How to Start a Concierge Medical Practice
Are you thinking of transitioning to or starting a concierge medical practice? While many physicians and advanced health care professionals (AHP) prefer the traditional model, there are other types of medical practices to consider—including concierge medicine. There are many things to consider when exploring alternatives to traditional medical practices.
A concierge medical practice emphasizes time spent with patients and simplifies staffing, billing, and practice operations. This practice model runs on a retainer fee for a personalized relationship with the physician.
Common services concierge medicine physicians offer are:
- Extended availability including after-hours and on weekends
- Same day or next-day appointments
- Personalized care including longer appointment times
- Preventative care and wellness management
- Chronic disease management
But just as in setting up a traditional practice, establishing a concierge practice takes time. Having the right tools and guidance can help you successfully open your practice.
How does concierge medicine differ from traditional medicine?
Unlike mainstream practices, concierge medicine offers a simple practice blueprint.
One surprising example is staffing.
In a concierge model, a practice can require minimal staff. Since patients sign up for a membership, physicians can design a regular appointment schedule to limit the number of concierge practice patients they can see. The workflow is predictable, and this simplification extends to billing.
For health care providers, the concierge model can translate to more time spent with individual patients. In traditional practices, the average time spent with patients is 18 minutes. A concierge medical professional may spend an hour or more with each person since they limit the number of patients they see.
The concierge retainer fee covers enhanced access and services but typically does not include all primary care services. Patients often use their health insurance for most medical services and the concierge fee covers additional services such as longer appointments and more immediate access. This model can be cost-prohibited for many potential patients, plus many still prefer seeing physicians who are within their insurance networks.
Checklist for starting a medical practice
We covered the primary steps to consider in this checklist for starting a medical practice. This checklist was written with concierge medical practice in mind but much of it could be used for starting a traditional practice as well. Download a PDF version of this checklist for your own use.
Do your homework
It’s essential to lay the groundwork for your new venture. There are initial considerations, such as adhering to legislative guidelines, wrapping up a current employment contract, and learning more about the model.
- Contact a start-up specialist: When you start a practice, you start a business. Consulting with a start-up specialist makes it easier to figure out the business side of things.
- Set a timeline: When you look at everything you need to do to start a business, the massive lists of tasks can appear overwhelming. Writing down a timeline can help you segment your tasks and make it easier to move forward.
- Consider starting with a hybrid approach: It is common to start a hybrid practice—using both the concierge and traditional models. You may choose to slowly transition to not accepting traditional insurance.
- Research: The next best thing you can do is learn more about the business. Reading about concierge medicine, reviewing competitor profiles, and speaking with colleagues in the space can help you flesh out your plans.
- Review applicable laws: There are several federal and state-specific regulations you should understand and incorporate into your practice. Guidance from regulatory agencies such as OSHA, HHS, CMS, and DEA provide enforcement of regulations.
- Review your current employment contract: Likely you’re already working with another practice or hospital. Check to see if there is a minimum number of days or weeks to give notice. Talk with an attorney if you have a non-compete clause in your contract.
Build a network
You’ll want to find a(n):
- Mentor: One of the best ways to learn about this business model is to find someone who has already developed their concierge practice. These individuals not only answer your questions and provide recommendations, but they can also introduce you to colleagues and other professionals.
- Health care attorney: Hiring or consulting with a health care attorney provides you with an additional layer of support. Attorneys offer insight into health care compliance, review your business contracts, and may point out ways to avoid a lawsuit.
- Accountant: Ideally, you’ll want to spend time with patients, not tracking down business receipts and decoding taxes. An accountant can take over these tasks for you.
- Medical malpractice insurance carrier: You may never face a medical malpractice lawsuit, but the right carrier provides both claims support and peace of mind. So it is critical to spend time evaluating carriers to find the best medical malpractice coverage for your practice.
Create a business plan
Once you have insight into the industry, designing your business plan is the next big step. It doesn’t have to be long. But it’s a good time investment. In fact, studies find that 70% of businesses with a plan survive for at least five years.
- Select a Business Entity or DBA Name: Most states' laws require business, which includes medical practices, to register with the state, and possibly county, agency or office that regulates businesses.
- Select your services: You’ll want to look at your core and potential premium services. This will tie in with your pricing structure.
- Credentialing: If you plan to accept insurance, you must start the credentialing process.
- Rent an office: You will need a space to start seeing patients. It’s important to keep regulations in mind when reviewing potential locations.
- Determine your staffing needs: Will you need someone to work the front desk or answer calls? If you don’t plan to hire anyone yet, you want to work with an answering service to take your messages.
- Set pricing: Once you know your expenses, you can plan your pricing structure. You may decide one flat fee is enough. But you can also create multiple membership tiers as a competitive advantage.
The next step is figuring out what you need to attract clients. Thanks to the rise of digital marketing, medical practices now have many affordable options available. Here are some of the must-haves:
- Professional headshots: Consider this your personal branding. You can use the same photo for consistency on your website, health care sites, social media accounts, ads, and other potential assets. This is a long-term investment.
- Branding: You may choose to invest in a branding package. This includes your logo, typeface, colors, and consistent business identity. Branding direction makes it easier to be consistent in your marketing and helps potential patients better remember your practice.
- Website: For many prospective patients, your website will be their introduction to your practice. A clear, concise website that states your mission, services, bio, pricing, and contact information creates a sense of transparency. And that builds trust.
- Email Marketing: Email is one of the best ways to reach prospective patients. Writing a regular newsletter with health insights or reminders (like getting your flu shot) can help subscribers stay on top of their health.
- Networking: Meeting colleagues and other physicians is a great way to generate referrals.
- Social Media: Spending time on social media can raise brand awareness and increase your presence online. The keys to success here are to ensure patient privacy is not compromised in your content, select social media you enjoy using, and be consistent.
When it comes to finance, you’ll need to look at both personal and professional expenses.
- Fee structure: Concierge programs run on membership fees. Typically, these are segmented by services or age. When calculating your fees, you will need to first review your startup costs, ongoing expenses, your desired income, if you will offer charity care, and the revenue and cost for each patient per month.
- Startup Costs: You’ll need capital upfront to set up your program. These funds may go towards licensing, rent, equipment, your website, and other essentials.
- Membership agreement: This contract clearly explains membership benefits, the renewal process, termination, service descriptions, excluded services, communication authorization, relevant waivers, and other critical information.
- Billing company: Outsourcing to a medical biller is a great way to streamline your payment process. A billing company will take over most payments-related processes, including processing, customer support, collections, and other key tasks.
- Set up a bank account: Opening a separate practice account will make keeping the books easier for yourself and your accountant.
- Set up merchant services: A merchant service provider processes payments. Stripe, Square, and Quickbooks are all examples of merchant service options.
Practice operation and management
There are other considerations when it comes to running a practice. Getting your technology and procedures right from the beginning can reduce stress down the road.
- Contact sales rep for medical equipment: As you select your location, you’ll want to form a relationship with sales representatives for your medical equipment. Forming long-term connections can help you maintain and replace old equipment as well.
- Contact IT consultant: Besides medical equipment, you will need hardware and software to run much of your operations. An IT professional, especially one who has worked in health care and is knowledgeable about confidentiality requirements, can point you in the right direction.
- Begin customizing the policy and procedure handbook: A policy handbook provides support as your business becomes more complex. It can also be useful when hiring and training staff.
Equipment and supplies
Next, you’ll want to look at equipment, software, supplies, and other medical or office items you need to effectively run your practice.
- EMR platform: Your electrical medical record (EMR) platform is critical to support and communicate the care you deliver. It serves as evidence with claims or investigations, supplements patient education, and communicates with members of the health care team.
- POS system/credit card charger: A point of sale (POS) system integrates with your merchant services to help you receive payments. While you may outsource most of your billing to a company, it can be helpful to have an in-office system for immediate payments.
- Billing services software: This software can be the same as your merchant services provider, or you can have a separate system. The medical billing process can get complicated, so asking the software company for their business associate agreement is critical.
- Office space for home: There will be days when you want to work from home or need to. While this is optional, it’s helpful to have a remote computer setup so you can access office files and a quiet space to work.
- Phone system: You will want to decide if you hire a live answering service or take phone calls directly. Knowing this will allow you to set up expectations for your patients.
- Order Rx pads: Depending on the state and the medication you are prescribing, you will need to order prescription pads.
Tying up loose ends
When you’re getting ready to open your practice, you will need to communicate the change with multiple people and organizations beforehand.
- Notify your patients: It’s also important to tell current patients that you are leaving the practice. Depending on your contract, you may be unable to give more information about your new practice. You may consider reviewing your payor agreements, especially regarding non-solicitation clauses.
- Plan the transition with your current employer: This process requires careful planning as well as legal and ethical considerations. Schedule a meeting with your employer to initiate the transition process well in advance of your planned exit.
- Submit a change of address form with various organizations: You will want to update your practice address with several organizations, such as professional associations, affiliated hospitals, vendors, insurance carriers, and more.
Applications to consider
There are additional applications you may need to complete before starting your practice:
- Apply for state license: Many states require medical licensing and specific specialties. Each state has different licensure requirements. You will want to review your state’s department of health or state medical board to determine your necessary licenses and submit the required documentation.
- Apply for EIN/Tax ID number: An Employment Identification Number (EIN)/Tax ID number enables you to file taxes using a business identifier rather than your personal social security number.
- Obtain hospital privileges, depending on your practice set up: Hospital privileges authorize you to admit or treat patients at a hospital and may include additional privileges like telehealth options.
- Apply for a DEA license: An active Drug Enforcement Agency (DEA) license enables physicians to prescribe medication.
- CLIA license: If you plan to perform testing at your practice, you must apply for a Clinical Laboratory Improvement Amendments (CLIA) license. For this reason, many practices prefer to forward samples to a lab.
- General liability insurance: This form of insurance protects you if your services, products, or operations cause bodily injury, personal injury, and property damage to another person.
- Certificate of Occupancy (CO): You can obtain this certificate from your local building or zoning inspection office. This certificate essentially says that your office meets building compliance standards. Businesses must get a CO before opening.
Making time for yourself and your patients
When deciding on how you want to operate your medical practice you want to ensure that your business model aligns with your current and future plans.
As a physician-led medical malpractice insurance carrier, MICA understands the challenges that independent medical practices face. Our experienced team of professionals are here to support and defend you every step of the way so you can focus on providing the best care for your patients. To learn more, please call us at 800-681-1840 or request a free personalized quote for coverage.