What is a hybrid concierge model?

This is a sort of boutique practice or cash-pay patient model blended with an insurance-based model. So what does it mean?

As you know, if your private practice owner passes several years of reimbursement from an insurance plan, they have been steadily decreasing and hurting private practice owners. You feel it every year, the same procedure. As inflation is going up, the reimbursement has been going down tremendously. And of course, because of the inflation, your operating expense, payroll expense, everything else has been going up.

Who does it affect?

Is it only hurting private practice owners? No, not only private practice owners but it is also detrimental to the patients. Why? Because patients’ insurance premium has been going up every year. Their annual deductible is not uncommon to see – $5,000 and $10,000 a year in network benefits with coinsurance 20% to 30%.

Even if you want to provide the best treatment option to your patients, if they have this type of insurance plan with a huge deductible, it is very difficult for them to accept your treatment solutions. It is actually very difficult for private practice owners to survive with current, typical insurance-based models that you have been used to.

Time for Change

I do not know if you have been practicing for many years, or you are just out of practice, or you are a resident who is ready to come to the real world. Really, if you do not shift, if we do not convert or at least consider, it is very difficult to survive. Only current practice models may work through ACO, HMO or to the big hospital to get volume feed from this big network with the current reimbursement.

Now, what is the disadvantage of that? Your revenue may be okay in that model, but how many patients do you see with that type of model (volume base model, insurance-based model)? You are contracted and you have to see just so many patients a week. How can you expect to provide the best quality care to your patients if you have to see 200 to 300 patients a week?

Again, you have to be employed by a hospital and they have a lot of staff. I know the physician’s assistant or nurse practitioners are taking over lots of doctor’s responsibilities just to save money from bleeding the insurance company money, government money, or a hospital. It is a very, very difficult situation. So by incorporating the hybrid concierge model for private practice, it just makes sense because now you participate in only certain insurance network plans that are fair.

Even if you are in a network, patients still have to pay a lot of huge deductibles. It is almost about the same in-network or out-of-network. It is a matter of if you can provide the best treatment solutions. I think that is what matters the most. So, you do not get your decision process to choose the proper treatment plan. It does not get influenced by what insurance or if that is covered by insurance. So, by establishing and building a preconceived model:

  • you can focus on patient care
  • you can focus on choosing the right solution for each patient
  • you can provide the best possible quality care with time

My Experience

So right now, I practice a hybrid concierge model. I only participate in two insurance plans, so it is possible. Then, I can see 10 to 12 patients a day. But you can provide the best quality time and undivided attention to your patient, each patient. And you can provide the right treatment for each patient. So that is really why I am encouraging private practice owners to seriously consider a hybrid concierge model.

A 3-Step Strategy

Now, how do you do that? In the next six months, this is where I believe you need to invest your time and your resources.

  1. You need to develop a niche skill set. So no matter what type of specialist you are, there has to be a niche treatment solution that you commit time to get better at. Learn more, study more and invest. Have a strong focus on a few niche skill sets so you can build authority in that treatment solution.
  2. You need to study and understand medical marketing and patient psychology. As a physician or a surgeon, it is very difficult to understand how patients think in the decision-making process. Most surgeons and physicians are used to diagnosing the problem and just letting the insurance deal with it.
  3. You need to develop communication skills. Without proper communication skill sets, it will be impossible to build concierge, boutique or patient-pay model practice. I am not teaching you how to sell like in typical sales. You are providing a service. If you believe your service is the best and patients are in-network, out-of-network or out of cash, they still have to pay.

If you do not know how to close that gap during the doctor-patient consultation phase, there will be no exchange of service. There will be no treatment solutions, therefore you will not help your patients. And if you believe in certain services, that niche skill set is great for patients’ health and a better life. If you are not able to communicate with your patients properly, I strongly believe you are doing a disservice to your patients.

So, I hope these 3 steps have awakened you a little bit if you are thinking about a hybrid concierge model.

To your wealth and success,


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