Concierge Medical Practice Startup Options

EXPLORE Your Options...

We offer a variety of services to our clients including

We start with a complimentary introductory call that lasts about 15 minutes. In that call, you'll do most of the talking to explain what you've done on your own, and the stage at which you currently are in. If you decide to move forward with us, the next step is to engage us and then schedule a telephone consultation to address your burning questions and supply the answers you need to make critical business model and timing decisions. We don't provide consultation in the introductory call. That's because we truly agree that prescription without diagnosis is malpractice. To answer your questions, a telephone consultation may be just the solution.  Prepare for your consultation by listing all your questions and sharing them with us in advance via email. Telephone consultations are priced hourly at the rate of $400 per hour. After your call, you'll be better prepared to decide if you can do everything yourself without our assistance or which parts you prefer to engage us to assist you further. There's never any pressure from our side.

Busy physicians often don't have the time and skills required to conduct market research and may be too close to the subject to be objective. We will conduct the research, gather the data and interpret in consideration of your stated objectives and goals. Save money and time by obtaining and supplying us with copies of your local hospitals' Community Health Needs Assessments (CHNA), which are available to the public upon request, and at no charge.  These reports are professionally prepared every three years in accordance with IRS compliance requirements for all not-for-profit hospitals. Our market research services go beyond the CHNA content and focus on research that is critical to establish your unique branding and business strategies. Research and interpretation is priced hourly.


Based on the assigned entries into your workbook (provided) and the data gathered from the market research we conduct or that you provide, we help you plan a strategic road map to build or transition your new concierge membership or direct pay practice model. Typically, this is done in a single-day, in-person consultation at your location. This is the point at which you decide if you will remain as a participating provider with Medicare and managed care and discount plans with which you may currently participate. We'll go over the pros and cons based on the business model you envisage and what your reimbursement contracts and conditions of participation may prohibit. If you decide to remain on contracted payer panels, we'll need to review the contracts to maintain compliance or devise compliant, effective adaptations to your business model to make it work for all concerned. If you decide to exit the panels, there are protocols to be followed to terminate your contracts and make arrangements for patients that will be reassigned to other local physicians.  You may come to us or we will come to you. Strategic planning consultations are priced daily, plus travel as may be required.  Contract review and analysis is priced by the hour.

We review the resources necessary to execute on the strategy. We discuss the gaps we see and can fill in the gaps for what you don't currently have and repurpose and reuse the resources that can be used in the transition or improvement.  If you are starting from scratch without existing resources, we provide specifications and other tools and checklists for what you'll need and some guidance on expected costs and deliverables to request or specify.  Resource planning is included in the strategic planning consultation but we list it discretely as many competing firms skip this critical step and leave you to sort it all out on your own and risk trial and error mistakes that can be very costly and time consuming.

Reduce blaming and oversights when everything you need is wrapped up in a single comprehensive package. You'll have all the tools and ingredients at hand to create a coordinated professional brand image. Your new business model may require rebranding. But you'll also need some photographs for your website and other collateral. We start by developing your marketing strategy, rebranding plan, and provide creative direction for photographers and videographers and graphic designers, design and set up your website, online newsletter and email and social media presence. Create photos and videos with multiple purposes in mind.  As a part of our marketing management services, we schedule quarterly updates to review outcomes, effectiveness, and see where you stand, maintain your brand image across all marketing and public facing channels, and set goals and KPIs for the next quarter.

Many of our clients outsource membership administration to us because they lack time, staff and/or software to handle the tasks associated with membership practices. We have a team ready to assist. Pricing is on a per account basis.

After the parts outsourced to our team of experts, there's plenty of work that remains to get you up and running. Among these, you'll need to sort out accounting and tax preparation, new corporation set up, rent and leases, malpractice insurance, equipment leasing and in-house technology, staffing and HR, remodeling and space planning, annual software and website hosting and licensing renewals, EMR and medical records, revenue cycle management for your old practice receivables, insurance billing and coding pricing formulas, and membership administration, after hours answering service, appointment scheduling, telehealth, HIPAA and GDPR compliance, and more. If you'll need a written business plan in order to arrange loans, you'll need the sections on marketing and budget proforma and income projections which are unique to each practice.


Concierge and DPC Clients


Internationally-published handbook


Team members in varying specialty areas

Time U.S. primary care physicians spent with each patient as of 2018

Cost Estimates

Many callers ask us what they should expect as far as costs to startup or transition to a concierge or direct pay practice. They need this information to create a budget pro forma for a business plan that will be used by lenders or simply for internal planning purposes.

Budget Line Item  Our cost estimate Actual cost
Corporate setup, legal fees unknown
Accounting costs, tax advice, accountant fees unknown
Bank fees and transactional costs unknown
Staffing and benefits unknown
Rents and leases unknown
Insurance policies unknown
Equipment and technology purchases, leases, office furnishings unknown
Interior remodeling, permits, contract labor, and space planning unknown
EMR and software/hardware computer associated expenses unknown
Revenue management expense, billing, coding, collections unknown
Answering service $250 /month
Appointment scheduling software integration unknown
Telehealth tools and technology unknown
Startup consultation $400 per hour
Market research $400 per hour
Strategic planning $4800 and up depending on scope and time at your location
Rebranding $10,000
Existing and new payer contract review, analysis, recommendations $2500 per contract, on average
Photography and videography, professional editing and production $10,000 for both, plus any travel and location use fees
Website setup, design, email, licenses, registrations, etc. $4500 first time, $2000 annual renewals
e-Newsletter setup, design, quarterly editing and mailing services $4000 annual
Social media marketing set up and management $5000 first year, $3800 annually thereafter
Sales tools creation, brochure, sales, flyers, member handbooks $5500
Member contracts (Medicare and non-Medicare templates) $750-1250

Don't "fear" the budget estimates above; instead, use them to your advantage.

Keep in mind these are only estimates. What you decide and how you deploy will all impact these estimates. You may not have budget to do all you'd like to do at the very beginning. That's perfectly normal. We take the approach that you do the best you can do, call on favors, supportive friends and family who may be graphic artists, photographers, web designers, English majors that can edit, and others to contribute to your cause. Barter with some patients if you must (always a last resort!) and stage the rest for later. The worst mistake you can make is to underestimate and under capitalize out of ignorance or insult someone's value by not perceiving the retail price they would get if you had to pay for their services.

Understand the competitive marketplace

According to MerrittHawkins published research, one tenth (n=3000+) of American physicians, both in primary care and surgical and non-surgical sub-specialties have declared intention to switch or launch a concierge membership or DPC practice. You must be positioned above your competitive rivals to win ideal customers (patients) and grow.

Eventually, for the ideal patient  seeking this style of healthcare delivery, price will merely act as a filter. The real competition you will face occurs at the perceived value proposition and differentiation level. It will occur each year at renewal decision time as well, where 30% attrition is normal and you must locate new members/buyers to maintain equilibrium. Living brands are hyper-personalized just like your concierge or direct pay medical practice business model. That's how you keep them size constrained to the maximum patient panel size you want while setting the income levels at a comfortable number. To do this, we use data from the CHNA, data from the demographics of your existing patients (if transitioning) and data from past utilization, procedures, diagnoses, and other indicators to assess your practice and create ideal customer personas.

Understanding brand value

Setting your value proposition so that the value you offer is also perceived by the members day in and day out is an objective of branding, rebranding and brand relevance. The perception that the extra amenities you provide must be conveyed through proper messaging, imagery, consistency in staff service and attitude, and the little differentiating extras that people will want to mention and appreciate in word of mouth comments to friends and family, online in feedback, and in repeat purchases. Physicians and dentists who functionally integrate around the customer with regard to the technology, data, marketing and the patient experience leapfrog beyond their competitive rivals by delivering their membership or DPC products and services not simply as an offer, but as an experience ecosystem: a hyper-contexual, empathetic, cohesive and humanized experience that responds to, learns from and anticipates its customers’ next moves and needs and willingness to renew subscriptions upon their contract anniversary. Everything you do, everything you invest in the budget estimate above must enhance your brand relevance to the ideal customers you want to attract and filters out those you don't. Therefore, above and beyond the basic startup expenses (rent, accounting, corporate formation, etc.) should be prioritized accordingly. Until you have created your "living brand" architecture, don't create a website, brochures, sales flyers, newsletters, and even a list of what is included in your amenities package until you've created the brand architecture or you'll waste time and money on do overs or be forced to live with ineffective website, brochures, sales flyers, newsletters and amenities packages until you can afford the do over or flat out fail at your new business model.

A sign that the initial customers didn't realize or perceive the same value you thought you presented is when they quit and transfer to a different concierge or DPC practice in the same community. This sort of attrition is very different from one where they quit and went back to traditional neighborhood "hamster wheel" practices...a sign that they believed could not afford to continue to pay for a "luxury." Or the attrition that occurs because of a significant life change (a new financial responsibility or a move).  Living brands are in learning mode all the time and use this knowledge to inform how they think, act, and engage with consumers. It is critical that you learn why the patient signed up and what gave rise to any attrition that occurs by reaching out with a personal call to each member who joins or leaves your practice.  Your "brand" is not a collection of static logos or advertising campaigns, but instead, a total immersive experience of how you help people advocate for themselves for their healthcare and wellness. Without this, you won't grow. You'll simply have a business model that involves a membership amenities fee and/or no longer accepts insurance as payment for services.

Your patients bring you value as well

In some cases, you may wish to have a discretionary "waiver" allowance for certain patients you want to retain, no matter what. That discretionary allowance will affect your income projections, but perhaps there is something that patient can offer (influence, services, or something else) in trade that will cut costs elsewhere.  Allowing them to trade value for value (at full retail barter) enables them to maintain their dignity and self-respect and desire to remain in your practice even if they can't afford to pay for your services otherwise. First, come back to the budget list above and figure out what you can cross off the expense column in trade. Is what they bring mission critical? Prioritize this!

We offer this counsel to everyone. While some of these services may be the very services we offer, we want you to succeed even if it means not using our services. We don't mind working with your daughter, the journalism major, to help edit your web and brochure content as long as she can deliver on time, on target, and provide value equal to a professional we would otherwise bring to your project. We don't mind working with your patient, the website designer or social media "hot shot" as a substitute for a team member we might otherwise introduce. In fact, we'll welcome them and integrate them onto "your" team.

With some 800,000+ licensed physicians in the USA, and 10% of them with intentions or decisions to move to these business models, we know we can't claim the market and that not all physicians who decide to transition or start up a concierge membership or direct pay practice will be our customers. Of the addressable market, we've assisted about one-half of one percent. They come with all sorts of ideas, differentiation, locations, budgets, and dreams. Reach out and let's start with a 15 minute courtesy introductory call. There's no obligation to go beyond that. If we aren't the best fit for what you want and need or if we are too busy to help you in the time frame you desire, we will happily refer you to professional colleagues we know and trust who may be able to help you.


To arrange a consultation send us a message or call us by phone (800) 727. 4160