DPC News

Membership Medicine and DPC in 2019: 6 developments you should know about

So, now you know there is still a tremendous need for what you do as a DPC Physician if you weren’t already convinced. For further proof, we’ve designed a DPC HEAT MAP of new Patient Search Inquiries for the past two years to show you where the new patient concentration and interest in joining a DPC practice and program is (see below).

By Michael Tetreault, Editor | See also Disclaimer Below related to Trend Lines Below

DECEMBER 1, 2018 – Membership Medicine and DPC are alive and strong. Thousands of people each year believe it or not are looking for a relationship with a Physician in their local community and each year, the number increases.

To prove my point I’ll use a real-time example from our 2018 Direct Primary Care Journal ANNUAL REPORT.

In the calendar year of 2017 (Jan 1 – Dec 31, 2017), prospective patient search inquiries increased by more than 341 patient inquiries than in 2016. This data is according to our own Prospective Patient Search inquiries via our DOC FINDER in which we received real, actively seeking Patient inquiries from across the U.S. in 2017, and even more specifically, looking to join membership-style clinics and DPC Physician programs. Most new patient search inquiries were from rural and some suburban centers. Documented consumer awareness decreased nationally in 2016 according to The DPC Journal when we looked at the numbers of prospective patient search inquiries. So much so that by more than 232 patient search inquiries in 2016 (Jan 1 – Dec 31, 2016 totaled 727), down from 495 prospective patient search inquiries from the prior year in 2015 (Jan 1 – Dec 31, 2015). In the calendar year of 2014, 463 prospective patient search inquiries were received between (Jan 1 – Dec 31, 2014).

So, now you know there is still a tremendous need for what you do as a DPC Physician if you weren’t already convinced. For further proof, we’ve designed a DPC HEAT MAP of new Patient Search Inquiries for the past two years to show you where the new patient concentration and interest in joining a DPC practice and program is (see below).

(C) The Direct Primary Care Journal, 2018 | Duplication & Reuse Without Credit Is By Permission Only | T: 770-455-1650 ext 131 or editor@directprimarycare.com

(C) The Direct Primary Care Journal, 2018 | Duplication & Reuse Without Credit Is By Permission Only | T: 770-455-1650 ext 131 or editor@directprimarycare.com

So what will 2019 look like for DPC and Membership Medicine and subscription-based healthcare programs and clinics?

  1. First, January is ALWAYS the most popular month for new Patient subscribers. We’ve found this trend continues and that first and third quarters of 2019 will trend in that same trajectory as we’ve observed in past years.
  2. Fight the battle on paper, on purpose. Plan Wisely On Before Marketing and Announcing Your Service Offerings and Evaluate More Closely Your Internal Hard Costs: So what’s next for the Membership Medicine? More great Doctors will enroll for sure. Expect them to learn from those who have blazed the path before them but be ever mindful of those who didn’t make it all the way to success, particularly in DPC where the moonlighting abounds, the fees are collected monthly vs. annually and the patient panels need to increase in order to create a viable, self-sustaining practice. Those entering the membership medicine space must plan their membership service offerings wisely in an effort to increase new members’ delight.
  3. Give Yourself A Raise: Physicians tell us that their membership fee for the upcoming year and any price adjustment(s) are usually completed (for now) by mid-December. Many [DPC] Physicians will tell you that it would behoove you as a medical practice owner to ‘give yourself a raise each year.’ In fact, when we asked how often membership medicine doctors give themselves a raise, 57% said ‘Yes! Avg. increase is bet. 5-9% …’ and 28% said ‘I give my staff raises, but I have not taken one myself.’
  4. Fee Increases: Back in October 2017, we raised the cost question of standard primary care subscription all new patients and received the following insight. Nearly 10% of DPC Physician polling respondents stated that they believe some DPC clinics today won’t be able to stay in operation due to lack of local consumer interest. The DPC Journal also found that closures of DPC clinics are not being closely monitored nor reported. Less than 18% of DPC Physician stated they believe DPC should be defined by price. A majority of Physicians believe price shouldn’t matter and that the Doctor’s service offering/membership fee should be based upon the services offered, level of education, demographics, etc. In 2017, we saw subscription fee increases in monthly memberships rise by an additional $20-$50/pmpm. In 2018, nearly 8/10 monthly DPC subscription fees are now trending between $51-$99/pmpm. Since then, the mood in DPC around price hiking the cost on memberships among existing patients is 50/50. Some will do it incrementally, possibly age-banding, some with make small increases like $10-24/pmpm and others won’t increase their fee structures whatsoever. But now finally, all price adjustments should be in place as you enter the new year and consider marketing and new service offerings for 2019. Does $25-$85/pmpm sound too rich for your blood? Good news: The basic DPC monthly plan average trend line is telling us the following: 68% of fees inside most DPC practices cost between $25 to $85 a month, on average according to The DPC Journal. Most however, (45%) of DPC Medical Offices average between $51-$85 per month per patient, usually dependent upon age and services included. However, in 2017 and continuing into Q1-3 of 2018, we are seeing monthly fees rise significantly inside these [DPC] programs by more an additional $20-$50 pmpm (per member, per month).
  5. Brand Identification: Will DPC PMPM fees jump over $99-$150/pmpm? News flash, they already have. Even Yahoo News in April of 2018 reported Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee — often between $50 and $150 a month — that covers most of what the average patient needs, including visits and drugs at much lower prices.
    In 2016, the monthly DPC pmpm fees and trend lines for DPC monthly programs $99 and up per member, per month was averaging at 12% to 15% of clinics with DPC monthly fees were over $99/pmpm. Fast forward to 2018, now the same question tells us that between 18-20% of DPC monthly fee plans are now over $99/pmpm. Will the argument continue to be made that DPC is ‘Concierge Medicine’ for the masses …’ or will these Physician fee programs over $99/pmpm pivot their brands and identify less with low-cost conscious audiences (e.g. Millennials and Gen-Xers) and be identified by their loyal followers as private medicine doctors or even Concierge Doctors and appeal more to (e.g. upper age Gen X-ers and Baby Boomers)? Time will tell but we do expect there will be a dividing line at the $100/pmpm mark. In reality, should there be? Probably not. Could this move mark an inflection point in the DPC business model and maybe blur the lines between OTT (over-the-top) care and the traditional pay your Doctor and leave industry beyond recognition? Perhaps not as much as you’d think… From many (e.g. just over 80% — click here) in DPC’s shared perspective (by some, not all — ), the monthly membership fee remains rooted in the knowledge of what it is and what it does best — while keeping an eye out for ancillary revenue streams. According the 2018 DPC Journal poll, less than 16% of DPC Physician stated they believe DPC should be defined by price. A majority of DPC Physicians believe price shouldn’t matter and that the Doctor’s service offering/membership fee should be based upon the services offered, level of education, demographics, etc. “DPC remains primarily a direct-to-Patient business, but we see bundling initiatives as an attractive supplemental revenue channel,” notes the 2018 Direct Primary Care Journal ANNUAL REPORT. “Are all of these programs and Doctor’s providing care via a closer relationship with their Physician? Yes! That is what they all have in common and that is something they all share.”
  6. Bundles: We are beginning to see the trend the innovators in DPC will begin including more low-cost, in-house screenings and “limited” genetic tests (Click here to read and listen to our interview with Dr. Brandon Colby about the difference between limited genetic testing and comprehensive Whole Genome Testing) in some bundled membership and “up-sell” offerings in an effort to increase bottom-line, overall annual revenue for the practice. We’ve already started to see this happening inside the DPC2B offerings and some individual pricing programs. Patients want value. Netflix for example is breaking down the walls between itself and cable in a new initiative that’s the first of its kind. Marking the first time Netflix has ever been included in a TV provider bundle. Comcast announced this earlier in 2018 that it will embed the streaming service within several of its Xfinity bundles. Billing will be handled exclusively by Comcast, so you just get one combined charge on your monthly cable bill. DPC bundled offerings and availability will vary by market for both new and existing Patients but innovating in this way will allow DPC community partners (e.g. local labs, small box hospitals, small community-based pharmacies DPC may work with) to attract more Patients and to up-sell to existing DPC subscribers.

Disclaimer

This article, web site(s), programs and all other associated reference guides and materials are designed to provide accurate and authoritative information with regard to the subject matter covered. The information is given with the understanding that the authors, publishers, distributors and its related affiliated or subsidiary companies are not engaging in or rendering legal, accounting or other professional advice. The authors, publishers, distributors and its related, affiliated or subsidiary companies, stress that since the details of an individual’s personal situation are fact-dependent, you should seek the additional services of a competent professional for legal, accounting and business advice for your individual practice.

It is your responsibility to evaluate the accuracy, completeness and usefulness of any opinions, advice, services or other information provided as it pertains to your practice. All information contained is distributed with the understanding that the authors, publishers, distributors and its related, affiliated or subsidiary companies,  are not rendering legal, accounting or other professional advice or opinions on specific facts or matters, and accordingly assume no liability whatsoever in connection with its use. Consult your own legal or tax advisor with respect to your personal situation.

In no event shall the authors, publishers, distributors and its related, affiliated or subsidiary companies, be liable for any direct, indirect, special, incidental or consequential damages arising out of the use of the information herein.

Intended Audience

This information is published for some, but not all the residents of the United States. This work is not intended for use outside of the United States of America.

Please Be Aware

While we make every effort to ensure that at the date of this book and its publication that the contact information below is up-to-date and accurate, we do recognize that the contact information, names, etc., are subject to change at any time. In addition to the resources, contacts, individuals and doctors mentioned in this book, we have provided you with a list of trusted physicians, resources, attorneys and businesses that you are welcome to reach out to at www.DirectPrimaryCare.com.

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