How many SLP practices can see client progress across the whole caseload?

31% of SLP practices say they have a consistent, reliable way to track client progress. That’s the highest of the three disciplines (PT 16%, OT 24%).

→Why it matters. Knowing whether clients are progressing is the point of the work. It’s also the practice’s early-warning system: a client who has stalled is often the first sign of a scheduling, engagement, or billing problem. Practices that can see progress across the whole caseload catch those problems earlier. Across rehab therapy, thriving practices are twice as likely as those getting by or struggling to say they have enough visibility into client outcomes (38% vs. 18%).

SLPs have the clearest view of client progress of the three disciplines. Only 14% say they can’t tell whether their approach is working across the caseload (for PT it’s 40%, for OT 29%). Most SLPs also feel equipped to talk with clients about progress: about one in four (24%) say limited visibility gets in the way of those conversations, again the lowest of the three. Progress is visible, and it gets talked about.

The catch is time and scale. The most common barrier for SLPs is the one every discipline names: 42% say compliance, documentation, and paperwork crowd out outcomes tracking. And 23% say they can assess each client but can’t see patterns across the caseload. So a third of SLP practices have tracking that works. Most of the rest know how to see progress one client at a time, but can’t find the hours to see the full picture.

Why SLP practices can’t predict their cash flow

42% of SLP practices say cash flow is unpredictable and hard to plan around, the highest of the three disciplines (PT 38%, OT 31%).

→Why it matters. Money is the domain that decides whether everything else gets to continue, and it’s the one where a small practice has the least margin for surprise. A denied claim or a slow payer doesn’t stay a billing problem; it becomes a hiring decision, a raise you can’t give, a supply order you put off. Across rehab therapy, this is one of the sharpest separators between thriving and struggling practices: thriving practices are eight times as likely to say nothing significant blocks their view of the finances (38% vs. 4%), and far less likely to learn about a problem only after it has hit cash flow (18% vs. 52%).

Most SLP practices pay close attention to their finances. Two in five (41%) actively track them, and most can see the basics. Only 23% say they can’t tell what’s been billed, collected, and written off, and only 20% say they lack a benchmark for what good looks like, the lowest of the three disciplines. SLPs know their numbers. What they can’t do is predict them.

Insurance is the reason most often given: 55% name insurance complexity as a barrier to seeing their finances clearly. When the timing of your revenue depends on payers, a clear ledger tells you what happened, not what’s coming. The cost shows up downstream. 40% of SLP practices say they miss revenue leaks until they’ve compounded, and another 40% find out about problems only after they’ve hit cash flow. Among SLP practices that are getting by or struggling, that last figure rises to 59%.

What slows SLP practices down: documentation backlogs

40% of SLP practices say documentation backlogs are a top operational challenge. It’s the most common answer for SLPs.

→Why it matters. Operations is the domain nobody went to school for and everybody feels: the schedule, the notes, the authorizations, the handoffs. When it runs on a process, the practice keeps running when someone is out. When it runs on memory, one absence becomes a week of catching up. Across rehab therapy, thriving practices are three times as likely as struggling ones to handle operational problems with a defined process (35% vs. 11%), and far less likely to name scheduling (16% vs. 37%) or documentation (32% vs. 50%) as a problem at all. The problems don’t disappear in thriving practices. They get caught earlier.

For most SLP practices, the day-to-day holds up. About one in four say scheduling and coverage are unpredictable (24%) or that getting new clients started takes too long (26%), and one in five say information doesn’t flow reliably across the team (20%). Documentation is the exception. It’s the one operational problem a large share of SLP practices have in common (40%), and it’s the one with the longest tail: notes that fall behind create problems everywhere downstream, from billing to the next session.

The number that matters more is how problems get handled. Only 17% of SLP practices have a defined process for catching and fixing operational issues. 55% deal with problems as they come up and usually understand why they happened. That works in a small practice as long as the person who understands why is in the building. It stops working the day they’re not.

How often do SLP practices track clinician well-being?

67% of SLPs say that if the clinicians in their practice were thriving, the biggest improvement would be to their own quality of life as clinicians. That’s the most common answer among SLPs, ahead of a better practice culture (58%) or fewer burnout-driven disruptions to the schedule (50%), and it’s higher than the share of PTs (60%) or OTs (66%) who said the same.

→Why it matters. Clinician well-being is the domain rehab therapists say matters most and watch least: only one in five practices actively tracks it. In a small practice, it’s also the domain with the least slack. When one clinician is running on empty, it shows up within weeks as gaps in the schedule, notes that fall behind, and sessions that feel rushed to clients. Across rehab therapy, two habits separate thriving practices from struggling ones here: regular workload review (53% of thriving practices vs. 27% of struggling ones) and structured peer support (64% vs. 34%). Neither costs money. They just need a recurring spot on the calendar.

SLPs put the payoff of well-being on the person before the practice. Asked what would improve if their clinicians were thriving, SLPs are less likely than PTs or OTs to say the practice’s culture would improve (58% of SLPs, compared with 69% for PTs and OTs), and more likely to say their own quality of life would.

That makes the next number stand out. Only 32% of SLP practices review clinician workloads on a regular basis, the lowest of the three disciplines. Structured peer support is more common (46%), which means many SLP practices already have a standing meeting. Adding a workload check to it is the opportunity.

Do SLP practices know why clients stop coming?

42% of SLP practices are very confident they understand their clients’ experience, the highest of the three disciplines (PT 30%, OT 32%).

→Why it matters. Client experience is what keeps a family coming back, and it’s usually the first place a problem shows: a scheduling hassle, a confusing bill, a session that didn’t feel useful. Practices that hear about those things early keep the client. The ones that don’t, only find out when the calendar opens up. Across rehab therapy, this is where thriving and struggling practices differ most on any single question in the survey: thriving practices are nearly three times as likely to be very confident they understand their clients’ experience (69% vs. 24%), and twice as likely to have a consistent way of learning why clients leave (58% vs. 28%).

44% of SLP practices have a reliable process for finding out why a client stopped coming. Another 51% find out sometimes, when it happens to come up, but have no consistent way to ask. SLPs tend to work with families closely and for a long time, and it shows in how confident they are.

One thing gets in the way. Only 17% of SLP practices actively track client experience. Confidence is high; measurement is low. Our 2026 Practice Success℠ Report called this the tracking gap, and rehab therapy has it too: across all three disciplines, the space between feeling sure and checking is what separates doing well from thriving.

SLP practices already do the hard part: they can see their clients. The next step is turning the same attention on the practice itself: the cash that’s coming, the workloads that are building, the families who quietly stop. The shared section below, “What’s true in all three,” shows what that looks like across the disciplines.

Why PT practices struggle to track client outcomes across the caseload

40% of PT practices say they can’t reliably tell whether their treatment approach is working across their caseload. Only 16% say they have a reliable way to track progress.

→Why it matters. For a PT practice, client progress is more than the point of the work. It’s the currency of the business: progress is what justifies the next authorization, keeps a referring physician confident, and tells you when to discharge. Practices that can see it across the whole caseload catch a stalled client before a payer does. The survey-wide numbers say the same: 38% of thriving practices have enough visibility into client outcomes, against 18% of struggling ones.

What gets in the way? Mostly the paperwork. 55% of PT practices say compliance, documentation, and administrative demands leave no room for outcomes tracking, by far the most common answer. 36% say their software doesn’t make it easy to track or review outcomes. 35% can assess each client but can’t see trends across the caseload.

Part of this is the caseload. Practices that mostly serve adults are far more likely than pediatric practices to say software gets in the way of tracking outcomes (46% vs. 16%), and almost every adult-serving practice in this survey is PT. Adult caseloads turn over faster and depend on payer authorizations, so progress has to be shown to a payer every few visits, not just seen in the room. That makes this a systems problem, and systems problems are the fixable kind.

How insurance complexity keeps PT practices from seeing their finances

71% of PT practices say insurance complexity, meaning claim denials, reimbursement delays, and payer rules, gets in the way of seeing their finances clearly. It’s the most common barrier any discipline named in the survey.

→Why it matters. For a PT practice, financial visibility mostly comes down to payers. If you can see denials, expiring authorizations, and payment timing as they happen, you can plan around them: shift a schedule, chase a claim, hold a hire. If you only see them at month’s end, every month ends with a surprise. Rehab therapy-wide, this is one of the sharpest divides between the groups: 38% of thriving practices say nothing significant blocks their view of the finances, against 4% of struggling ones, and thriving practices are far less likely to learn about a problem only after it has hit cash flow (18% vs. 52%).

Other blind spots compound the insurance problem. 39% of PT practices also say they don’t have a clear picture of what’s been billed, collected, and written off. 29% don’t know what good financial performance looks like for a practice like theirs. And the consequences are real: 51% say they miss revenue leaks until they’ve compounded, and 50% find out about a financial problem only after it has hit cash flow.

Here’s a surprise from the PT data: practices that are doing well are more likely to find out about money problems after the fact (62%) than practices that are getting by or struggling (38%). One likely reason: when money is tight, you watch the account every week. Once there’s a cushion, it’s easy to stop looking until something has already gone wrong. A practice can be doing well and still be reading its finances in the rearview mirror.

Where PT practice operations break down: documentation and scheduling

58% of PT practices say documentation backlogs are one of their biggest operational problems, and 44% say keeping the schedule full and staffed is unpredictable. PT is the only discipline where nearly half of practices call scheduling a problem.

→Why it matters. Operations is the everyday machinery of a practice: who’s on the schedule, whether the notes are finished, whether an authorization gets renewed before it lapses, who covers when someone is out. For PT practices, where caseloads turn over quickly and many visits depend on payer approval, an operational slip becomes a revenue problem within the same week. Across rehab therapy, thriving practices are three times as likely as struggling ones to handle these problems with a defined process (35% vs. 11%). That process is the difference between noticing an open slot on Monday, while there’s still time to fill it, and noticing it on Friday, after the week’s revenue is already gone.

For PT practices, the schedule is the pressure point. Documentation backlogs are the most common problem (58%), but scheduling is what sets PT apart: 44% say keeping the schedule full and staffed is unpredictable. Two related problems travel with it. 37% say information doesn’t flow reliably across the team, and 31% say getting a new client scheduled, documented, and started takes too long. Each time coverage changes, there’s another handoff, and each handoff is a place where something gets missed.

Most PT practices respond the way most rehab therapy practices do: 62% handle problems as they come up and usually understand why they happened. Knowing why a problem happened is useful. It just isn’t the same as catching it before it happens, and that’s why the same problems keep coming back.

Which well-being supports PT practices are missing

36% of PT practices give clinicians structured peer support or supervision, and 26% have norms around after-hours contact with clients. On both, PT practices are the least likely of the three disciplines to have the support in place.

→Why it matters. PT is physical work done on a productivity clock, and the PTs we surveyed described the squeeze plainly: too many clients in a day, too little time to write notes, and a work-life balance that gives way first. Well-being here is what keeps a clinician from leaving, and finding and keeping clinicians is the second most common threat to sustainability that rehab therapy practices name (50%). The two well-being habits that separate thriving practices from struggling ones across rehab therapy are regular workload review (53% vs. 27%) and structured peer support (64% vs. 34%).

On peer support and after-hours norms, fewer PT practices have the support in place than in the other disciplines. 36% give clinicians structured peer support or supervision. 26% have norms around after-hours contact with clients. 39% review workloads regularly. The one support most PT practices do offer is flexible scheduling (62%), which is also the most common well-being practice across rehab therapy. Flexibility helps a lot. But flexible hours don’t tell you when a clinician is overloaded, and they don’t give anyone a place to talk through a hard case. The other supports do.

What PTs expect from well-being is telling. Asked what would improve if their clinicians were thriving, 69% of PTs say the practice’s culture would improve (OTs say the same), and 60% say there would be fewer burnout-driven disruptions to scheduling and coverage, more than either other discipline. PTs experience well-being as an operational issue. When a clinician runs out of road, the schedule is where it shows first.

Do PT practices know why clients drop out before finishing care?

Only 32% of PT practices have a reliable way to find out why a client stopped coming before finishing care. 56% find out only sometimes, when it happens to come up.

→Why it matters. For a PT practice, a client who stops at visit six of twelve is an open slot, an unfinished plan of care, and often an authorization left unused. Most of those clients don’t complain on the way out. They just don’t rebook. It shows in the survey-wide numbers: 58% of thriving practices have a consistent way of learning why clients leave, against 28% of struggling ones, and 69% are very confident they understand their clients’ experience, against 24%.

PT practices have a partial picture here. 30% are very confident they understand their clients’ experience, and 65% are somewhat confident, meaning a general sense without knowing whether it reflects the full picture. When a client stops coming, 32% have a reliable way to find out why; 56% find out only sometimes, when it happens to come up.

The odd part: PT practices are more likely than SLP practices to say they actively track client experience (28% vs. 17%). Tracking satisfaction isn’t the same as hearing from the people who left. The clients who fill out a survey are the ones who stayed.

Adult-serving practices are the clearest about what would help, and most of them are PT

Half of all rehab therapy practices say seeing their performance across all five domains would definitely help them make better decisions. Among practices that mostly serve adults, that jumps to 76%, 32 points higher than pediatric-serving practices, and almost all of those adult-serving practices are PT.

PT practices work with more moving parts than most: adult caseloads, payer authorizations, coverage that changes week to week. The PT practices that are thriving haven’t changed any of that. They’ve made it more visible, so a denial, a stalled client, or an open slot gets caught while there’s still time to do something about it.

Can OT practices show families the progress clients are making?

41% of OT practices say limited visibility into client outcomes makes it harder to have informed conversations with families about progress. 29% say they can’t reliably tell whether their approach is working across the caseload.

→Why it matters. In OT, the results that matter most often happen where the clinician can’t see them: at the breakfast table, in the classroom, at bedtime. A child holds a spoon on their own, gets through a transition without a meltdown, writes their name. Families notice those moments first, and they judge the therapy by them. That puts OT practices in an unusual spot. The clinician sees the session; the family sees the life. Progress tracking is how those two pictures get compared, and when it’s missing, the family conversation turns into reassurance instead of evidence. It also gets harder to know when a plan isn’t working, or when a child is ready to discharge. Across rehab therapy, thriving practices are twice as likely as struggling ones to say they have enough visibility into client outcomes (38% vs. 18%).

Most OT practices have some of the pieces. 24% say they already have a consistent, reliable way to track progress across the caseload. The barrier the rest name most is familiar: 40% say compliance, documentation, and administrative demands crowd out outcomes tracking. The goal data is usually being written down, sometimes into individual notes where nobody can see the pattern.

Do OT practices know what good financial performance looks like?

31% of OT practices don’t know what good financial performance looks like for a practice like theirs. Only 5% call financial health a clear strength.

→Why it matters. Most OT practices can see what came in and what went out last month. What fewer can see is whether those numbers are healthy for a practice like theirs. That’s what a benchmark does: it turns a number into a signal. Below the line, it’s a problem to fix. Above it, it’s proof that something is working and room to invest. Without one, every month’s numbers are just numbers, and money stays a worry even when the practice is doing fine. Rehab therapy-wide, thriving practices are eight times as likely as struggling ones to say nothing significant blocks their view of the finances (38% vs. 4%).

For OT practices, the biggest barrier to seeing finances clearly is insurance: 57% say claim denials, reimbursement delays, and payer rules make it hard to know where they stand. Unpredictable cash flow is a problem for about one in three (31%). And not seeing clearly has a cost. 38% of OT practices say they miss revenue leaks until they’ve compounded, and 37% learn about a problem only after it has hit cash flow. OT practices aren’t in financial trouble as a group. Many just can’t tell, month to month, how they’re doing.

Where OT practices still need a defined process: documentation

26% of OT practices have a defined process for identifying and addressing operational problems. 59% handle problems as they come up and usually understand why they happened.

→Why it matters. A defined process is what lets a practice keep running when the person who knows everything is out sick. OT practices have built more of it than SLP practices have (26% vs. 17%). Across rehab therapy, 35% of thriving practices run on a defined process; 11% of struggling practices do. So the question for OT isn’t whether to build process. It’s which problem to point it at next.

Documentation. 47% of OT practices name documentation backlogs as a top operational challenge, well ahead of scheduling and coverage (27%), client intake (26%), and team communication (23%). Notes that fall behind slow everything downstream: billing, authorizations, the next family conversation. The OT owners who described their habits to us run operations with written procedures, named owners, and regular check-ins. Documentation just hasn’t been added to that list yet.

What OT practices do for clinician well-being that other disciplines don’t

68% of OT practices give clinicians structured peer support or supervision, and 51% review clinician workloads regularly.

→Why it matters. These are the two well-being habits where thriving and struggling practices differ most, across all three disciplines: 53% of thriving practices review workloads regularly and 64% run structured peer support, against 27% and 34% of struggling practices. OT practices already do both more than any other discipline, and it shows in the rest of the picture: OT is the discipline most likely to describe itself as doing well. The habits that protect clinicians turn out to be the ones that protect the practice.

OT practices lead on nearly every support we asked about. 70% offer flexible scheduling, and 38% have norms around after-hours contact with clients. The OT owners we surveyed described it in practical terms: paying clinicians for their full-time hours even when clients cancel late, four-day weeks, documentation time built into the schedule, one-on-one meetings to catch problems early.

What OTs expect from well-being is balanced. 69% say a thriving team would improve the practice’s culture, and 66% say it would improve their own quality of life. For OTs, the personal payoff and the practice’s payoff are nearly the same size.

How OT practices hear from families who leave, and the ones who stay

45% of OT practices have a reliable process for finding out why a client stopped coming before finishing care. 32% are very confident they understand their clients’ experience.

→Why it matters. For OT, the client experience is mostly the family’s experience: whether appointments work around school, whether communication between sessions is clear, whether parents feel supported and can see the carryover at home. Families who feel unheard don’t usually complain. They stop coming. Across rehab therapy, thriving practices are twice as likely as struggling ones to have a consistent way of learning why clients leave (58% vs. 28%), and nearly three times as likely to be very confident they understand their clients’ experience (69% vs. 24%).

Fewer than half of OT practices (45%) reliably find out why a client stopped coming; another 51% find out sometimes, when it happens to come up. Fewer still feel sure about the families who stay: only 32% are very confident they understand the client experience, and 58% have only a general sense. Several OTs told us they rely on what parents happen to mention to a therapist. That works until a family that says nothing leaves.

OT practices have built the structure: peer meetings, workload checks, written processes. The next step is a way to see what that structure is producing, in client progress and on the business side, so a practice that’s doing well can tell exactly how to get to thriving.