Package Pricing: Removing the Pain of Payment

by Mark Sanna, DC, ACRB Level II, FICC • 

President & CEO Breakthrough Coaching • 

In the realm of chiropractic care, delivering high-quality treatments and helping patients achieve better health is paramount. Yet, there is one hurdle that often disrupts the smooth flow of a patient’s healing journey: the payment process. Imagine a scenario where a patient, feeling renewed after an adjustment, approaches the front desk only to face the “pain of payment.” It’s a jarring moment that can negatively impact the overall patient experience and, in some cases, may even deter them from returning for further care.

To remove this unnecessary friction, many chiropractors are turning to package pricing models that simplify and enhance the payment experience. This strategy enables patients to focus on their well-being without being reminded of financial transactions after every visit. This article will delve into the importance of package pricing, bust common myths surrounding it, and explain how chiropractors can legally and efficiently implement these packages while maintaining compliance with regulatory standards

The Inefficiency of Per-Visit Payments 

One of the least effective ways to handle patient finances is through the traditional per-visit payment model. When patients are asked to make a payment at the front desk after each visit, they are given the opportunity to reassess whether or not they want to continue care, often basing that decision on how they feel in the moment. This creates a potential barrier to care continuity, as patients might prematurely terminate their treatment plan based on temporary relief or discomfort from having to part with their money at each visit.

By switching to a package pricing model, chiropractors can eliminate these psychological barriers. Patients no longer have to make a financial decision after every session, allowing them to stay in a positive, health-focused mindset. Package pricing ensures that patients commit to a plan upfront, making it easier for them to complete their treatment programs and achieve long-term health benefits.

Myth Buster: “People Won’t Pay for Package Pricing in My Town”

One of the most common objections chiropractors face when considering package pricing is the belief that their patients won’t accept such a model. Statements like, “People in my town won’t go for that,” are often heard, but this is simply a fallacy. In reality, people will always be willing to pay for value. If the care and services provided demonstrate clear benefits to the patient’s health and well-being, they will see the value and will commit to the investment.

What chiropractors need to focus on is educating patients about the advantages of package pricing. Patients are more likely to agree to a package when they understand that it simplifies their experience, provides consistent care, and, in many cases, offers financial savings in the long run. The key is to communicate how package pricing aligns with their health goals and makes it easier to stick to a care plan without unnecessary interruptions.

Legal Considerations: Avoiding Inducements and Compliance Issues

A significant concern with offering package pricing is ensuring compliance with legal and regulatory standards, particularly the Stark Law, which addresses issues of inducement in healthcare. Inducement refers to the act of offering free or discounted services as an incentive for patients to seek or continue care. Chiropractors must be cautious not to offer discounts on covered services, as this can be seen as an illegal inducement.

The distinction between covered and non-covered services is crucial when building package pricing. Covered services are those typically reimbursed by insurance companies, whereas non-covered services include offerings such as wellness visits, nutritional counseling, or decompression therapy that may not be covered by a patient’s insurance plan. Chiropractors can legally bundle non-covered services into packages, but it is essential to avoid discounting covered services as part of the package. Doing so could raise red flags under healthcare regulations.

It is also important to disassociate payment plans from treatment plans. A payment plan is designed to facilitate how a patient pays for their care, but it should not be mistaken for a guarantee that a particular number of visits or services will resolve a patient’s condition. Chiropractors should be clear in their communication that the payment plan is simply a financial arrangement, not a promise of a cure. This distinction ensures that patients understand the limitations of the payment plan and protects the practice from any claims that the number of visits purchased is tied to guaranteed treatment outcomes.

Leveraging a Discount Medical Plan Organization (DMPO)

To legally offer discounts on services without falling into the trap of creating a dual fee schedule (where insured and uninsured patients are charged different rates for the same services), chiropractors can utilize a Discount Medical Plan Organization (DMPO). An example of this is ChiroHealthUSA (ChiroHealthUSA.com). DMPOs create a contractual relationship between the patient and the organization, allowing chiropractors to offer discounted services through the DMPO’s legal framework.

The process works similarly to third-party insurance agreements with major providers like Blue Cross Blue Shield, Aetna, and UnitedHealthcare, where specific fee schedules are followed. By joining a DMPO, chiropractors can offer discounted services to patients who opt into the plan, legally sidestepping the issues associated with traditional fee-for-service discounting.

The Time Factor: Incorporating Wellness Visits

An effective package pricing model doesn’t just bundle services but also offers flexible payment options that make care more affordable over time. For instance, incorporating wellness visits into a patient’s package can help spread payments over a longer period. This makes the financial commitment more manageable for the patient while still ensuring they receive ongoing care.

By offering wellness visits as part of the package, chiropractors encourage patients to stay on track with their long-term health goals. Wellness visits, which are often non-covered services, are also an ideal way to continue engagement with patients beyond their acute care needs.

Chiropractic and Multidisciplinary Bundles

Chiropractic services are naturally well-suited to package pricing, but this model can extend even further when integrated with multidisciplinary practices. Bundling chiropractic adjustments with other services such as decompression therapy, laser treatments, shockwave therapy, nutrition counseling, and durable medical equipment (DME) like braces or foot orthotics, allows practices to offer comprehensive care in a streamlined, convenient way for patients.

For practices that include multidisciplinary services such as regenerative medicine, functional medicine, bioidentical hormone replacement therapy (BHRT), and DME, package pricing offers even greater flexibility. Patients can receive a full spectrum of care under one roof, and the practice can ensure consistent revenue flow by bundling high-value services together.

Do You Really Need Low Reimbursement Insurance?

Many chiropractors face the challenge of working with insurance companies that offer low reimbursement rates. The question arises: does the volume of low-fee visits compensate for the inadequate reimbursement?

With package pricing, chiropractors have more control over their revenue model. Instead of relying solely on high-volume, low-reimbursement insurance visits, they can focus on delivering high-quality care to patients who are committed to their health goals. By offering comprehensive packages that bundle covered and non-covered services, practices can reduce their dependence on poorly reimbursing insurance companies and foster a more sustainable business model.

Implementation: Getting Started with Package Pricing

Implementing package pricing doesn’t have to be complicated. By following a few key steps, chiropractors can begin offering patients package plans that improve their experience and ensure compliance:

1. Identify Services to Bundle: Start by identifying the most commonly used services in your practice. These could include chiropractic adjustments, wellness visits, decompression therapy, and other modalities like laser or shockwave therapy.
2. Set Clear Terms: Define the length of time or number of visits covered by the package. Ensure that both covered and non-covered services are appropriately bundled to maintain compliance with inducement laws.
3. Offer Flexibility: Create different package options that allow patients to choose the one that best fits their needs and budget. Consider offering payment plans that spread the cost of the package over several months to make the investment more manageable.
4. Communicate the Value: Educate patients on the benefits of package pricing, emphasizing the continuity of care, convenience, and potential cost savings.

By implementing package pricing, chiropractors can provide patients with a more streamlined, stress-free payment process while ensuring long-term care engagement. This shift not only improves the patient experience but also contributes to a more sustainable and profitable practice model. As the healthcare landscape continues to evolve, package pricing offers chiropractors a practical solution for delivering high-quality care without the “pain of payment.”

Dr. Mark Sanna is the CEO of Breakthrough Coaching. He is a Board member of the Foundation for Chiropractic Progress, a member of the Chiropractic Summit, and a member of the Chiropractic Future Strategic Plan Leadership Committee. To learn more, visit www.mybreakthrough.com. He is the author of Cracking the Code: Marketing Chiropractic—How Chiropractors Align Spines and Minds, available on Amazon.com.