Creating a Subscription or Membership Plan in Your Practice

Woman choosing service plan

This question is asked almost daily on the Elite NP Facebook group and from nurse practitioners emailing me. So, I am going to write a post about this as many nurse practitioner entrepreneurs have a difficult time creating a subscription or membership program in their practice. It doesn’t matter if you are in the startup phase of your practice or wanting to restructure your practice’s current pricing scheme, it is important to know how to create a pricing structure for subscription or membership-based services.

Alright, so what is subscription/membership-based pricing anyways? It means the patient pays your practice (hopefully your own business!) a set monthly rate every month for a selection of services your niche practice provides.

First off, why even bother with subscription/membership pricing? Because patients find a TREMENDOUS amount of value out of it, that is why. This article goes over the differences between recurrent and one time pricing, so I am not going to dive into the differences. But I want to outline a few points on why monthly pricing is more valuable to a patient vs. charging per product service (a fee for a visit, a fee for a medication, a fee for a procedure, etc…):

  1. First off, patients don’t feel like they are getting nickel and dimed with subscription pricing! If you are charging for every single thing you do, then patients become wary that you are just wanting to rack up their bill. Instead, if you charge a flat monthly rate that includes everything, then they don’t experience this negative emotion.
  2. It makes your pricing scheme simple. Instead of having all these different products and services your patient can select from, you will just have a few options, and this keeps the buying process for the patient simple.
  3. It is predictable and keeps life simple for the patient. If you are charging the patient automatically every month, then they expect it and there are no surprises! I couldn’t tell you how many patients I have had tell me that they love how they just get automatically billed every month.
  4. They feel like they are a member of something special. If you have a membership program in your weight loss clinic, then they feel more connected to the program. It truly helps motivate patients and they enjoy that aspect of being in a “club” so to speak.

Those are a few points on why patients enjoy subscription-based pricing. Why should you do this as a nurse practitioner practice owner?

  1. It keeps your product and service list simple. This essentially keeps your books a lot more streamlined.
  2. It creates a predictable flow of revenue into your practice. The best way to grow any kind of business, especially a niche practice, is to have predictable income every month. You can always rely on that income, and you can GROW it monthly!
  3. It makes your business more hands off. If you are setting up your patients on an automatic payment for your subscription program, then you don’t need to be collecting payments all the time. It just happens because it is automated! This is how you work smarter, not harder. The only downside is you must stay on top of it. So, be sure you are looking at your transaction history before refilling medications when patients need the refill.
  4. It creates a foundation for your pricing. You have this baseline subscription plan and anything else can be added onto it to stack your income. This is another great growth strategy because you should be offering a variety of complementary services.

Alright, so how do you set up a subscription-based membership for your practice? Here are the steps in order:

  1. Determine what your base service is. This is the FOCUS or the SELL in your practice. This would be weight loss, IV infusion, hormone replacement therapy, and so forth. This is what you are selling and is the main draw in your practice.
  2. Create your foundational monthly subscription as a combination of the visits AND the service/prescription. In my men’s health clinic for example, this would be the visits plus the testosterone replacement therapy and injection supplies. THAT is my foundation and 99% of our patients are on that $140 a month subscription. For a weight loss clinic, it would be the visits AND semaglutide with the injection supplies for example.
  3. Determine if there is a limit to what you are doing. This monthly subscription includes unlimited visits at my men’s health clinics (don’t worry, most people are too busy to be bothering you all the time) and a refill of the testosterone when a refill is needed. If you break the bottle, then tough shit -> you are paying a $50 restock fee AND going to be charged your normal monthly fee. We don’t just hand out free stuff at my clinic. If you are doing IV infusions, then you need to have different tiers for 1, 2, 3, or 4 infusions a month. You have to set boundaries within your subscription program essentially.
  4. Determine if you want to include anything else in your monthly subscription that patients will find value out of. At my men’s health clinic, we also include free B12 injections with the monthly subscription. People absolutely love it! But you need to include the visits and your baseline service at a minimum!
  5. Come up with 3-4 various subscription options. At my men’s health clinic, if someone wants to do peptides only, then the rate is $220-240 a month which includes the visits, the peptide, and the injection supplies, for example. If you are doing weight loss, then you should have a semaglutide option and a phentermine option, for example.
  6. Figure out how much you are going to charge on a monthly basis to generate a profit for your business. Remember, your goal is to generate AT LEAST a $100 a month profit in your practice. Honestly, you should be striving for $120-150 or even more depending on what you are providing, and the risk associated with it. The $140 a month at my men’s health clinic easily generates more than a $100 a month in profit. Charging $350 a month for semaglutide easily generates a profit of $150 a month. So, be sure you are not underselling yourself and generating a profit that makes all this worthwhile.
  7. Determine when patients are going to be billed. We charge patients every month depending on when they sign up. We set up an automatic monthly payment to come out every Wednesday of the week. If someone signs up the first week of the month, then they are billed the first Wednesday of the month. If they sign up during the 3rd week, then they are billed the 3rd Wednesday.

That is practically it folks! It is very simple to set up a monthly subscription/membership program in your practice. It is worth your time to think this through in your business because the recurring monthly revenue in your practice is a great thing to have. I can predict how much my men’s health clinic will make every single week because we have that recurrent revenue coming in every Wednesday. It is AWESOME to have that $10,000-$20,000 hit your bank account every Wednesday. Plus, it makes your practice more automated, and patients find a lot of value out of it!

12 Responses

  1. Does this work for mental health services as well such as antidepressants, Mood stabilizers etc?

    1. No… I don’t make anyone sign a contract. Patients typically don’t like being locked into a contract

  2. With the membership is there a term they have to sign up for? Or do you only order one month of medication at a time to ensure you are paid for the product? My weight loss products will cover more than one month at a time so I am worried about they paying the first month and then trying to cancel the next month.

    1. No terms. We typically order 3 months to limit shipping costs. Don’t worry about people screwing you over. It has only happened a handful of times over the past 4 years.

  3. Do you just ship to your office for the 3 month supply and they pick up there?
    What system do you use for the autopay set up?

    1. Most of the time we just have the medication shipped to the patient. And you can use our preferred vendor for autopay payment processing at the GPO link at the top of the page.

  4. Hi Justin, Thank you so much for all of your wisdom. I have a few questions.

    1. If you are running a cash-only practice, can you order labs using your patient’s in-network lab and have their health insurance cover the cost of those labs, assuming you use the correct ICD-10 codes?
    For example:
    – R53. 83: Fatigue: TSH, Testosterone, CBC
    – E66.9: Obesity: CMP, Lipids, CBC, TSH, A1c

    2. Is the lab ordering integrated into the EMR “simple practice”, or do you have to order on a separate platform?

    3. Do you need additional prescription software if you are prescribing testosterone through a compounding pharmacy, (authenticator), or do the pharmacies allow direct online ordering for testosterone/phentermine?

    1. 1. Yes that is fine.. do it all the time. 2. I just give them a good old fashion paper order and they go anywhere they want. 3. Usually you have to fax a signed order for most compounding pharmacies…

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