How Do I Start a Chiropractic Hybrid Membership Program in 2026?
by Gerek Allen ~ Last Updated: Dec 9, 2025 ~ 12 Min Read
by Gerek Allen
~Â Last Updated: Dec 9, 2025Â ~
~ 12 Min Read ~
Starting a chiropractic hybrid membership program comes down to three things: designing tiers that combine in-person adjustments with virtual care, picking the right tech, and creating pricing that generates predictable monthly revenue.
Here's the thing.
The traditional pay-per-visit model? It's broken.
Studies show the average new patient only visits 6 times before dropping off. The national average for chiropractic patient retention sits around a painful 20%.
That's a lotta revenue walking out your door.
A hybrid membership flips this whole thing. You're bundling a set number of in-person visits with virtual check-ins, exercise corrections, and wellness coaching. Patients get convenience and predictable costs. You get recurring revenue and way better retention.
According to research from Bain & Company, a 5% increase in customer retention can lead to a 25% to 95% jump in profits.
That math hits different when you're running a practice.
The hybrid model works because it gives patients what they actually want: flexibility without sacrificing quality care. Someone gets their adjustment in-person, then does a quick video check-in the following week to review their home exercises.
No driving across town. No waiting room.
This guide walks you through everything. Tier design. Pricing strategy. Technology selection. Legal stuff. And the exact steps to launch.
Let's get into it.
Understanding the Hybrid Membership Model
Alright, let's keep it real.
The hybrid model isn't just "regular chiropractic plus some Zoom calls." It's a fundamentally different approach to patient care.
Traditional practices live and die by appointment volume. Miss a few days? Revenue tanks. Patients cancel last minute? You're eating that cost.
The hybrid model builds in flexibility that protects your bottom line while actually improving patient outcomes.
What Makes Hybrid Different From Traditional Memberships
Traditional chiropractic memberships typically offer a set number of in-person visits per month for a flat fee.
That's it.
Hybrid memberships layer virtual care on top. This creates multiple touchpoints between visits where you can:
- Monitor progress (virtual check-ins) - Quick video calls to assess how patients respond to treatment, catch problems early, and adjust care plans without requiring an office visit
- Correct exercise form (live video sessions) - Watch patients perform their prescribed exercises and provide real-time corrections, which dramatically improves compliance
- Provide ergonomic assessments (screen sharing) - Have patients show you their home office setup and make specific recommendations they can implement immediately
- Deliver educational content (on-demand resources) - Video libraries, exercise demonstrations, and wellness education that patients access anytime
The American Chiropractic Association notes that practices with membership programs report higher patient retention rates.
Adding the virtual component? That amplifies the effect by keeping you connected between visits.
The Business Case for Going Hybrid
Let's talk numbers.
A practice running on pay-per-visit typically needs 40 new patients per month just to replace those who drop off.
That's a brutal treadmill.
A membership practice with strong retention? You might need only 5-10 new patients monthly to maintain and grow revenue.
Sound fair?
| New patients needed monthly | 30-40 | 5-10 |
| Revenue predictability | Low (fluctuates) | High (recurring) |
| Patient retention rate | ~20% national average | 60-80%+ reported |
| Marketing cost per patient | High (constant acquisition) | Lower (retention-focused) |
| Staff scheduling stress | High (variable volume) | Lower (predictable bookings) |
The subscription economy is worth over $650 billion in the US, according to UBS research.
Healthcare is embracing this trend. You should too.
Who Benefits Most From Hybrid Care
Here's the kicker.
Not every patient fits the membership model. And that's totally okay.
Ideal membership candidates include:
- Wellness-focused patients (ongoing maintenance) - People who understand the value of regular care and want to maintain progress long-term
- Busy professionals (time-constrained) - They'll gladly pay for convenience and appreciate virtual options that don't require travel time
- High-deductible insurance patients (cost-conscious) - When their deductible is $5,000+ and insurance won't cover chiropractic anyway, predictable monthly fees win
- Uninsured patients (cash-pay preferred) - Clear pricing without insurance complexity appeals to patients who prefer straightforward relationships
- Athletes and active individuals (performance-focused) - Regular maintenance plus virtual exercise guidance helps them stay at peak performance
The key insight?
You're not trying to convert everyone. Focus on patients who value ongoing care and appreciate the convenience factor.
Designing Your Membership Tier Structure
Your tier structure can make or break the program.
Too simple and you leave money on the table. Too complex and patients get confused, which kills conversions.
The sweet spot? Two to three tiers with clear differentiation and obvious value progression.
The Three-Tier Framework That Works
Here's a proven structure based on successful chiropractic membership programs:
Tier 1: Maintenance/Basic ($99-129/month)
- 1-2 in-person adjustments per month
- 1 virtual check-in per month
- Access to exercise video library
- Basic appointment scheduling
- Target: Wellness maintenance patients with stable conditions
Tier 2: Active/Standard ($149-199/month)
- 2-4 in-person adjustments per month
- Unlimited virtual check-ins
- Custom home exercise program
- Priority scheduling
- 10% discount on additional services
- Target: Active patients wanting regular care with flexibility
Tier 3: Premium/Comprehensive ($249-299/month)
- 4-6 in-person adjustments per month
- Unlimited virtual consultations
- Comprehensive exercise prescription with progress tracking
- Nutritional guidance sessions
- Family member add-on option ($25-50/member)
- Priority booking and extended hours access
- Target: High-engagement patients wanting full-service care
The progression should feel natural.
Each tier adds meaningful value. Not just more of the same thing.
Pricing Psychology and Strategy
Your pricing communicates value.
Price too low? Patients assume lower quality. Price too high without clear differentiation? You lose conversions.
Research your local market. What does a single adjustment cost? Most areas range from $50-100 per visit.
Now... this part matters.
Do the math. If your Standard tier includes 3 adjustments ($150-300 value) plus virtual services for $175/month, the patient sees obvious value.
They're getting the in-person care they'd pay for anyway, plus virtual support essentially "free."
| Basic | $129 | $100 (1-2 visits) | $50 | $150+ |
| Standard | $175 | $200 (3-4 visits) | $100 | $300+ |
| Premium | $275 | $300 (4-6 visits) | $175+ | $475+ |
The Joint Chiropractic franchise model shows patients will pay $18-40 per visit when bundled into membership plans.
Your hybrid model can justify premium pricing because of the added virtual value.
Adding Family and Corporate Options
Family add-ons are profit accelerators.
Once a patient enrolls, adding family members at a reduced rate ($25-50/month each) is nearly pure margin.
The patient's already committed. The family member gets a steep discount. Everyone wins.
Corporate wellness partnerships take this further. Offer employers discounted group rates for their teams.
A company paying $100/employee/month for 20 employees? That's $2,000 recurring revenue with minimal additional acquisition cost.
Pretty damn good deal if you ask me.
NEED MORE CLIENTS?
Free conversion-focused analysis uncovers the 3 biggest problems killing your bookings — we'll walk you through your results personally
Selecting Your Technology Stack
Technology either makes your hybrid program seamless or becomes a frustrating bottleneck.
Choose carefully.
You need three core systems: telehealth video platform, practice management with recurring billing, and exercise prescription software.
These can be separate tools or bundled solutions depending on your practice size and budget.
HIPAA-Compliant Telehealth Platforms
- This is non-negotiable.
Your video platform must be HIPAA compliant with a signed Business Associate Agreement (BAA).
Top options for chiropractic practices:
- Doxy.me (free-premium tiers) - Super simple, browser-based, no downloads required for patients. Free tier works for basic needs. HIPAA, GDPR, and HITECH compliant with free BAA
- VSee ($29+/month/provider) - More robust features including customizable workflows and EHR integration. Used by NASA for astronaut telemedicine (kinda cool, right?)
- Zoom for Healthcare ($200+/month) - If patients already know Zoom, the learning curve is zero. Healthcare version includes BAA and encryption
- Practice Better (bundled with practice management) - All-in-one solution popular with wellness practitioners
Here's the thing about patient friction.
The fewer steps for patients to join a video call, the higher your attendance rates. Browser-based solutions with no downloads win here.
Practice Management and Billing Systems
Your existing EHR might already support membership billing.
If not, you need a solution that handles:
- Recurring automatic payments
- Failed payment retry and notifications
- Membership tier tracking
- Visit counting and usage reporting
- Integration with your scheduling system
Popular chiropractic-specific options:
- ChiroTouch (leading market share) - Comprehensive EHR with CT Payments integration for recurring billing and auto-pay
- zHealth ($119+/month) - Cloud-based with built-in membership management specifically designed for subscription models
- ChiroSpring (subscription model focus) - Purpose-built for chiropractors transitioning to memberships with automatic visit write-offs
- Jane App (popular for cash practices) - User-friendly with strong telehealth integration
Quick reality check.
If you're already on a platform, check their membership features before switching. Migration is painful and expensive.
Exercise Prescription and Home Care Platforms
Virtual care without structured home exercise programs? That's incomplete.
Patients need visual guidance they can reference between visits.
Exercise prescription platforms worth checking out:
- WebExercises (chiropractic-focused) - Large library of chiropractic-specific exercises with video demonstrations
- Rehab My Patient ($14-35/month) - Over 5,000 exercises with HD video, supports 45 languages, mobile app for patients
- My Rehab Connection ($14/month) - Exercises sync automatically to patient's phone app, no re-printing when you update programs
- Wibbi/Physiotec (enterprise option) - 20,000+ exercise videos, extensive integrations, push notifications
The best platform is the one your patients will actually use.
Mobile apps with push notifications dramatically improve compliance compared to emailed PDFs.
Legal and Compliance Considerations
Telehealth regulations vary dramatically by state.
Getting this wrong can mean license issues, fines, or worse.
Take compliance seriously.
State Licensing Requirements
The fundamental rule?
You must be licensed in the state where your patient is located during the virtual visit. Not where you are. Where they are.
According to the Center for Connected Health Policy, 38 states plus DC and Puerto Rico offer some type of exception to licensing requirements for telehealth.
But these exceptions vary wildly.
Some states like Michigan have introduced specific telehealth standards for chiropractors. Others have broader laws. A few allow limited practice across borders for established relationships.
Action steps:
- Contact your state chiropractic board directly for current telehealth requirements
- Review the CCHP Policy Finder for your state's specific regulations
- If you have patients who travel or snowbird seasonally, research those states too
- Consider joining interstate compacts if available for your profession
Don't assume. Verify.
HIPAA Requirements for Virtual Care
Every telehealth interaction involving patient health information must comply with HIPAA:
- Use HIPAA-compliant platforms (BAA required) - Regular FaceTime or standard Zoom won't cut it. You need healthcare-specific versions with signed Business Associate Agreements
- Secure data transmission (encryption required) - All communications must use HTTPS protocol
- Private patient access (waiting room features) - You control when patients enter the video session
- Documentation standards (same as in-person) - Virtual visits require the same level of clinical documentation as office visits
The HHS.gov telehealth guidance has detailed info on maintaining compliance.
Creating Membership Agreements
Your membership agreement protects both parties.
Include these elements:
- Clear service descriptions - Exactly what's included in each tier and what counts as a "virtual visit"
- Billing terms - Payment frequency, automatic renewal language, failed payment procedures
- Cancellation policy - Minimum commitment period, notice requirements, refund terms
- Telehealth consent - Specific consent for virtual care, technology requirements, privacy acknowledgments
- Scope limitations - Clear statement that telehealth doesn't replace in-person examination when clinically indicated
Have a healthcare attorney review your documents before launch.
This is not where you cut corners.
Step-by-Step Implementation Guide
Theory is great.
Implementation is where most practices stall out.
Here's your actionable roadmap to launch within 30 days.
Week 1: Foundation Planning
Days 1-3: Market Research and Tier Design
- Survey your current patient base about interest in membership options
- Research local competitor pricing for single visits
- Design your 2-3 tier structure with pricing
- Calculate breakeven points for each tier
Days 4-5: Technology Selection
- Demo 2-3 telehealth platforms
- Review your current EHR's membership capabilities
- Get quotes for any needed software additions
- Make final selections and begin setup
Days 6-7: Legal Document Drafting
- Draft membership agreement using templates
- Create telehealth consent forms
- Outline cancellation and refund policies
- Schedule attorney review
Week 2: Systems Setup
Days 8-10: Technology Configuration
- Set up telehealth platform with your branding
- Configure recurring billing in your practice management system
- Test payment processing with small transactions
- Create membership tiers in your booking system
Days 11-12: Exercise Library Creation
- Set up exercise prescription platform account
- Create 3-5 template exercise programs for common conditions
- Record any custom exercise videos specific to your techniques
- Test patient access and app functionality
Days 13-14: Workflow Documentation
- Write step-by-step enrollment procedures for front desk
- Create scripts for presenting membership options
- Document virtual visit workflows and protocols
- Train staff on all new systems
Week 3: Soft Launch to Existing Patients
Days 15-17: Internal Testing
- Run complete enrollment process with team members as test patients
- Conduct mock virtual visits to troubleshoot tech issues
- Process test payments and verify tracking
- Refine any problem areas
Days 18-21: Existing Patient Outreach
Start with your best candidates. Patients who already visit regularly and would benefit most.
- Identify 20-30 ideal candidates from your patient list
- Reach out personally via phone or email to introduce the program
- Offer founding member pricing for early adopters
- Enroll 10-15 members before public launch
This soft launch validates your systems with patients who already trust you.
Problems are way easier to solve with forgiving audiences.
Week 4: Public Launch
Days 22-25: Marketing Activation
- Update your website with membership info and online enrollment
- Create social media content announcing the program
- Add membership presentation to new patient consultations
- Train staff on handling questions and objections
Days 26-28: New Patient Integration
- Present membership options to all new patients during report of findings
- Create comparison handouts showing membership value vs. pay-per-visit
- Set enrollment goals and track conversions
Days 29-30: Optimization
- Review first month metrics
- Gather feedback from enrolled members
- Adjust pricing, services, or processes as needed
- Plan month 2 growth initiatives
Marketing Your Hybrid Membership Program
Building a great program means nothing if nobody knows about it.
Your marketing strategy should emphasize what makes hybrid membership uniquely valuable.
Positioning and Messaging
Lead with patient benefits. Not features.
Wrong approach: "Our membership includes 3 adjustments and 2 virtual visits per month."
Right approach: "Get the care you need without the hassle. Your adjustments when you need them, plus expert guidance from your phone whenever questions come up."
The hybrid angle solves real problems:
- "I don't have time to come in as often as I should" - Virtual check-ins keep you on track without extra trips
- "I forget my exercises by the time I get home" - Video library and live corrections mean no more guessing
- "I never know how much it'll cost" - One predictable monthly payment covers everything
- "I can't tell if I'm making progress" - Regular virtual touchpoints track your improvement
Converting Current Patients
Your existing patients are your easiest conversions.
They already trust you.
Identify ideal candidates:
- Patients who visit 2+ times per month consistently
- Those with high-deductible insurance plans
- Cash-pay patients who value transparency
- Patients who frequently ask exercise questions
- Those with chronic conditions requiring ongoing management
Here's a conversation framework that works:
"I noticed you've been coming in pretty regularly, which is great for your progress. I wanted to let you know about our new membership option that might actually save you money while giving you more support. Instead of $75 per visit, it's $175/month for up to four adjustments plus unlimited virtual check-ins. Based on how often you come in, you'd save around $125/month plus get way more support between visits. Want me to explain how it works?"
Website and Online Enrollment
Your website should make enrollment super easy.
Essential elements:
- Clear tier comparison table (not buried paragraphs)
- Transparent pricing displayed prominently
- Online enrollment form with payment processing
- FAQ section addressing common objections
- Testimonials from satisfied members
If enrollment requires calling during business hours?
You'll lose conversions. Enable 24/7 online signup.
Measuring Success and Optimizing
What gets measured gets managed.
Track these KPIs to optimize your hybrid program over time.
Key Performance Indicators
Revenue metrics:
- Monthly Recurring Revenue (MRR) - Total membership revenue per month
- Average Revenue Per Member (ARPM) - Total revenue divided by active members
- Churn Rate - Percentage of members who cancel each month
- Lifetime Value (LTV) - Average total revenue per member over their entire membership
Operational metrics:
- Visit Utilization Rate - Percentage of included visits actually used
- Virtual Session Completion - Percentage of scheduled virtual visits that happen
- Time to First Virtual Visit - Days between enrollment and first video session
Satisfaction metrics:
- Net Promoter Score (NPS) - Would members recommend your program?
- Member Satisfaction Surveys - Quarterly feedback collection
- Retention Rate - Percentage who stay enrolled month over month
| Monthly Churn Rate | Under 5% | Above 10% |
| Visit Utilization | 70-85% | Below 50% |
| Virtual Session Completion | Above 80% | Below 60% |
| NPS Score | Above 50 | Below 30 |
Continuous Improvement Process
Schedule monthly reviews of your metrics.
Look for patterns:
- Are certain tiers underperforming? Consider restructuring or repricing
- High churn at month 3? Something about your commitment period or value delivery needs attention
- Low virtual utilization? Patients may not understand the benefit or find the tech confusing
Survey members quarterly. Ask specifically:
- What's working well about your membership?
- What would make it more valuable to you?
- Would you recommend this to a friend? Why or why not?
Small adjustments compound over time.
A practice that improves 1% monthly is 12% better after a year.
Frequently Asked Questions
How much should I charge for a hybrid chiropractic membership?
Most successful hybrid memberships range from $99-$299 per month.
A solid starting point is $149/month for 2-4 in-person visits plus unlimited virtual check-ins. Premium tiers with additional services like massage therapy or nutritional counseling can reach $249-$299/month.
Do the math based on your market. If a single adjustment costs $75 in your area, a membership including 3 adjustments for $175 is obviously good value.
The virtual component becomes a value-add that justifies premium positioning.
What technology do I need for virtual chiropractic care?
At minimum, you need a HIPAA-compliant video platform like Doxy.me, VSee, or Zoom for Healthcare.
Most chiropractors also add an exercise prescription platform such as WebExercises, Rehab My Patient, or My Rehab Connection for home care programs.
Your practice management software should support recurring billing and membership tracking. If your current EHR doesn't handle memberships well, solutions like zHealth or ChiroSpring are built specifically for subscription models.
Is telehealth legal for chiropractors in all states?
Telehealth regulations vary by state.
Michigan has specific telehealth standards for chiropractors, while other states have broader laws that apply to multiple healthcare professions. You must be licensed in the state where your patient is located during the virtual visit.
Check your state chiropractic board and the Center for Connected Health Policy for current requirements. Don't assume. Verify before providing any cross-state telehealth services.
What services can I actually deliver through telehealth?
While spinal adjustments obviously require in-person visits, telehealth works really well for:
- Initial consultations and health history reviews
- Exercise instruction and real-time form correction
- Posture assessments via video
- Ergonomic evaluations of home and work setups
- Nutritional counseling and lifestyle coaching
- Progress check-ins between adjustment visits
- Home exercise program modifications
These virtual touchpoints complement your hands-on care and keep patients engaged between office visits.
How do I handle patients who don't use all their membership visits?
Most membership programs operate on a use-it-or-lose-it basis.
Unused visits don't roll over. This is standard practice and should be clearly stated in your membership agreement.
Some practices offer credit for missed visits if patients give advance notice. The key is setting clear expectations upfront and using automated appointment reminders to maximize visit utilization.
If utilization consistently runs below 50%, your tier structure may need adjustment.
Should I require contracts for hybrid memberships?
A minimum commitment period of 2-3 months is standard practice.
This allows patients enough time to experience results while giving your practice predictable revenue for planning.
After the initial commitment, most practices transition to month-to-month billing with 30-day cancellation notice. Clear cancellation policies protect both parties.
Patients appreciate knowing exactly what they're committing to upfront.
How do hybrid memberships affect patient retention?
Dramatically.
Practices with membership programs report significantly higher retention rates compared to pay-per-visit models. The national average chiropractic retention rate hovers around 20%, with the average patient visiting only 6 times before dropping off.
Membership practices typically require only 5-10 new patients monthly to maintain revenue. Compare that to 40 new patients for traditional practices running the acquisition treadmill.
The recurring revenue model fundamentally changes your business economics.
Can I offer hybrid memberships alongside insurance billing?
Absolutely.
Many practices offer hybrid memberships as an alternative for patients with high-deductible plans, no chiropractic coverage, or those who prefer predictable monthly costs.
Some practices operate fully cash-based with memberships. Others maintain both insurance and membership options for different patient preferences.
Just ensure your membership pricing and services don't violate any insurance contracts you have in place.
Building Your Hybrid Future
The hybrid membership model isn't a trend.
It's the future of chiropractic practice.
Patients increasingly expect healthcare on their terms. Convenient. Transparent pricing. Accessible when they need it.
The practices that deliver this win. Those stuck in the old pay-per-visit model will keep fighting the retention battle.
Starting is simpler than you think.
Pick your tiers. Choose your tech. Launch to your best current patients first.
The hardest part isn't the implementation. It's making the decision to start.
Look, I get it. Between treating patients, managing staff, and keeping the books straight, adding a whole new program feels overwhelming.
If you're thinking "this all makes sense, but I don't have time to figure out the website and tech side," you're not alone. Most chiropractors we work with felt exactly the same way before they realized their website was quietly costing them 15-20 qualified patient leads every single month.
That's why we created our Free Website Conversion Analysis. It's not a sales pitch. It's a genuine walkthrough of the 3 biggest problems killing your bookings, delivered personally via Loom video within 24 hours.
We'll show you exactly:
- Why visitors leave without booking
- What's broken on mobile devices (where most searches happen)
- Missing trust signals costing you patients
- Where you rank vs. local competitors
- Simple fixes that drive more calls this month
You'll also get an instant case study while you wait, showing real examples of how other chiropractors fixed these exact problems.
Get your free analysis here — no credit card, no obligation, just actionable insights you can use whether you work with us or not.
Because every day you wait to optimize your online presence is another day patients are finding competitors who've already figured this out.
Gerek Allen
Co-Owner iTech Valet
Entrepreneur, patriot, CrossFit junkie, IPA enthusiast, loves to travel to tropical destinations, and knows way too many movie quotes.
About iTech Valet
iTech Valet specializes in web design and content marketing for online entrepreneurs who want to share their expertise.
Services Include:
- Web Design
- Graphic Design
- Sales Copy
- Funnel Building
- Authority Sites
- Membership Sites
- Course Creation
- Email Systems
- Content Marketing
- Competitive Analysis
- Tech Integrations
- Strategic Planning
NEED MORE CLIENTS?
Free conversion-focused analysis uncovers the 3 biggest problems killing your bookings — we'll walk you through your results personally
621 Enterprises, Inc. | Copyright 2022 | All rights reserved