Physician Specialists and Emerging Practice Business Models: Choosing Forward

If you serve within a specialty practice—as a physician, advanced practitioner, or administrator—you may now have more options for how patient care is delivered, and how the practice is paid.

When we think of concierge models of care, we think of internal medicine and primary care—you know, the large concierge care ‘branded’ franchisors that bundle in practice conversions as part of their franchisee services agreement (like MDVIP, SignatureMD, and Castle Connolly).

The majority of primary care private clinics who convert their practices to operate under a large franchisor’s umbrella tend to be mid- to late-career physicians looking to reduce their patient panels. They aspire to improve their income and quality of life, along with giving more attention to each patient and working fewer hours. Interestingly, most are not fellowship trained in lifestyle, integrative health, or functional medicine.

However, if you’re a specialist—and especially if you have training, certification, and a desire to comprehensively support the patient host environment ala integrative health—a customized practice conversion or introduction of an episodes of care program may be the best business and professional decision you can make. Because…

Concierge care and various hybrid models and programs are not just for primary care. It can also be an ideal move for specialists and specialty practices. You certainly do not have to give away part of your practice income or any aspect of control to a large franchisor to successfully convert your practice.

And you don’t need to transition every physician in a multi-practitioner clinic to some form of concierge (e.g., hybrid insurance and membership, or an episodes of care specialty program). You can test these options—or others—to see what works most effectively for the population you serve.

If your clinic meets specific criteria, you may be remarkably well-positioned to develop a customized model and care delivery program for your specialty practice.

Consider utilizing a smaller expert conversion partner with extensive experience in business modeling, episodes of care programs, practice design, and patient communication.

More specifically, if you are a physician specialist (or administrator) already practicing within the umbrella of integrative health (e.g., integrative medicine, functional medicine, lifestyle medicine), you are starting the process with an important competitive edge, and will be best served by a conversion expert with deep knowledge of the field.

[Related content: Time to Rethink Your Practice Business Model]

Let’s face it, the current fee-for-service model encompassing commercial payers and CMS does not consistently allow for the delivery of high-quality care. You are forced to deliver volume of care to maximize reimbursements to ensure the financial health of the practice.

It is unfortunate—even frustrating—that complex patients need more time, attention, and support than you can deliver based on the compensation received/available.

As earlier mentioned, although few specialists currently operate entirely outside of the fee-for-service commercial payers and CMS model, here are a dozen medical specialties that can potentially be a good fit for practice modeling and ideation using various hybrid (insurance and membership) and program models.

1. Cardiology (cardiovascular and heart disease)
2. Endocrinology, Diabetes and Metabolism
3. Gastroenterology
4. Gynecology
5. Neurology
6. Oncology/Hematology
7. Pain Medicine and Pain Management
8. Physical Medicine and Rehabilitation
9. Pulmonology
10. Rheumatology
11. Sports Medicine (Orthopedic Surgery)
12. Psychiatry

When executed at a high level, the time and resources invested in the process will provide critical financial ROI and allow for higher-touch quality care leading to better patient outcomes.

Yes, it takes time to reimagine and shift your practice model, but if you agree with, or fit into, one or more of the criteria below, the conversion can be made relatively seamlessly.

• Do you and your practitioner colleagues have the training, skillset, experience and desire to deliver a more comprehensive and generous approach to patient care?
• Are you interested in a team approach that could potentially include health coaches and group (think scale) medical appointments?
• Are you interested in developing conditions-based, cash-based programs—also known as episodes of care?
• Do you have a sizeable, loyal patient panel?
• Do a significant percentage of your active panel get seen more than three times per calendar year?
• Do the demographics of the population you serve potentially support a model of care that does not 100% rely on insurance and CMS? (Have you consulted the government census data for your city or county, or otherwise run the zip codes from your active panel?)
• Did you know that it’s possible with multi-physician specialty practices for different practitioners to offer different care delivery and remuneration models, which allows for careful testing for what may be possible for the larger practice over time?
• Are you aware of the potential in conversion: the multitude of customizable care delivery and business models for your practice—and the processes, technology, and financial modeling and forecasting that most accurately show you what is possible?

Summing Up

1. Concierge and programs are not just for primary care—specialists and specialty practices have options for converting their practice business models.
2. Models can be creative and customized, and designed as ‘tests’, then considered for roll-out practice-wide.

3. You don’t have to use larger conversion companies or those that are attached to license/franchise brands.

4. If you espouse the core tenets of integrative health—and your clinic already has an affinity for focusing on the host environment, not just the disease or pathology—then working with a partner with vast experience in the field will be a significant plus.

Work smarter. Provide better patient outcomes. Earn more. Live better. 

A pivot in your business model can benefit both the clinic and its provider(s) financially and professionally, while also delivering much improved, measurable health outcomes for your patients.

It is time to invest the energy to better understand what may be possible with today’s emerging practice business models and, critically, options for improved patient care delivery and sustainable high-quality outcomes for patients.

Want to discuss your current practice business and care delivery model? Get in touch to schedule a 30-min complimentary consultation.

About FON

FON is a leading integrative health and medicine business development and strategy consulting firm. FON specializes in custom solutions for growing patient volume, developing programs, and increasing product sales. Our practical business models are driven by innovative marketing, clear messaging, and customer engagement via branded storytelling.

Image Credit: Bigstock.com/Aleksandra_Aleroeva