Practices try out monthly payment plans to promote preventive care
Posted April 16, 2014
||Photo by R. Scott Nolen
The recession took a little while to hit Encina Veterinary Hospital near San Francisco.
When it did, the practice looked for answers in the 2011 Bayer Veterinary Care Usage Study. In one key finding, the study revealed that 45 percent of pet owners said they would visit a veterinarian more often if the practice offered a wellness plan billed monthly.
Encina Veterinary Hospital rolled out its wellness plans in 2012. Within a year, the practice had enrolled hundreds of patients in the plans, which include various packages of preventive care services with charges billed monthly rather than at the time of each veterinary visit. The program is still going strong in 2014 as the practice continues to refine it.
For Banfield Pet Hospital, wellness plans have been part of its philosophy since 1988, long before the original hospital grew into a national chain. Banfield leaders point to the plans as one reason for not having seen the decrease in patient visits that many practices saw in the past decade.
The consumer really is in favor of these plans. They like to be able have this comprehensive annual plan that they can pay out monthly.”
-Dr. David B. Goodnight, senior consultant for Brakke Consulting
At practices large and small, wellness plans offer the promise of enhancing preventive care for patients while improving finances for clients and veterinary clinics. In reality, the plans can be hard to create and maintain, and pet owners sometimes confuse them with pet health insurance. The 2011 Bayer study found that only 5 percent of practices offered a wellness plan billed monthly, although 29 percent would be willing to do so.
Partners for Healthy Pets introduced free resources in 2012 to help practices implement monthly payment preventive health care plans. At least half a dozen companies now provide services to assist practices with plan development or administration. And more practices are trying out the plans with their clients.
Upsides of the plans
Dr. David B. Goodnight, a senior consultant for Brakke Consulting, said the veterinary community has taken a great deal of interest in wellness plans—partly because of the success of Banfield.
When Dr. Goodnight was with Nestlé Purina, he developed the Partners in Wellness program as a turnkey system for practices to offer monthly payment plans for preventive care. He said pet owners who enrolled in the plans visited their veterinarians more often because they knew they had already paid for at least part of their pets’ veterinary care for the year.
Purina later discontinued the program, stating that the decision was based on “economics and months of careful analysis.”
“I’m a big believer in these wellness plans, and I believe they do hold a lot of promise for the profession,” Dr. Goodnight said. “The consumer really is in favor of these plans. They like to be able have this comprehensive annual plan that they can pay out monthly.”
The mission of Partners for Healthy Pets is to promote preventive care through regular veterinary visits. Jessica Goodman Lee, a practice management consultant for Brakke, developed the coalition’s free resources on monthly payment plans.
Goodman Lee did research with the few practices that had plans and looked at the Banfield model as well as payment options in human dentistry. She found that one popular aspect of the plans at certain veterinary practices, including Banfield, is the inclusion of additional examinations at no additional charge.
“What people who have done them so far are finding is that they are making more money,” Goodman Lee said. “The client may be spending less at each visit, but they’re coming in more often, and the overall revenue is increasing—and the care is increasing.”
||Dr. Kristin Hussey, lead veterinarian at the Banfield Pet Hospital in Lake Oswego, Ore., examines Boo Boo, whose owner, Phyllis Lapainis, has had an Optimum Wellness Plan since 2010. (Photo by Jeff Hinds Photography)
Dealing with the details
Implementing preventive care plans can be difficult, and sometimes they don’t take off at a practice.
Dr. Goodnight is familiar with how challenging wellness plans can be for individual practices. The practice team must have the motivation to make the plans happen, he said.
“The person in the hospital who is the champion has to keep the momentum going on these things and keep them ever present in the staff’s minds and in the clients’ minds,” Dr. Goodnight continued. “Things have a way of sliding, so the challenge there is just keeping the momentum going once the plans are set in place to reach some kind of a critical mass where they can have a positive impact on the practice.”
In his experience, some practice teams became extremely motivated, despite the complexity of wellness plans. He listed components of the plans as including plan design, secure billing, tracking of usage, and annual renewals. He said practices can turn to service providers to alleviate the administrative burden.
Goodman Lee said a major technical hurdle is a lack of integration between most payment platforms and practice management software. She thinks the slow adoption rate for preventive care plans also results from other difficulties with implementation or from a wait-and-see attitude, depending on the practice.
The client may be spending less at each visit, but they’re coming in more often, and the overall revenue is increasing—and the care is increasing.”
-Jessica Goodman Lee, practice management consultant for Brakke Consulting
“A lot of people have signed on with a payment provider and done the research, and then have just stalled out because it takes a lot of work and time and training,” she said.
To be successful, Goodman Lee said, a practice needs to sell the plans to at least 10 percent of clients to start and 30 to 40 percent of clients after a few years.
Dr. Goodnight is an advocate for wellness plans to cover routine preventive care and pet health insurance to cover the risk of illness or injury. According to the Partners for Healthy Pets resources on preventive care plans, the practice team should explain to clients the difference between wellness plans and pet health insurance.
Encina Animal Hospital
Angela Linvill was hospital administrator for Encina Animal Hospital when the practice decided to try wellness plans to increase traffic and loyalty. The hospital is not only a general practice but also a specialty and emergency practice, she said, and the practice team wanted to change its reputation for providing good but pricey medicine.
The practice team at Encina designed the wellness plans to be very flexible but still built in some savings. The plans provide for one or two examinations annually and basic laboratory work, with everything else being optional. The veterinarian who performs the initial examination of a pet checks off items on a menu to create a custom plan.
“In order for the program to really be successful, you need doctors who completely believe in it and are comfortable talking about it in the exam room,” Linvill said. “Doctors do not want to ever feel like they’re selling something. They want to make medical recommendations.”
Linvill said the administrative side of wellness plans is mountainous. The hospital started out with service provider ExtendCredit and now is trying TruePet. More clients actually pay for the wellness plans in full rather than monthly, but they often pay monthly for secondary plans for services such as dental cleaning.
Dr. Wendi Aengus, an associate veterinarian at Encina, is a believer in wellness plans as a way to allow clients to budget for veterinary care.
“You want your bonded clients to have the ability to afford the necessary preventative medicine services,” Dr. Aengus said. “They love their animal, and we love their animal. We all want what’s best. It allows the practitioner to practice preventative medicine and to help diagnose potential problems early and extend the life span.”
The wellness plans have been an adjustment for the practice, she said, but the response from clients has been very positive.
In the first year, the hospital sold 700 primary plans and 124 secondary plans. In the same time frame, the hospital saw 1,932 patients for wellness examinations.
||Dr. Wendi Aengus, associate veterinarian at Encina Veterinary Hospital in Walnut Creek, Calif., poses for a photo with Alex, who was found to have lymphoma as a result of routine bloodwork. The hospital recently introduced monthly payment preventive care plans. (Photo by Jen Tsutsui)
Banfield Pet Hospital
Dr. Jeff Klausner, Banfield’s chief medical officer, said the idea from the beginning of the Banfield chain was to make preventive veterinary care easier for clients by removing barriers.
Banfield offers Optimum Wellness Plans at hundreds of hospitals across the country. The monthly payment plans feature twice-yearly comprehensive examinations, unlimited free office visits, and discounts on most services and products within and outside of the packages. Plans come in three levels with additional options.
“When you don’t charge for exams, that just takes one barrier away, and people keep coming,” Dr. Klausner said. “It gives us the opportunity to educate clients about what is important for prevention.”
Over the years, Banfield has updated the wellness plans to keep up with changing recommendations for preventive care. Currently, the plans largely follow the 2011 guidelines for preventive care from the AVMA and American Animal Hospital Association.
Banfield clients with wellness plans bring in their pets much more often than other Banfield clients do, Dr. Klausner said.
“What they really love is it’s a package of care. They don’t have to worry that something is missing, they don’t have to remember all these things because they buy the package, and it gives them peace of mind,” he said. “Most importantly, we can find things early.”
Banfield veterinarians like the wellness plans for many of the same reasons that the clients do, Dr. Klausner said.
“What the veterinarians really love is this builds the bond, it builds the partnership between the veterinary team and the client,” he said.
For wellness plans to succeed at any hospital, Dr. Klausner said, the veterinary team needs to have a strong focus on preventive care. Then the team needs to educate clients about the value of preventive care.
Resources and results
The Partners for Healthy Pets website features a toolbox full of free resources to help practitioners deliver preventive care. The resources on monthly payment preventive care plans are among the most frequently viewed tools. Whether viewers use the resources is another matter, developer Goodman Lee said.
The resources provide an overview of preventive care plans, an implementation manual with worksheets, and a team training manual with a customizable presentation. The implementation manual covers topics ranging from plan design to marketing.
For clinics and for clients, Goodman Lee said, preventive care plans are not just about the economy but also about the way many people like to do business. She said many people look for a partnership with a service provider, regardless of the type of service.
The service providers that assist practices with wellness plans have proliferated over the past several years. Many of these companies are reporting good initial results (see article below).
Goodman Lee said most practices will find preventive care plans to be worthwhile. “The ones that have really taken the time to implement are very, very happy.”
Partners for Healthy Pets offers free resources at www.partnersforhealthypets.org
to help practices implement monthly payment preventive health care plans.