Patient Membership Programmes - Are you (and they) missing out?

Uncategorized Jan 18, 2024

Patient Membership programmes - what are they?

You are probably familiar with a membership model in the form of Amazon Prime, Netflix, or Costco membership, but may not have considered it as an option for your healthcare practice.
A monthly or annual subscription in exchange for a members only, fast, efficient, often personalized, or discounted service.

So the same model has been working in several healthcare settings (mostly dentistry), for a number of years, and in this blog, I want to help a wider audience understand how a membership programme might work to help you in a number of different ways in your practice, as well as providing more support for your patients on their health journey.

Also known as concierge health, subscription medicine, or care plans, this is a model of healthcare provision that can be summarized as a bundled service, providing either a VIP patient experience or a way to spread the cost of care.

This is essentially a shift from high volume, time for money based transactional service delivery, to a true value driven, continuous care service, based on long term deeper relationships that can support either the patient looking for a more personal VIP type of service, or those patients still wanting great outcomes but need a way to spread the cost of their care.

In simple terms, patients pay a monthly, quarterly, or annual membership fee and in return receive some or all of :

A discounted bundle of standard care appointments
Staged payments
Supporting products
More of your time
24/7 or emergency access to practitioners
Patient suport videos
More thorough results
Quicker results

The membership elements are almost endless and can be built around a very specific patient cohort and what they want, making them very attractive as a care pathway option.

Patient Memberships - how do they work?

You've heard the phrase "putting skin in the game"?

Taking a personal stake or investment in something, indicating your commitment to it.

Well, memberships work on the principle of getting patients to put skin in the game by paying upfront for access to things that are appealing to them.
Things like:

Discounted products
Longer appointments
Exclusive access to you
24/7 support
Staged payments for high-ticket products or services

Putting skin in the game in the form of an upfront payment is going to encourage members to utilise the services they have paid for and quite probably buy more in the long run than they would, if they didn't have the membership.
In super simple terms you bundle some of your services together, possibly at a discounted rate (I'll explain in more detail in a minute) and you charge a monthly or annual fee to access them, your patients then utilise those services, possibly more than they would have without the membership package, they have a great experience get better outcomes, become raving fans and your reputation grows.

It’s well documented that Amazon Prime members spend 4 times as much on the platform as non Prime members and are way more loyal to shopping on Amazon than non members.

Recent (ish) research from the US dental industry showed that:

Insured patients (i.e those not paying out of pocket for each visit) visited the dentist on average 1.5 times per year, and uninsured patients only visited once every two years
Uninsured patients also only accepted treatment recommendations at half the rate that insured patients did - potentially meaning that uninsured patients could be experiencing reduced health outcomes.

Interestingly of the uninsured patients in this study, 89% indicated interest in a care plan that is simple, affordable, and transparent - but we'll come back to that in a minute.

The same has already been proven to be true in dentistry in the UK with members of dentistry practice memberships spending 3 times as much in practices than non members.

Now yes this is only within the dental field but I'm happy to apply the pattern of behaviour to other healthcare professions.

I’m fairly certain that most patients paying uncertain amounts, out of their own pocket, would visit your practice less frequently, and certainly for preventative care, than those covered by insurance. Also, I believe that given the opportunity to pay a smaller amount regularly to cover a basic level of care, would see those patients attending more frequently, possibly buying more additional services, and most importantly probably getting better long-term outcomes as a result.

So patient membership programmes have the potential to build great loyalty and make financial sense.

The difficulty is, that to many practices and patients alike, this subscription model in healthcare is a foreign concept. Making it a bit like the frontier of private practice.

BUT that doesn’t mean you shouldn’t at least investigate this model further.

What does a patient membership programme look like?

Of course, every profession and practice is individual but I'm hoping these general concepts help you understand the idea and see how you might be able to apply one of the models to your profession and practice.

Patient membership programmes tend to have a selection of these elements embedded in them:

A 12 month bundle of different kinds of essential appointments
Related physical products
Long term focus on prevention or maintenance
A sense of belonging to something that makes patients feel cared for
Discounted services
Educational elements
Diagnostic services
Periodic assessment tests
Emergency services
Preferential appointment scheduling
Member-only events or offers
Dedicated communications channel

Your creativity can go to town here. Just make sure you are adding value to your members and not detracting from your regular patients.

Tiered membership

Your membership can be an all or nothing offering where anyone paying the standard membership fee gets access to the full membership package, or you can offer two or three levels of membership where the offering gets more complete as the price increases.

This is not for everyone

DISCLAIMER

Please note I am neither legally qualified or a trained accountant and what I am discussing here are general business principles not tailored business advice!!
Please do your due diligence before implementing any new business development strategies.

This membership business model will not work for every practice as it relies on a number of key elements being in place for it to succeed. The elements you choose and the way you structure your membership require some serious consideration and an honest review of two things in your practice:

The kind of patients you serve (or want to serve)
The infrastructure you have in place to effectively support a programme

I can probably explain this best by discussing the two different models for a patient membership programme.

Sorry, I couldn't resist 😉.

There are two models of patient membership programmes and you can choose one or the other, or potentially a combination of the two.

The two models

1. The VIP patient experience model

In this model, you are targeting patients who value a personalised, exclusive service that will give them more of you in terms of appointment time, ongoing support, and specialist expertise as well as other VIP perks, making them feel special.
In this model, the focus is on delivering the ultimate patient experience. Think about your current patient experience and double it, or triple it, the effort, the touch points, the support etc. Your objective is to create a ⭐️⭐️⭐️⭐️⭐️ experience for your members.

For this, you can see you need a very specific type of patient who would be prepared to pay for this level of service that will both get them great clinical outcomes and also make them feel very special. Part of an exclusive club.

This doesn't have to be based around luxury, but potentially patients who have a lot riding on getting a great outcome as quickly as possible.

2. Cost management model

This provides a package of essential appointments and support products that can be spread throughout the year, based on the optimum health outcomes for a specific kind of patient. For example, hypothetically speaking, if you know you get optimum results for a patient with low back pain from:

Initial consultation x 1
Diagnostic Tests x 3
Pain management planning session x 1
Physical therapy sessions x 6
Weight management coaching - virtual
Rehab support video library - online

Knowing that a majority of self funding back pain patients would normally only access a few of these elements, you could build a Back Pain membership package that included all of the above at a 10% discount, knowing that this means your members are going to be paying for additional services that will benefit them, but that they would not have otherwise paid for. With the cost added up and broken down into 12 equal monthly payments it becomes more affordable for the patient and you are providing a more complete service to your patients, hopefully delivering faster more complete results.

Alternatively, you set up a skeleton package of only absolute essential services, calculate a monthly rate, and then offer each additional service to members at a discount - but in this model, you need to be proactive about selling the additional services in order to get the best patient outcomes.

In this cost management model, you can also provide preventative or continuous care elements to reduce the risk of your patient relapsing and keep them out of pain and living an active life on an ongoing basis.

There are so many ways you can structure this kind of membership, but this model is a win for everyone.

Patient membership programme benefits

Whichever way you choose to introduce a membership, there are many benefits to choosing to incorporate a patient membership model into your practice.

The need to see fewer patients
More invested and engaged patients
More predictable cash flow
Improved financial forecasting
Cost saving for patients
Reduced cancelations
Easier budgeting for patients
Better patient outcomes
Growing focus on prevention
Enhanced patient experience
Improved patient loyalty
Growing reputation
Strengthens the business
Reduced marketing spend

I could go on but hopefully, you get the idea 😁.

Patient membership programme pitfalls

There can be a lot of benefits to running a membership programme but for completeness, I want to look at the flip side too, so that you are better equipped to make an informed decision, and as the implications of the pitfalls are potentially more serious, I want to expand on each of these just a bit.

Membership admin
Implementing and managing a patient membership program will create administrative tasks, including managing renewals, card expiry issues, and additional communication. This can be resource-intensive for the practice at least until you get some automation and standard systems in place.
Patient education and communication
Additional patient education is essential to sell the membership in the first place and clear communication about the terms and benefits of the membership program is essential. If patients are not fully informed, misunderstandings may arise, leading to dissatisfaction or confusion.
Limited appeal
Membership programs may not appeal to all patients, particularly those with insurance coverage. Some patients may prefer traditional fee-for-service or insurance-based models, limiting the program's reach. But this is where good education comes in.
Getting it right
Patient needs and demands can vary, and designing a membership program that satisfies a large enough group of patients can be challenging. Taking time to do your research and build something that addresses real patient demands will help.
Resource allocation
Resources devoted to managing the membership program might divert attention from other essential aspects of the practice, potentially affecting overall efficiency and patient care.
Technology and infrastructure costs
Implementing a membership program may require investments in technology and infrastructure, such as software for billing and member management. These costs should be carefully considered and built into the pricing of the membership over time.
Ethical considerations
There may be ethical concerns related to promoting a membership program, particularly if it is perceived as prioritising members over non-members. This is why it is important to add VIP elements to existing services as the membership and not detract from existing services.

All in or 50/50?

I found some examples of practices in the US that have gone all in on this model, switching 100% members only, driven largely by the complexity and failings of their Medicaid and insurance driven system, and the demand from affluent patients to receive higher quality care.

But you don’t have to go all in. You could decide to just open 50 or 100 places as “Platinum members” and take the time to develop your membership offering, building out the membership services and community of members slowly over time.

This is the beauty of running your own practice you get to call the shots!!!

OK, that pretty much wraps up my thoughts on patient membership programmes. If you made it this far, thanks for your attention and your time. If you have any comments or questions please use the comments at the bottom of this page.

Until next time