CareNow, a division of Hospital Corporation of America operating 26 centers in the Dallas/Ft. Worth area, has a membership program for patients without insurance. It appeals particularly to patients with high-deductible health plans who will be responsible, out of pocket, for the costs of their urgent care visits and thus choose to not use their insurance.
CareNow charges $18/month for the membership and $68 for sick visits with the membership. Complex procedures, such as incision & drainage or lacerations, receive a 20% discount with the membership. Additional services (eg, labs, x-rays) receive a 20% discount with the membership, which can be cancelled after the second month. So, for the first visit it’s $18 + $68 collected at the point of service. The credit card must be billed at least once, which is the second month, for $18. The membership can be cancelled any time after that.
CareNow uses a third-party vendor to print and send out the membership cards and bill the credit card; they’ve also tied in some additional benefits like network access for medical, vision, dental, and prescriptions. As with an insurance payer, the front desk can verify through the vendor’s website that the member is paid up on his dues.
A program like this could be offered without using a vendor, but the issue is the center would have to develop a process to bill the credit cards, track eligibility, process cancellations, etc. The additional benefits added to the card—ie, the network access and pharmacy discounts—aren’t things most people will use, but make for a nice “kicker” in selling the cards.
Another urgent care center in Texas, Austin Urgent Care, has implemented a similar program, charging an application fee and offering some additional discounts (eg, for sports physicals and flu shots), demonstrating that a membership program can be configured however a center wants.
Yes, there is some concern over “churn” (people who cancel their membership after the fee hits their credit cards—but after they’ve gotten the first, discounted visit), and it does take some effort for the front desk to sell the cards—meaning you have to offer some incentive, like a $10 bonus for every card sold or something along those lines. However, the nice thing is the card brings in a steady flow of income regardless of what patients the center actually sees. Besides, “hungry” front desk staff selling 10-12 cards a week see a nice salary boost.
Consider the membership fee runs $200/year, and the patient uses it four times. Divide $200 by 4 (=$50), and add that to the $68 visit cost; this results in an effective net revenue per visit of $118, which isn’t too far off from insurance. Of course, a center is better off from a net realizable value perspective if people use the card less frequently.
Alan A. Ayers, MBA, MAcc
VP, Strategic Initiatives, Practice Velocity, LLC;
Practice Management Editor,
JUCM—The Journal of Urgent Care Medicine
