MEDICAL · CONCIERGE & DPC
Membership renewal is an intake problem
A concierge or direct-primary-care practice has two front doors: the one new members come through, and the one existing members walk back out of every twelve months if nobody holds it open. Both are intake, and the second one is the one most practices leave to memory.
THE SHORT ANSWER
The expectation that comes with the fee
A member paying a monthly or annual fee for access expects to be answered. Not necessarily by the physician at 10 PM, but by the practice, quickly, in their language, with a real next step. A member who texts at 9:30 PM about a prescription question and hears nothing until the next afternoon has just been shown what the fee does not buy. The immediate reply, the acknowledgement that a person will respond and by when, and the option to book or to mark it urgent, is the difference between a concierge practice and a practice with a membership fee.
The reply is logistics. It does not answer the prescription question, which is clinical and belongs to the physician. It confirms the message reached the practice, says when a clinician will respond, and offers the urgent path. The clinical answer comes from a person, inside the practice’s own protocol.
Renewal as a stage
- Ninety days out: the member’s card moves to a renewal stage with the date on it. Nothing is sent yet; the practice can see who is coming up.
- Sixty days out: a message in the member’s language, from the practice number, with the renewal link and an offer of a brief call with the physician if they would like one. Stops on renewal or reply.
- Thirty days out: one more, same shape, if nothing has happened. Then the card flags for the physician or the practice manager to reach out personally, because a member who has not renewed by thirty days out is telling the practice something.
- After lapse: a single, warm message at a set interval, and then the card closes as lapsed with a reason if one is known.
A renewal message to a current member is about a date on an existing agreement. It is still sent inside the 8 AM to 8 PM window and under the daily cap, because there is no cost to that and it keeps every message the practice sends inside the same rule.
The DPC version
Direct primary care runs the same sequence on a monthly cadence with less ceremony: the renewal is automatic unless the member cancels, so the stage is about failed payments and about members who have not been seen in a while rather than about a signing date. The message is “we noticed your card did not go through” or “it has been a while; here are two times,” in the member’s language, with a real link. The report shows churn by month, by clinician, and by language, which for a DPC practice deciding whether to add a Spanish-speaking physician is the number that matters.
The referral in this model
New members in a concierge practice come from existing members, from spouses, and from professionals nearby, not from referring physicians. The source field captures that, and the report shows which members have brought in others. That is the list the practice thanks at the end of the year, and it is also the list that tells the practice what its members value enough to recommend.
The Brickell version
A concierge practice in Brickell has members who work late, travel, and expect the practice to run on their schedule. The after-hours reply, the telehealth booking from the same message, and the renewal handled without a phone call during business hours are not luxuries in that market. They are what the membership was bought for, and a practice whose intake cannot do them is competing on the physician alone.
What the report shows
Renewals due in the next ninety days, in dollars. Renewals completed, lapsed, and pending, by month. Members not seen in six months. Response time to member messages, by hour. Source of every new member. It is the same report the other verticals get, with the stages renamed, and it is the first time most membership practices see renewal as a pipeline rather than a spreadsheet the office manager keeps.
Questions we get asked about this
What does the after-hours reply say to a member?
That the message reached the practice, when a clinician will respond, and how to mark it urgent. It does not answer the clinical question; that comes from a person inside the practice's own protocol.
How does the renewal sequence run?
Ninety days out the card enters a renewal stage. At sixty and thirty days a message in the member's language offers the renewal link and a brief call. At thirty days out with no action the physician or manager reaches out personally.
How is DPC different?
Renewal is usually automatic unless cancelled, so the stage tracks failed payments and members not seen in a while, on a monthly cadence, with churn reported by month, clinician, and language.
Where do new members come from in this model?
Existing members, spouses, and nearby professionals. The source field captures that, and the report shows which members have brought in others.
Related
How many renewals are due in the next ninety days?
If the answer lives in a spreadsheet, a 30-minute consultation shows what the renewal stage and the after-hours member reply look like for your practice.