New chain of chiropractic clinics cracks the traditional insurance model

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A chiropractic physician from The Joint Chiropractic Clinic demonstrates a procedure on a patient.

The Joint Chiropractic Clinic

A chiropractic physician from The Joint Chiropractic Clinic demonstrates a procedure on a patient. Launch slideshow »

VEGAS INC archives

John Leonesio started Massage Envy in 2002 and in less than a decade turned the chain of massage parlors into a $300 million business.

He hopes to do the same now with The Joint, a chain of no-appointment-necessary chiropractic clinics.

The industries are different, but Leonesio’s philosophy remains the same: provide affordable, convenient care.

“We did the Massage Envy model for chiropractic care,” said Leonesio, who sold Massage Envy in 2008. “We’ve tried to change how (chiropractic care is) delivered."

The Joint opens its first Southern Nevada location today at 4150 Blue Diamond Road, Las Vegas. Another practice at the Boca Park Marketplace, 8820 W. Charleston Blvd., is scheduled to open before the end of the year. The company plans to add eight more locations in the valley by the end of 2013.

Las Vegas was a natural fit for the chain, Regional Developer Christina Ybañez said.

“Hospitality workers are there, and they’re on their feet 24-7,” Ybañez said. “They’re standing for long days and hours.”

For $20, first-time customers receive a consultation, an adjustment and an exam. Subsequent adjustments cost $29 each. A wellness plan reduces the price to $49 a month for four adjustments.

The Joint accepts only out-of-pocket payments and doesn’t work with insurance companies.

“Most of those price points are below the insurance co-pay,” said Ybañez, who said she used to pay $50 to $60 per chiropractor visit through insurance companies.

The Joint also forgoes appointments. Patients can walk in whenever they have time.

The Las Vegas clinics are expected to be open seven days a week to accommodate patients with non-traditional schedules. The Boca Park site will be open from 10 a.m. to 7 p.m. weekdays and from 10 a.m. to 5 p.m. on weekends.

Customers also can visit any of The Joint's 322 nationwide locations, as patient information is kept in a shared database.

“We heard from the customers that they wanted something more convenient,” Leonesio said. “We wanted to have a walk-in-as-you-needed type of facility open on nights and weekends.”

Phoenix chiropractor Dr. Andrew Richetto initially was skeptical of the cash model, having worked solely in insurance-based practices. But he also estimated it took him half a day to complete administrative work to keep the insurance companies happy.

“You feel like you’re under scrutiny,” he said.

Richetto moved to The Joint in February. He now has more time to see patients, as the long hours completing paperwork are gone.

Leonesio said The Joint’s model also means doctors make more money since their overhead costs aren’t as high. They don’t have to hire as many administrative assistants to help with paperwork.

“We’ve increased the cash flow to be instant,” Leonesio said. “I think over the next five to 10 years, (cash-based models) will become industry standard. I think eventually, 100 percent of (insurance companies) will stop paying for chiropractic care.”

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  1. Our family Doctor ran the same business model back in the 80's. He charged $25 per office call. Would not deal with Insurance at all. Cash only.

    His wife was his nurse and they hired a girl to work the office area and phones. He did that for 30 years and retired. Was sorry to see him go. He was a good doctor and treated his people right.

    Kept a small office with only three patient rooms. He would take appointments though so you did not have to wait long to see him.

  2. Inspiring business plan--provide for needs, not health-care / insurance gimmicks.