Economic and Managerial Drivers of Telerehabilitation Adoption in Outpatient Physical Therapy: A Cost-Effectiveness and Operational Efficiency Analysis

Abstract

Background: While telerehabilitation has proven clinically effective, its post-pandemic integration into routine outpatient practice remains uneven. Sustainable adoption depends on economic viability, resource allocation, and workflow management.

Objective: To evaluate the cost-effectiveness, return on investment (ROI), and operational performance of integrating a hybrid telerehabilitation model into outpatient physical therapy clinics.

Methods: A 12-month prospective comparative cohort study was conducted across 12 outpatient rehabilitation facilities. Clinics were assigned either to a Traditional In-Person Model (n = 6) or a Hybrid Telerehabilitation Model (n = 6). Key metrics evaluated included cost per episode of care (CPEC), missed appointment/cancellation rates, therapist productivity (billable units/hour), clinic overhead expenses, and Quality-Adjusted Life Years (QALYs) gained.

Results: The hybrid model demonstrated a 24.2% reduction in overall CPEC ($310 vs. $409, p < .001) and reduced missed appointments from 18.5% to 6.2% (p < .001). Therapist capacity utilization increased by 14.8%. Incremental Cost-Effectiveness Ratio (ICER) analysis showed that hybrid telerehabilitation was a dominant strategy, offering higher QALY gains at lower total delivery costs.

Conclusion: Strategic integration of telerehabilitation improves clinical access while significantly lowering operational costs and overhead. Aligning rehabilitation management with economic incentives is critical for long-term health system sustainability.