How Sollis Health created an on-demand emergency room

As the pandemic squeezed practice margins and forced thousands of clinics to close, physicians increasingly moved to a newer, more reliable business model: concierge medicine.

Under a concierge model, patients pay an annual membership fee to a physician practice and in turn get access to a suite of benefits like 24/7 on-demand doctor access.

Most concierge practices focus on primary care, but New York City-based Sollis Health is changing up the game and offering concierge emergency care.

The company—which was founded in 2016 and has raised $50 million in venture capital across two funding rounds—bills itself as the “first and only concierge urgent and emergency care provider,” and has 10 clinics in New York, California, and Florida.

“Our mission is to provide immediate access to quality acute care, and our members are willing to invest in that given how challenging the alternatives are,” Sollis Health CEO Brad Olson told Healthcare Brew.

How Sollis Health works

Sollis members get access to a number of services, including unlimited same-day appointments, diagnostic services like imaging and lab testing, a team of care coordinators, and quick access to specialist physicians.

As a concierge emergency provider, Sollis is able to provide more services than a concierge primary care provider, Olson said. For instance, all Sollis clinics have in-house labs that can typically turn around results within an hour, he said.

Sollis sees a limited number of patients, so clinicians can spend more time with each one and patients get a more thorough healthcare experience, Olson said. The company has yet to place a cap on the number of members it accepts, but is “constantly monitoring” the patient experience, according to Scott Braunstein, national medical director at Sollis.

“If we feel that our membership is growing to the point where we’re concerned that we might not be able to offer that, we might open a second clinic very close by […] to help reduce the volumes that any one clinic is seeing,” Braunstein said.

Sollis brings in patients through a few different channels, according to Olson. One is directly through the company’s internal membership team, which works to enroll individual members. The company also partners with concierge primary care physicians who can either refer patients to Sollis or build Sollis into their practice’s offerings. The company also partners with employers to make membership an employee benefit.

Sollis has more than 17,000 members across its clinics, Olson said.

The company employs 200–300 emergency clinicians, including physicians, nurses, technicians, and advanced care providers like physician assistants and nurse practitioners.

How the company makes money

Sollis primarily makes money through the annual membership fees, according to Olson. The amount a patient pays varies by age—prices start at $3,500 for adults and $1,500 for kids, and the company offers packages for families.

The majority of services are covered by the membership fee. The only things not included are house calls, more advanced imaging like MRI or CT scans, and advanced bloodwork, which all cost an extra fee, according to Olson.

Sollis has set membership fee prices based on age because older patients tend to utilize more healthcare services and have more acute health concerns that require costly treatments, Olson said.

“The average out-of-pocket cost to the consumer after an ER visit is not too far off from an annual Sollis membership,” he said.

That average out-of-pocket cost of an ER visit for a patient with a large employer insurance plan is $646, according to research from the Peterson-KFF Health System Tracker. But for people without insurance, the average cost for a single visit was $2,600 in 2021, according to insurer UnitedHealthcare.

Sollis doesn’t accept health insurance to cover the cost of its membership fee, but if a patient needs services that cost an additional fee, the company can submit a claim to an insurer to see if the fees are eligible for reimbursement, Olson said.

Having a majority of revenue coming from membership fees “makes business planning much easier” compared to the traditional fee-for-service business model that most healthcare practices use, according to Olson. The business model’s predictability makes it easier for Sollis to estimate earnings and plan spending, he said.

Advantages and challenges

Being the first company in a market has advantages, Olson said.

“We’re really the only ones that play in this space. It’s exciting to create and build a category of our own,” he said. “We get to be the market leader. We get to define a standard of care. We get to define how things are done. That’s been great for us as we’ve built this business because it’s given us a first-mover advantage.”

But being the first also comes with challenges.

“The burden is on us to explain the category that we’ve created and the service that we’re offering,” Olson said. “The challenge is really to better explain the value proposition of who we are and what we offer. When folks hear ‘concierge,’ they generally think concierge primary care because that segment has a 15-year head start on us in terms of awareness and growth.”

He added that while he’s sure competitors will eventually pop up, he doesn’t think it is a concern for Sollis.

“We’re ready for competition—if and when it comes—but I do think as folks get to know us, they realize that we’re a pretty distinct offering in the healthcare system,” he said.

Update 12/15/23: The number of locations is 10, not nine as appeared in an earlier version of this story.