Physiotherapy in Ticino: moratorium is not enough, Physioswiss

Context

In brief

• Outpatient physiotherapy is growing in Ticino
• Reimbursements per insured person rose by 42% between 2017 and 2023
• The SUPSI study was delivered in May 2026
• Physioswiss proposes a register to the DSS

Key facts

What → growth of outpatient physiotherapy in Ticino Who → Physioswiss Ticino Study → commissioned from SUPSI's DEASS Location → Bioggio Period → particularly marked increase in Ticino since 2020 Swiss data → reimbursements for physiotherapy per insured person rose by 42% between 2017 and 2023 Training → 32 SUPSI places; 120 in Italian and 120 in French at Campus LUDES Proposal → register of active healthcare personnel, censuses and checks

In Bioggio, in May 2026, Physioswiss Ticino presented an independent study commissioned from SUPSI's DEASS and delivered that same month. The research argues that outpatient physiotherapy is growing in Ticino, but that limiting new authorizations to independent practice would not be sufficient to manage the phenomenon.

The analysis confirms a significant increase in consumption and expenditure borne by compulsory insurance, particularly marked in Ticino since 2020. However, the phenomenon concerns the whole of Switzerland: between 2017 and 2023, reimbursements for physiotherapy per insured person rose by 42%. The reasons cited include shorter hospital stays, care at home, separate billing in nursing homes and greater use of medical prescriptions. The study also considers the gradual shift from hospital to outpatient care.

Authorizations, training and checks

According to Physioswiss, a moratorium on new authorizations would not prevent existing facilities from hiring employed physiotherapists. The same problem would affect new graduates and could encourage market concentration.

The study highlights the importance of training. In addition to SUPSI's 32 places, Campus LUDES offers 120 places each year in Ticino for a bachelor's degree in Italian and the same number in French. The qualification is issued by a foreign university and subsequently recognized in Switzerland.

SUPSI also identified some critical issues: active professionals who are not registered in the national register of healthcare professions; offerings that combine fitness and gym services with services reimbursed by health insurers; business models that present physiotherapy as a highly profitable investment.

For Physioswiss, what is primarily lacking is a precise picture of the sector. It is not known how many physiotherapists are actually active in Ticino or at what level of employment. The association therefore proposes to the DSS a register of active healthcare personnel, censuses, systematic checks of registrations, more effective quality criteria and a clear distinction between healthcare services and fitness.

«We are not asking for preferential treatment. We are asking that the measures target the real problems», says president Tamara Roncati.

Operational details

Why a moratorium is not enough to capture the sector

A moratorium applied to new authorizations for independent practice would target a specific point, but on its own would not measure the actual presence of professionals. Existing facilities can hire employed physiotherapists; therefore, the number of authorizations would not necessarily correspond to the number of active professionals or to their employment rate. This distinction is what makes the register proposed by Physioswiss central.

Three levels for assessing the impact

The practical picture also changes for those entering the profession. A new graduate is not only faced with the possibility of obtaining an authorization: they may find themselves in a market where existing facilities continue to hire. The study thus points to a possible shift in growth toward existing operators, with the risk of greater concentration.

The second level concerns reimbursements. The 42% recorded between 2017 and 2023 is calculated per insured person and concerns the whole of Switzerland. The figure must be read together with consumption, expenditure covered by compulsory insurance and the factors identified to explain the growth: shorter hospital stays, continued care at home, separate billing in nursing homes and greater reliance on medical prescriptions.

A more precise database would therefore serve to separate the issue of quantity from that of the appropriateness of care. Monitoring registrations addresses a different aspect from the distinction between healthcare services and fitness; quality criteria add a further level. Anyone assessing a professional placement can consider these questions alongside consulting annunci di lavoro: what form of activity is being offered and how is the service described?

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Key points

An operational framework for the DSS and the sector

The dossier sets out a sequence of checks concerning the DSS. For those who work, study or follow physiotherapy in Switzerland, the order helps distinguish the issue of authorizations from that of the actual presence of personnel, quality and the distinction between healthcare and fitness.

Five steps to keep distinct

First step: separate independent practice from employed work in existing facilities. This is the boundary that makes it possible to understand what a moratorium would affect and what would remain outside its scope.

Second step: take stock of the active healthcare personnel. The register proposed by Physioswiss should make clear the number of physiotherapists actually active in Ticino and their employment level, two pieces of information that the association currently considers missing.

Third step: systematically check registrations in the national register of healthcare professions. The verification addresses the issue identified by SUPSI concerning active professionals who are not registered.

Fourth step: distinguish healthcare services from fitness and gym activities. The separation serves to clarify which offerings are presented together with services reimbursed by health insurance funds and which belong to a commercial model.

Fifth step: apply more incisive quality criteria and assess the appropriateness of care. From Physioswiss's perspective, growth should be managed with data, quality and appropriateness, taking into account the gradual shift from hospital to outpatient care.

For those following the sector, this framework makes it possible to examine upcoming measures without confusing authorizations, employment and training. Training should be kept separate from the employment count: the study indicates the 32 places at SUPSI and the places proposed by Campus LUDES in Italian and French, while Physioswiss is also calling for a census of the personnel actually active.

The criterion indicated by the association remains to manage growth on the basis of data, quality and appropriateness of care. To explore the economic side of work in Switzerland, use the calcolatore stipendio.

Source: tio.ch