There are several factors that will impact how the HCO obtains Physical Therapist services. We need to begin by performing a cost-benefit analysis for each of the alternatives to determine which best meets the HCO’s current needs. Option one, hiring the Physical Therapist, involves high start-up costs but allows the most overall management by the HCO. They need to determine if the cost and time associated with finding and hiring professionals, management, and nonprofessional staff needed for the physical therapy services would best contribute to the overall HCO mission and patient care. Additionally, they need to determine what the return on investment after the initial costs will be. Since the HCO has total control over this option they are able to ensure the care provided aligns with the mission, adjust staffing for changes in patient volume, support for regulatory compliance, utilize evidence-based models for OFIs, implement improvements, and negotiate goals internally.