Check Out TherapyNotes

The Emerging Market of Concierge Therapy

Updating Your Professional WillOver the last several years, the world of primary care medicine has seen an increase in the provision of concierge medical services. Many physicians are developing thriving practices based on this patient-centered, cash-pay business model, and they are learning that this highly proactive and individualized approach can actually be not only cost-effective for the patient, but it can also result in a bigger bottom line for the provider.

What does this  mean for psychotherapists and the private practice business model?

“Concierge therapy” can be defined as a “total-care” service system implementing an anytime, anywhere practice model whereby clients have the security in knowing that their mental health provider will be available whenever the need arises. This "total-care" service offers flexible, immediate, and individualized treatment through various service models and retainer-style or membership -based fee programs. The concierge private-pay structure allows providers to define a treatment arrangement that is more convenient and comprehensive for the client than regular private pay structures, and it allows the provision of services without the restrictions of insurance regulations, insurance adjusters, or their third party adjusting agencies. The benefit of this model is that it allows therapists to focus on the client’s treatment needs, rather than on watching the session clock and filling out insurance forms. Simply put, the provider’s attention is placed solely on the client.

Here are some examples of the services which may be offered in concierge therapy:

  • Clients receive same day or next day appointments. Block out space in your calendar that is only to be used for your last-minute concierge clients, and base the amount of blocked-out calendar space on the popularity of your concierge program. Even if the time remains empty, the hole in your calendar will be paid for by the membership fees of your concierge clients.
  • Clients may self-schedule appointments using an online calendar.
  • Clients can communicate by email, text message, and voicemail, including evenings and weekends.
  • Provider response time is often prompt, usually within 1 or 2 hours. Some offices have added a special phone line that helps to distinguish the concierge callers from other clients. 
  • Appointment settings can be in the client's location of choice, whether such be in the client’s own home, the client’s office, the provider office, or via telephone or video conference.
  • Hours are extended to evenings and weekends to meet the needs of the client's availability. Weekday hours may be extended based on a last-minute concierge client appointments, and weekend appointments can be limited to concierge clients only.
  • Service hours are very flexible and providers are often on-call .
  • Extended session times: Instead of a standard 45- or 50-minute session, concierge clients receive 60-minute sessions as part of the service.
  • Session length is based on the discussion, and session end times are estimates. A free grace period is often offered, should the extra time be needed. 
  • All appointments start on time, so the client is never left waiting.
  • Private waiting rooms may be offered for concierge clients. Some offices have added a second waiting room with refreshments and snacks to promote a relaxing environment and decrease awkward client encounters.
  • In busier cities with parking restrictions, the provision of a designated VIP parking space for concierge clients can provide further impetus for selection of this preferred service system.

It is a myth that concierge therapy is obtainable only by the wealthy. Many therapists are already declining insurance and charging fees within the $100 - $200 per hour range, so a treatment plan providing for 4 sessions per month would come out to roughly $400 - $800 per month. Clients desiring the "total-care" service afforded by the concierge system may be willing to pay a couple of hundred dollars more to enjoy the added benefits of a concierge membership. For therapists who accept insurance, it is possible to create a model that works in conjunction with insurance, especially when there are deductibles that must be met before the insurance payer begins to reimburse, and limitations to the number of visits a client may have under the insurance policy. Monthly memberships of $1000 or more are usually inclusive of a certain number of sessions per month. For example, a monthly membership package of $1500 can include up to 8 hours of concierge services per month, which results in costs of $187.50 per session. If your current fee-for-service rate is $150 for a 50-minute session, clients may be willing to pay the extra $37.50 for the "anytime, anywhere" service with a grace period. In contrast, membership or retainer plans can range from a $1000 to $4000 annually, with individual session fees paid on a fee-for-service basis.

Transitioning from a traditional practice model to a concierge model can be a frightening thought. No one wants to lose their clients by implementing a change in fee structures, nor is it necessary. One solution may be to consider integrating a hybrid practice model. This model allows the provider to continue offering services to clients through insurance reimbursement and fee-for-service methods, then adding the concierge service for clients who see the value in the "total-care" option. You may be surprised to see just how many clients would be interested in a treatment model of slightly increased cost that allows greater access to their therapist.



Read the complete issue: The Argonaut Navigator, July 2015 Issue

Similar articles: Do More with Client Self-Scheduling