Therapy Matters

The Axis
The Axis

Therapy Matters explores the ideas and innovations reshaping the leadership of rehabilitation therapy. Raintree Systems is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations.

Episodes

  1. 1d ago

    The Hidden 7%: What It Really Costs to Get Paid in Rehab Therapy-and How to Reduce It

    An experienced biller stuck on hold with an insurance company all afternoon is a cost many clinics quietly learn to accept.  Nick Hedges, CEO of Raintree, calls revenue cycle management the most expensive, most human-hours-lost problem in the entire industry, and his clients spend 7% or more of everything they collect just to get paid.  That number is why Raintree acquired Spike Technologies, the agentic AI company Povilas Gudzius co-founded after earning his PhD in machine learning. Hear why the fix is not more staff or cheaper offshore labor, but AI that can think its way through a payer call. Hedges walks through why robotic process automation keeps breaking. When a payer moves one button on a portal, the bot fails and claims stop going out the door. For a business that runs on cash flow, a broken bot nobody noticed is a serious payroll problem waiting to happen. Gudzius makes the case for what he calls objective-oriented orchestration: instead of scripting every step, you hand an AI agent a goal and let it find its own path, adapting live when a human on the other end of the phone says something unexpected. This is the difference between a system that follows rules and one that can actually hold a conversation. The larger vision is what Hedges calls the invisible EMR, software that quietly handles the work no one went to school to do, so therapists, billers, and front-desk staff spend their time on people instead of keyboards. Both are clear that humans do not disappear; someone still has to orchestrate at the top and catch the edge cases AI cannot. If your practice is spending 7% to collect what it is already owed, this conversation reveals exactly where that money goes and what it could look like at one percent instead. Nick Hedges Chief Executive Officer, Raintree Systems Nick Hedges leads Raintree, the EMR and practice management platform trusted by many of the largest rehab therapy organizations in the country. He became CEO in 2022 after a 25-year career building high-growth software companies, including Velocify, which he led for a decade before its sale to Ellie Mae, and MomentFeed.  A veteran of Bain & Company and Accenture and a Harvard Business School graduate, he moved into healthcare looking for work that would make a real dent, and found it in rehab therapy. Today he is betting Raintree's future on becoming AI-native, so practices can spend less on administration and more on patients. Connect with Nick Hedges on LinkedIn: https://www.linkedin.com/in/nickhedges/ Learn more about Raintree: https://www.raintreeinc.com/ Povilas Gudzius, PhD Co-founder & CEO, Spike Technologies Povilas Gudzius is the co-founder and CEO of Spike Technologies, an agentic AI company he built with co-founder Nikita Pajanok to bring machine-learning-grade automation to health data.  He spent seven years earning a PhD in machine learning, set on that path by Ray Kurzweil's The Singularity Is Near, and previously worked in data and AI technology sales at Bloomberg. His team's technology powers a single API connecting hundreds of wearables, devices, and medical records, and now, through Raintree, an agentic layer aimed at automating the revenue cycle across U.S. rehab therapy. He describes himself and his fellow founders as scientists who fell in love with an industry most people find impossibly complex. Connect with Povilas Gudzius on LinkedIn: https://www.linkedin.com/in/gudzius Learn more about Spike Technologies: https://www.spikeapi.com/ Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes. Connect with Sarina Richard on LinkedIn: https://www.linkedin.com/in/sarinarichard/ About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree: https://www.raintreeinc.com/request-a-demo/

    The Hidden 7%: What It Really Costs to Get Paid in Rehab Therapy-and How to Reduce It

  2. Jun 29

    Building a Forever Company in Physical Therapy

    Forty-one years in, the chairman of one of America’s largest publicly traded rehab operators still runs his playbook on a single principle: people. Chris Reading leads U.S. Physical Therapy from Houston, oversees more than 800 clinics across 40-plus states, and started his clinical life treating ACLs and complicated shoulders in Virginia. What separates USPH from the rest of the consolidation conversation is structure. Where private equity buys with the intent to sell in three to five years, Reading describes his company as a permanent home for the local entrepreneurs it partners with — same ticker, same balance sheet, no recap on the horizon. Sarina Richard asks him what that model actually changes for a partner, and what it asks of the leader sitting in the chair. Reading walks through how he scaled culture across hundreds of markets without flattening it. Local partners shape what their market culture feels like; the foundation stays consistent enough to avoid friction. He is also direct about the cost of getting it wrong, including why he eventually left HealthSouth and brought the best of his old team with him. He also tells the origin story of APTQI — a single phone call about an AMA/APTA coding initiative that would have rewritten how outpatient therapy bills and codes. The meeting at NCAA headquarters in Chicago that followed became the seed of an industry coalition that now keeps fierce competitors at the same table for the greater good. On reimbursement, Reading argues that small practices accepting low commercial rates set the floor for everyone, and shares the Richmond case-rate story where he kicked out the negotiator and his biggest competitor took the deal and nearly broke itself trying to honor it. He also makes the case for physical therapy as musculoskeletal primary care, and for why the profession cannot wait another 41 years for the system to catch up. If you are weighing whether to sell, partner, hold the line on a contract, or rethink how your clinic shows up in the local healthcare ecosystem, Reading’s 41-year view is an hour well spent. Chris Reading Chairman and CEO, U.S. Physical Therapy, Inc. (NYSE: USPH) Chris Reading is chairman and CEO of U.S. Physical Therapy, Inc. (NYSE: USPH), one of the largest publicly traded operators of outpatient physical therapy clinics in the United States. He joined USPH as chief operating officer in 2003, became president and CEO in 2004, and was named chairman in 2024. Under his leadership, the company has scaled to more than 800 clinics across 40-plus states through a partnership model that keeps local operators in control of the businesses they built. Before USPH, Reading spent more than a decade at HealthSouth in operations and senior leadership roles spanning rehab, ambulatory surgery, imaging, and rehab hospitals. He graduated magna cum laude from the Medical College of Virginia in 1985 and is a co-leader of APTQI, the industry coalition he helped form to advocate for outpatient rehab providers in Washington. Connect with Chris Reading on LinkedIn Learn more about U.S. Physical Therapy Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes. Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations.Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    Building a Forever Company in Physical Therapy

  3. May 13

    The People-First Playbook for Scaling a Regional PT Practice

    Al Moreau grew up in the world of physical therapy. His father founded Moreau Physical Therapy in 1977, and today Al leads that same network across more than 26 locations in Louisiana and Texas.  Building on a family legacy isn't just about honoring the past. For Al, it means pushing the practice forward while staying rooted in the values that made it matter in the first place. Al's approach to scaling starts long before a new clinic opens. Rather than hiring for headcount, he identifies clinicians with leadership potential and builds expansion plans around them, training directors in-house, investing heavily in continuing education, and creating career pathways that give ambitious therapists a real reason to stay and grow. When it comes to acquisitions, Al has a clear rule: he won't buy a job. Moreau PT only pursues deals where an existing, staffed team is already in place and culturally aligned. In rural markets where hiring is already a challenge, acquiring a solo-operator practice and watching the founder walk out the door isn't a growth strategy — it's a staffing crisis waiting to happen. Recruiting to rural East Texas and North Louisiana is one of Al's most persistent challenges. With Houston just an hour from some of their Texas locations, the competition for talent is constant. And while artificial intelligence holds real promise — Moreau PT is actively piloting AI scribes and compliance tools — the rollout requires as much care as the technology itself. If you're building a practice and wondering how to grow without losing what makes it special, this episode is your blueprint. Al Moreau Owner, Moreau Physical Therapy Al Moreau is the owner of Moreau Physical Therapy, a multi-specialty rehabilitation network his father founded in 1977 that now spans more than 26 locations across Louisiana and Texas. He leads the organization with a people-first philosophy rooted in the belief that sustainable growth comes from investing in the right people, not just opening new doors. Known for building strong internal leadership pipelines, Al has developed formal programs to grow clinicians into directors and guide the next generation of practice leaders. Under his leadership, Moreau PT has expanded into rural markets across two states while maintaining a close-knit culture built on mentorship, community, and the core value of growing together. Connect with Al Moreau on LinkedIn Learn more about Moreau Physical Therapy Follow Moreau Physical Therapy on Instagram @moreaupt Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes. Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    The People-First Playbook for Scaling a Regional PT Practice

  4. Apr 1

    The Career Curveball That Turned a Small PT Clinic Into a Market Leader

    Dan Rootenberg’s career changed course not because of a big win—but because a dream fell apart. On track for a professional baseball career, the 1994 MLB strike ended his dreams in an instant and forced him to rethink his future. When another student no-showed on the first day of PT school, a last-minute acceptance led Dan to find his footing in physical therapy. With just $6000, he co-founded Spear Physical Therapy in 1999 in a rented room inside a gym with the belief that clinical excellence and five-star service should go hand in hand for patients and staff alike. That people-first philosophy fueled their growth, from data-driven hiring and leadership development to bold pandemic decisions like signing new leases, refusing layoffs, and cutting executive pay to zero. After COVID, these decisions helped Spear emerge as the clear market leader in NYC. Dan shares how his leadership evolved from hustle to clarity, why a CEO’s real job is being a “sense maker,” and what it takes to build a culture strong enough to scale and survive. GUEST Dan Rootenberg Co-Founder & CEO, Spear Physical Therapy Dan Rootenberg is the CEO of Spear, the only two-time National Practice of the Year award winner. Dan co-founded Spear in 1999, working out of a small treatment room in midtown Manhattan. He had a singular vision for combining clinical excellence with a five-star customer service experience. Spear has since grown to 77 locations throughout NYC, Westchester, Long Island, New Jersey and CT, employing over 1100 people currently and is continuing to expand further. Connect with Dan Rootenberg on LinkedIn Learn more about Spear Physical Therapy Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes.   Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    The Career Curveball That Turned a Small PT Clinic Into a Market Leader

  5. Feb 18

    The Heart & Hustle of PT: How People-First Leadership Builds Stronger Teams

    An injury in high school introduced Tony Mikla to physical therapy—but it was the frustration of that experience that sparked his lifelong mission to help athletes recover faster and perform at their best.  Today, as a leading voice in sports orthopedics with clinics across Sacramento, Reno, and Las Vegas, Tony has built a model of care that redefines what a thriving workplace looks like in healthcare. Tony’s path from injured athlete to clinic founder wasn’t just about mastering rehabilitation—it was building a people-first company that attracts passionate talent, brings in fresh ideas from outside healthcare, and thrives even in the tough world of insurance and reimbursement. With new technology, Tony believes AI is the key to bringing the human element back to healthcare, using AI to slash documentation time and shift more focus to patients. Whether you’re a clinic owner, physical therapist, or just curious about the future of sports medicine, Tony offers practical lessons on building culture, embracing innovation, and leading with purpose. Tony Mikla, DPT, CSCS, XPS Physical Therapist, Strength Coach & Founder of KIME Performance Tony is a leading sports physical therapist, performance coach, and researcher. He speaks and teaches nationally on sports physical therapy and regularly publishes research in international journals. Tony previously served as the Physical Therapy Manager at the world-renowned EXOS in Phoenix, AZ, working with some of the best athletes in the world. He was the Medical Director for the Sacramento Sports Commission and adjunct faculty in Physical Therapy at Sacramento State University and Northern AZ University. In 2015, Tony was named a finalist for the NSCA Sports Medicine Specialist of the Year and was awarded the 40 Under 40 Award from the Sacramento Business Journal in 2017. Connect with Tony Mikla on LinkedIn Learn more about KIME Performance Follow KIME on Instagram @kimeperformancept Listen to KIME’s podcast, KIMEcast Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes. Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    The Heart & Hustle of PT: How People-First Leadership Builds Stronger Teams

  6. Jan 21

    Making The Case for Physical Therapy as Primary Care

    Dr. Anthony Buccafurni never planned on becoming a CEO. He started as a sports-focused physical therapist, raised by a pediatric nurse mom and a hospital administrator dad—giving him an early, front-row seat to both sides of the American healthcare system. When he began working with older adults on the brink of losing their independence, his path shifted to FOX Rehabilitation and a mission-driven career to help people stay safely in their homes as long as possible. Along the way, he realized leadership gave him the chance to impact far more patients and clinicians than he ever could one-on-one. He explains why rehab therapy has long been undervalued and how policy decisions have quietly treated therapists as “specialists,” leading to years of cuts. He argues therapy should be viewed as primary care for movement, function, and prevention, not a last stop after something goes wrong. Dr. Buccafurni also shares how FOX has built a culture rooted in craft, community, and cause, where advocacy is part of the job, not an extra. Hear his hopes for the future of the PT industry, from the idea of “discharge” fading away to the profession speaking with one loud, unified voice. GUEST Anthony Buccafurni, PT, DPT CEO of FOX Rehabilitation Dr. Anthony Buccafurni is a practicing Physical Therapist and Chief Operating Officer of FOX. Dr. Buccafurni joined FOX as a full-time clinician in 2003 and was quickly promoted to regional field leadership. During his early leadership at FOX, Dr. Buccafurni was instrumental to the expansion of FOX into Atlantic, Ocean, and Monmouth Counties in New Jersey.  During his years as Executive Vice President of Operations, Dr. Buccafurni used his change management expertise to successfully reorganize Quality Assurance and Professional Development, Sales, and Admissions while leading Clinical Operations. Connect with Anthony Buccafurni on LinkedIn Learn more about FOX Rehabilitation Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes.   Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    Making The Case for Physical Therapy as Primary Care

  7. 12/17/2025

    PT Leadership Against the Current: AI, Access, and the Fight for a Better PT Model

    Simon Hargus turned a small family clinic into a 50-location practice serving rural Ohio and West Virginia without losing the heart of hands-on, patient-first care. He leads with intention, focusing on culture over scale. By creating individualized career paths and flexible opportunities, Simon helps therapists build meaningful, lasting careers instead of following a one-size-fits-all model. He opens up about the journey behind First Settlement Physical Therapy—how he built a place people want to grow, what it takes to recruit in a post-COVID world, and how to keep quality care alive when volume often wins. Hear why he believes advocacy, creativity, and a touch of innovation are key to securing the future of physical therapy. Simon Hargus Owner and CEO of First Settlement Physical Therapy Simon Hargus is the owner of First Settlement Physical Therapy, a family-run practice that’s grown to about 50 clinics and 300 employees serving rural Ohio and West Virginia. A PT who moved from the clinic to the C‑suite, he’s known for building a people‑first culture, long‑form patient care, and individualized career paths to curb burnout. He’s active in advocacy, pushing for state‑level wins and a stronger political voice for PT, and he embraces practical tech like AI scribe tools where they deliver real ROI. Learn more about First Settlement Physical Therapy Connect with Simon Hargus on LinkedIn Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes.   Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    PT Leadership Against the Current: AI, Access, and the Fight for a Better PT Model

  8. 11/19/2025

    Built to Last: The Inspirational PT Leadership Model That Preserves Culture While Scaling Growth

    Aaron Kraai’s fascination with movement as a teen grew into a lifelong mission. Mentored by clinic owners, he learned both the science of physical therapy and the business behind it—folding towels, scouting locations, and negotiating leases before he even had a title. Years later, he enlisted his family to launch Doctors of Physical Therapy, painting walls and assembling equipment by hand. Today, DPT has grown to over 160 clinics nationwide. Central to its success is a culture of “brutal honesty, transparency, and trust.” Aaron hires for character first and keeps it personal, texting staff to celebrate milestones across a 1,700-member team. Aaron leads with transparency, authenticity, and an unwavering belief in building businesses that put ethics and relationships before profit. He shares the lessons, challenges, and leadership insights that helped him build a thriving, mission-driven company—giving you practical takeaways for leading with purpose and growing with heart.  Aaron Kraai Founder and CEO of Doctors of Physical Therapy (DPT) Aaron Kraai is the founder and CEO of Doctors of Physical Therapy, one of the fastest‑growing PT organizations in the U.S. A lifelong learner in the field, Aaron started working in physical therapy at just 14 years old and grew his company from a single clinic into a national brand rooted in honesty, family, and servant leadership. In 2024, he was honored with USC's Distinguished Alumnus Award, recognizing his years of dedication to advancing DPT and championing physical therapy as a profession.  Learn more about Doctors of Physical Therapy Connect with Aaron Kraai on LinkedIn Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes.   Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    Built to Last: The Inspirational PT Leadership Model That Preserves Culture While Scaling Growth

  9. 10/17/2025

    The Science & Soul of PT: Why the Left-Right Brain Combination is the Secret to Great Leadership

    Musculoskeletal conditions account for an astonishing one-third of all healthcare costs. Brady Hill, CEO of Cypress Health Partners, believes physical therapy should play a central role in solving that problem—and he’s proving that it can. With a career path that’s anything but traditional, Brady has built a thriving enterprise by combining analytical precision with emotional intelligence. He draws on both sides of the brain to strike balance: using the “left brain” to drive systems, analytics, and scalable processes, and the “right brain” to inspire creativity, connection, and purpose in his leadership. When it comes to acquisitions, Cypress is far from cookie-cutter. Brady shares how his data-driven yet people-first approach helps identify partners who truly align with the company’s mission. Beyond expansion, he’s advocating for smarter reimbursement models that reward physical therapists for the value they deliver—not just the hours they bill. From the hard lessons of startup life to his bold vision for a better healthcare system, Brady offers a roadmap for purposeful leadership, sustained motivation, and a future where physical therapy plays a larger role in keeping people healthy. Brady Hill, CEO Cypress Health Partners Brady is the CEO of Cypress Health Partners, the leading provider of physical therapy and musculoskeletal health in the Northeast. He advances innovative care models that emphasize prevention, early intervention, and better patient outcomes. Drawing on broad experience in strategy, investing, and pediatric home healthcare, Brady is committed to expanding access and helping both patients and providers reach their potential. Learn more about Cypress Health Partners Connect with Brady Hill on LinkedIn Sarina Richard Chief Strategy Officer, Raintree Systems Sarina Richard has spent twenty years as a Healthcare Technology Executive across the healthcare continuum, from operator to service provider to financier. At Raintree, Sarina oversees corporate strategic planning and leads cross-departmental initiatives to build best-in-class teams, systems, and processes.   Connect with Sarina Richard on LinkedIn About Raintree Raintree is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations. Discover why Raintree is the trusted EMR and practice management platform for the largest and most ambitious rehab therapy organizations in the U.S. Request a demo of Raintree

    The Science & Soul of PT: Why the Left-Right Brain Combination is the Secret to Great Leadership
  • 9 Episodes

About

Therapy Matters explores the ideas and innovations reshaping the leadership of rehabilitation therapy. Raintree Systems is the rehabilitation and physical therapy software of choice for enterprise and large therapy provider organizations.

Information

  • Channel
    The Axis
  • Creator
    Raintree Inc.
  • Years Active
    2025 - 2026
  • Episodes
    9
  • Rating
    Clean
  • Copyright
    © 2025
  • Show Website
    Therapy Matters

More From The Axis