ratings

About

Exploring the possibilities of a new healthcare. Let’s get real: Healthcare is broken. You know it. I know it. Every clinician who came into this field from a desire to care for others, knows this to be undeniably true. We feel it everyday when we enter our clinics, hospitals, and practices. We feel the burden of time-based productivity metrics, utilization rates, and the expectation to behave like cogs in a giant, soul-crushing machine aimed at extracting revenue from our patients in exchange for “units” of treatment. Healthcare should be about one thing: PEOPLE! Yet how many clinics, organizations, or healthcare professionals live their lives by the numbers? Metrics & spreadsheets drive most of our healthcare decision makers and administrators. That leaves patients -the people we serve- lost in the mix. Patient’s feel lost, forgotten, and ignored by a system that prioritizes efficiency & productivity over their own personal experiences, priorities, or goals. It’s time for clinicians to finally stand up and say what we’ve all been thinking for so long: enough is enough! It’s time for healthcare organizations to commit to serving the individual needs of each unique patient that they are charged with serving. Join Rafael E. Salazar II, MHS, OTR/L (Rafi), principal of Rehab U Practice Solutions and host of The Better Outcomes Show as he explores the possibilities of a new healthcare. Guests range from clinicians trying new techniques and treatments to executives and entrepreneurs exploring new service delivery methods, business models, and organizational structures.

Information

  • Creator
    Rafael E. Salazar II, MHS, OTR/L
  • Years Active
    2020 - 2026
  • Episodes
    170
  • Rating
    Clean
  • Copyright
    © Copyright Rehab U Practice Solutions (SALAZAR ENTERPRISE, LLC). All Rights Reserved.
  • Show Website
    The Better Outcomes Show

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