Episode 55 - The Bad Business Decisions That Built a 1,500-Patient Direct Primary Care Practice with Dr. Charles Opperman
Dr. Charles Opperman built Simplicity Health, a Direct Primary Care practice in Ohio, on membership tiers based on access instead of age. He shares how his gold, platinum, and concierge tiers work, how he recruits physicians, and how he keeps 24/7 access from taking over his life.
Is age-based pricing really the only way to run a Direct Primary Care practice? For Dr. Charles Opperman, internist and founder of Simplicity Health Direct Primary Care in Ohio, the answer was no. When COVID dropped his schedule from 20 patients a day to two, his hospital system took away his vacation time for leaving early and told him to sit in the office from 8:00 to 5:00. So he used those hours to model out a Direct Primary Care practice. Six years later, Simplicity Health has 1,500 patients, four physicians, and plans to hire more.
Dr. Opperman first heard about Direct Primary Care from a residency colleague he deeply respected. She wasn't ready to leave, so he opened his own practice in 2020 and kept texting her for six years asking if she was ready to join. She finally did, and her panel filled in nine months. When he started, he read every book he could find and leaned on the Facebook community, but the rules for pricing a Direct Primary Care membership still weren't really written. That gave him room to try something different.
Most Direct Primary Care practices use age-based pricing, but Dr. Opperman saw a problem with it. A 30-year-old might text him at 8:00 at night about a broken toenail, while an 80-year-old who doesn't use a cell phone would pay more. So he built tiers based on access. His under 40 tier is $49 a month and his gold tier is $79 a month, with the same services. His platinum tier is $129 a month and includes his cell phone number. He landed on that price by asking himself what amount would make a text during family movie night worth it.
"Ultimately, it's my cell phone, it's my life, it's my personal life. I should be able to set the price on that."
At the top is his diamond concierge tier at $199 a month, which includes weekend appointments, house calls, basic labs, most pharmacy medications at no extra cost, and courtesy visits for family members visiting from out of town. Some patients who aren't wealthy still choose it because they take 10 medications and it saves them money. Dr. Opperman explains that a higher tier also helps patients choose the middle option, since people rarely want the lowest option and many are happy with the "silver medal." His patient mix is about 25% gold, 50% platinum, and 25% diamond, which averages out to $99 a month.
"Patients know what concierge is, and patients associate concierge with high quality care."
That's why he believes Direct Primary Care physicians shouldn't avoid the word "concierge." His website says "concierge style care without the concierge prices," which helps patients who search for a concierge doctor and have never heard of Direct Primary Care find his practice. He also shares what he would change. Early on, he offered so many discounts that the practice ended up with too many pricing rules, so they streamlined everything. He admits he may pay his physicians too generously, with a two-year guaranteed salary and 60% of membership income, but he says the culture they've built is worth more to him than extra profit.
"When our people walk into work, they like being here and it's fun to be here."
When it comes to choosing a tier, Dr. Opperman walks patients through the math during their meet and greet. Gold members get one visit a year included and pay $50 for each additional visit, so for many patients the difference comes down to about a dollar a day for cell phone access. Patients are never allowed to sign up on the spot, because he wants them to go home and choose what fits them best.
"I want you to pick the tier that is best for you. I don't wanna pigeonhole you into a tier that you can't afford or a tier where you don't get enough access."
He also answers the question many physicians ask about 24/7 access. With four physicians sharing call coverage, someone is always available. He gets about one text a week and has been woken up only six times in six years. New patients tend to test the waters with after-hours texts for the first six months, then settle down with gentle reminders to contact the office for non-urgent needs. His biggest message for physicians listening is simple: it's your Direct Primary Care practice, so try your ideas and run with them.
Connect with Dr. Charles Opperman
Email: [email protected]
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