Going Boutique?

Offering premium services

In a concierge practice, patients pay an annual retainer or subscription fee of between $1,500 to $5,000 (for an individual) and $3,500 to $8,000 (for a couple), depending on the services received. Those services might include immediate and 24/7 access to physicians via phone, e-mail or personal visits. They can also sport same- or next-day appointments, and an emphasis on wellness, prevention and health counseling.

Beyond that, the practice can offer whatever premium services its patients desire and are willing to pay for: spa-like amenities and décor, house calls and out-of-office care, and telephone or e-mail consultations, for example.

There’s a caveat, however. The concierge fee doesn’t and can’t apply to clinical services for which third-party reimbursement may be sought from Medicare or private payers. The practice can either: 1) continue to perform the third-party billing function for its patients, or 2) forgo that responsibility entirely, leaving it up to patients to deal with their insurers.

A substantial investment may be necessary to get started. You’ll likely want a redesigned office space, for instance, along with staff retraining for greater customer sensitivity and new EMR capabilities for enhanced follow-up.

Because your practice will want to get the word out about its concierge services, you’ll also incur some marketing expenses. It can take one or two years to build up the patient volume to turn a significant profit.

The benefits for your practice

Once a concierge practice becomes fully operational with satisfactory patient flow, several benefits could begin to emerge. You may be able to downsize your existing coding and billing staff, potentially cutting payroll expenses. And with a smaller daily patient volume, you may need fewer front desk staff. Plus, moving to the concierge model often lets physicians focus on areas of medicine about which they’re truly passionate.

Of course, there are risks to the concierge model. Once patients remit their annual fees, be aware that they’ll have virtually unlimited access to you and your physicians at any time. Above all, you’ll be solely accountable for the fiscal welfare of the practice.

How to transition to a concierge practice

If the notion of a concierge practice interests you, do your homework before making the switch. For example, ask your physicians whether they’re willing to adapt to a more interactive relationship with patients. You’ll also need to decide whether the new practice format will continue to bill third-party payers or operate as a totally direct-pay operation.

In addition, research patient demographics and the local market to see if there’s sufficient demand with the necessary financial resources to participate. Next, determine which noninsured services and amenities you’ll offer and whether you’ll need additional training for staff and physicians. You’ll also need to calculate the monthly or annual fee/retainer that you’ll charge patients to cover costs for the new services.

Be prepared

Make sure you set a timetable for initiation and phase-in of the new format. And communicate with patients about the transition via letters, e-mails, phone calls, office visits or focus groups. Also, ascertain how to handle existing patients who won’t convert to the new practice model. Finally, create marketing materials and launch a campaign.

Work with your advisors

Your health care advisor can help you with the entire process. So make sure you get him or her on your team.

© 2015