Practice Value Maximization Report

Step 1 of 8

12%

Practice & Owner Details

Your name(Required)

First Last

Your role in the practice:(Required)

Practice owner

Practice manager

Staff physician

Other

Other role

Best email(Required)

Phone (mobile preferred)

Practice legal name(Required)

Practice website(Required)

Primary practice location (city, state)(Required)

City State

Number of practice locations(Required)

Year practice founded(Required)

Practice Snapshot

1. Number of full-time practicing physicians (including owner)(Required)

3–4

2. Number of full‑time advanced practice providers (NPs/PAs)(Required)

2–3

3. Target member panel size per full-time provider:(Required)

4. Total active concierge members(Required)

< 100

100–299

300–499

500–799

800-999

1000-1,199

≥ 1,200

5. Average annual membership fee per member(Required)

<$2,000

$2,000–$2,999

$3,000–$3,999

$4,000–$4,999

$5,000-$9,999

>$10,000

6. Months typically needed to fill a vacated membership slot(Required)

< 1

1–2

3–4

5–6

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Practice Structure Q1+Q2

Financial Proxies

7. Approximate revenue for the most recent fiscal year(Required)

<$750k

$750k–$999k

$1.0M–$1.49M

$1.5M–$1.99M

$2.0M-$3.99M

$4.0M-$4.99M

>$5.0M

8. Average annual revenue growth over the past three years(Required)

< 5%

5–9%

10–14%

15–19%

≥ 20%

Not sure

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7x8 Revenue Proxy

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4x5 Revenue Proxy

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Convert Revenue Proxy Value

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7 Value Points

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Convert 7 Value

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Convert 8 Value

Member Retention & Experience

9. Annual member renewal rate(Required)

< 80%

80–84%

85–89%

90–94%

≥ 95%

10. Do you quantitively track member satisfaction using NPS or another method?(Required)

Yes

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Q3 x Q5

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Convert Value Points Q3 x Q5

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Panel Value Points Q3 x Q5

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9/10/3/5 Total Value Points

Payer Mix

11. Percentage of total revenue derived from insurance or government payers(Required)

0% (100 % cash pay)

1–9%

10–24%

25–49%

≥ 50%

12. Ancillary & Cash‑Pay Services (“Select all that currently contribute ≥ 5 % of total revenue.”) (Required)

Nutraceutical / supplement sales

IV therapy & infusion services

Therapeutic plasma exchange (TPE)

Peptide therapies

BHRT

Stem‑cell or cellular‑based treatments

Wellness modalities (sauna, cryotherapy, red‑light, etc.)

None of the above

Other

Other service

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Q12 Ancillary Revenue Diversity

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Q11 Payer Independence

Operational Efficiency & Team

13. Which electronic health‑record system (EHR) do you use?(Required)

Concierge-specific cloud

Cloud-based general

On-premise or paper

14. Do you currently use an AI‑enabled scribing or documentation tool?(Required)

Yes

15. Number of full-time nursing and administrative staff:(Required)

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13 Single Value Convert

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13/14/15 Operational Foundation Total

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Q2 (APPs)

Growth Drivers

16. How much did you spend on marketing in the last 12 months?(Required)

Member referrals:(Required)

Member referrals:

Local physician referrals:(Required)

Local physician referrals:

Digital marketing (SEO/SEM/social):(Required)

Digital marketing (SEO/SEM/social):

Employer partnerships:(Required)

Employer partnerships:

Workshops/ speaking engagements:(Required)

Workshops/ speaking engagements:

Other:(Required)

Other:

18. What is the current wait time to enroll a new member?(Required)

New members accepted immediately

<1 Month

1-2 Months

>3 Months

Closed to new members

19. Planned expansion in the next 18 months (choose all that apply) (Required)

Add physician(s) 

Add location(s)

Add ancillary service(s)

No expansion planned

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Q8 Value Points

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Growth Momentum Totals

Certification & Submit

I certify the above information is accurate to the best of my knowledge and consent to be contacted by a LifespanMD representative.(Required)

I certify the above information is accurate to the best of my knowledge and consent to be contacted by a LifespanMD representative.

Instagram

This field is for validation purposes and should be left unchanged.