Active Physical Therapy is a 17-location physical therapy practice serving 12 communities across southern Minnesota. Back in 2018, when the practice had 7 locations, owner Brian McQuilkin began rethinking one of the most foundational elements of the business: clinician compensation.
At the time, the practice had a strong culture built around mentorship, clinical excellence, and patient outcomes. But the compensation model wasn’t aligned with the kind of performance and autonomy Brian wanted to reward.
As an early adopter of Prompt Compensation (formerly OnusOne), Active PT experienced improved margins and clinician earnings, plus nearly a decade of sustained growth.
Before Prompt Compensation, Active PT operated on a traditional salary structure with occasional extra incentives. Over time, Brian noticed a growing disconnect between effort and earnings.
Experienced clinicians were earning more based on tenure, while newer, highly driven therapists had limited growth opportunities, even when their performance exceeded expectations.
The biggest motivation for looking for a new compensation model, Brian explains, was the realization that a high performing, growth-oriented therapist could be making significantly less than someone coasting on a steady schedule.
The team had experimented with annual bonus structures and goal based incentives. But those models created long feedback loops. If someone fell behind early in the year, there was little motivation for them to reengage.
With Prompt Compensation, the timeline changed. Performance and pay were connected on a weekly basis. Clinicians could see where they stood and adjust in real time. That shift from delayed, abstract goals to short term clarity was critical.
As Brian evaluated solutions, 2 priorities stood out: transparency and flexibility.
A platform like Prompt Compensation was what we needed to have full transparency and execution of a better pay model.
Therapist compensation is one of the most sensitive and important elements of any organization. Managing complex incentive structures in spreadsheets introduced risk and limited visibility. Brian wanted a system that both leadership and clinicians could trust.
“A platform like Prompt Compensation was what we needed to have full transparency and execution of a better pay model,” Brian said.
Beyond the software itself, the partnership with the Prompt team was equally important. Early conversations helped Brian understand how to design a model that was fair, customizable, and aligned with the culture he had built.
“Anytime that I've reached out to [Compensation founder] Jason or his team to say, ‘Hey, I have a question about this, or a question about that,’ they’re available to kind of brainstorm, talk it through, and help us understand what was best for our specific practice and clinicians,” Brian said.
Together, the Prompt Compensation and Active PT teams focused on designing a compensation program with clear rules, fair incentives, and outcomes that benefit clinicians, the practice, and patients.
Rather than rolling out a top-down decision, Brian involved his clinicians directly from the beginning. He drafted the initial rules and then handed them to the team with a challenge: try to break it.
By pressure-testing the model with 8 clinicians before the full rollout, Active PT refined the new payment structure to ensure it rewarded evals appropriately, accounted for documentation time, and avoided unintended loopholes.
The philosophy was simple. If the model paid people less to do more, it would fail. Trust would erode, and Active PT’s culture would suffer.
That mindset made managing the switch far smoother. Clinicians understood how the system worked and believed leadership had designed it in good faith.
When Active PT implemented Prompt Compensation in 2018, the practice operated 7 locations and maintained approximately 15% net margins.
“The impact that Prompt Compensation has had at Active PT is we started in 2018 and we had 7 locations in southern Minnesota. And today we have 17 locations spanning 12 different communities,” Brian said.
This alignment between production, quality, and pay created room to both increase net margins and raise clinician compensation.
One of the most powerful outcomes of Prompt Compensation has been flexibility.
Recruiting in today’s market requires more than a competitive base salary. Clinicians want autonomy over their income, schedule, and time off. Prompt Compensation allows Active PT to tailor compensation conversations to their prospective hires’ individual goals.
Compensation gives them the autonomy to earn what they want to earn.
The level of transparency and flexibility that Compensation gives Active PT has become a recruiting advantage, plus it’s helped them retain their existing team. Prospective hires and seasoned clinicians alike can see a clear path to higher earnings if they choose to pursue it. Others can prioritize work life balance without being penalized.
“We know from research that therapists need autonomy, they need mastery, and they need purpose. And so we’re giving the keys to our clinicians. [Compensation] gives them the autonomy to earn what they want to earn,” Brian said.
For Brian as an owner, the greatest benefit of Prompt Compensation isn't just financial, it’s cultural.
My number 1 thing that I love about Prompt Compensation is we get to focus on leading with culture and mentorship versus micromanaging.
By aligning monetary incentives with outcomes, Active PT’s directors and owners spend less time policing visit volume and more time coaching clinical skills, communication, and exceptional patient care.
Metrics, Brian explains, are simply indicators of health. Just as athletes track performance stats and individuals track heart rate or blood pressure, clinicians can use KPIs to understand where they stand and how to improve. Rather than being punitive, access to clear data has allowed Active PT’s clinicians objective ways they can improve.
This shift toward coaching and mastery reinforces clinician autonomy and purpose. Clinicians know what’s expected of them. They know how they can earn more, and they’re in control of how they hit those goals.
For owners considering a variable compensation model, Brian offers direct guidance.
First, ensure your practice has sufficient patient demand. A performance based model only works if clinicians have access to volume.
Second, design the model carefully. Account for the extra time evaluations require. Avoid structures that push unrealistic increases in units or visits. If the system feels unfair, it will fail.
If you’re not getting the results you hoped for, Brian says, you have to go back to the plan you drew up. As the owner, you have to really understand your strategy and come up with a plan that benefits both the clinicians and your business.
Finally, examine your own leadership. Change requires trust, and if clinicians hesitate, it may be worth reflecting on whether leadership has earned that trust first.
Nearly a decade after becoming an early Prompt Compensation adopter, Brian remains an advocate for the software.
At its core, Prompt Compensation aligned Active PT’s compensation strategy with its mission to care for people and develop great clinicians.
By creating a fair, transparent system that rewards impact, Active PT has expanded its footprint, strengthened its culture, and built a scalable foundation for continued growth.
To see how Prompt Compensation can help your clinic grow, connect with one of our experts today.
