Be sure to complete the survey on What is Value, below.  I want to get some more data before I share the results.

We are now beginning our move into a medical/wellness hybrid practice model. Our goal is to receive 60% of our revenues from traditional insurance, and 40% from our cash sales – with total revenues of $4,000,000 from one clinic location.  Our goals extend to staff, who will be earning 15 to 20% more than they could in a traditional insurance-based practice.  Our company’s annual profit will be 20%.   We will also offer a four-week paid sabbatical to each full-time team member every three years.  By 2024, we are committed to the fact that we WILL achieve each of these goals!

As a traditional insurance provider for 20 years, I am stepping into this new hybrid identity as an owner and a leader with a very important mindset!


We must be careful not to see insurance as an inherent evil that holds us and our patients hostage. I have health insurance and I am glad I do. It has allowed my wife and I to get some urgent medical care this year that we could not have afforded otherwise.  Many different studies peg the number one cause of bankruptcy in this country as out-of-pocket medical expenses. One 2007 study concluded that more than 60 percent of all bankruptcies were declared due to medical debt. I do not advocate for anyone to drop or not have health insurance.

We are participating providers with most major insurance carriers. This is not easy to do.  It can take 5 to 10 years to become a network provider. Being an in-network provider with these companies brings us up to 200 new patients each month, and for this we are very grateful. Despite a very small budget for marketing, we have been a thriving, steadily-growing practice for the past 15 years. All of our past and present patients came through our doors because we accept their health insurance. Once through our doors, they experienced our professionalism, competence and ability to get them back to what they love without surgery or medication. They love us and are happy to refer their friends and family to us. They continue to come to us as lifetime customers because we continue to accept their insurance.

The fact is that approximately 95% of traditional insurance patients have experienced a positive outcome, and that in turn has provided income and stability for our practice and for the families of everyone who works for us. And for that I am truly grateful.  After all, that is why banks love giving loans to medical professionals.

However, I believe that by moving to a hybrid version – by offering cash options to our traditional insurance patients – we can empower both our patients and our staff by offering a better experience and outcome than insurance alone can provide.  The world is ready to receive this as a normal medical clinic experience just like we do with other insurance-based industries such as car insurance, pet insurance, or dental insurance.  They tell you what your insurance pays and you pay the difference.

Consider as an analogy that your insurance pays for prescription medication and you can add supplements by purchasing them for cash. With the appropriate supplements and behaviors, the goal is eliminate the need for prescription medication.  This requires a consistent out-of-pocket expense and investment that is well worth it.

Yes, the medical community is probably the last to get on board with offering added value for cash.  However, I promise you that this will be the norm very soon.

Here are  practical ways to Respect the Past:

  • Don’t make insurance companies the villains.
  • Make it safe and convenient to make a cash transaction.
  • Train your staff on the language and benefits of cash options and how it empowers the patient.
  • Remember, everything is an experiment – learn and adjust.
  • Survey your patients about what services they are looking for.
  • Founders club/member: Patients who pay for cash services at a discount, and give feedback as pioneers who are involved in developing value in the services or products.
  • Be patient and adjust – this is a massive transition for you, your team and your patients.


Take the Survey!

Grateful to be on this journey with you,

Dr. Matthew Harkness

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