One plan, $29.99, put everyone on it

Care Connect is an on-call phone system for small medical practices. A patient calls the practice’s normal number at 2am, the shift schedule decides who is covering, and that clinician’s own phone rings. That is the product. Pricing it took longer than building the first version of it, so here is where I landed and why.

What the practice pays today

Not to a competitor. To one of two things:

• A live answering service. Roughly $200 to $800 a month depending on call volume. People answer, they relay the message by phone or pager, and the practice keeps no record of what was said. This is the real incumbent and it has survived every software wave so far because it works.
• Nothing. The number rolls to voicemail, the doctor’s personal cell circulates on a sticky note, and the rotation lives in a shared calendar. Free, until the night a patient reaches nobody.

The software competitor is Spruce Health, which is a genuinely good product and the leader in this segment. It is $24 per user per month on the basic plan and $49 per user for the one with after-hours triage. Per seat.

Per seat is the mistake I did not want to copy

A small practice is twelve to twenty people once you count the MAs and the front desk. On Spruce that is $288 to $588 a month before the practice has decided which seat needs which tier, and every new hire is a pricing conversation. The predictable result is that half the team never gets a login.

I wanted the opposite. The whole point of the product is that the schedule is the routing, and the schedule only works if everyone who takes call is in it. So the price cannot punish you for adding people.

So, one plan

$29.99 a month per organization, 20 active users included, $1.99 per user past that. Telephony usage (numbers, minutes, texts, recorded minutes) is billed per unit at rates I publish on the site, set at about 20% over what the carrier charges me in the worst case. That last part is on the pricing page with an as-of date, because if my argument against the answering service is the number, the number has to be checkable.

A few things fall out of this:

• A two-person practice and a twelve-person practice pay the same $29.99. That is the point.
• The 20-user line sits at the top of the segment I am building for. Past it you are a group, and a group can carry two bucks a head.
• A bad flu season costs the practice more in minutes and earns me a little more. It does not blow up their bill the way it blows up an answering service invoice, because the software line does not move.
• There is nothing to compare. No basic versus pro, no feature that unlocks at a higher price. A buyer who has to weigh two plans has been handed a reason to put it off, and a six-person clinic does not have a procurement person to do the weighing.

Why I can afford to do this

Infrastructure is not the constraint. The production footprint is a small app service and a small Postgres, roughly $30 a month total, shared across every practice. A new organization costs me close to nothing to host. The margin on the software plan pays for the software; the margin on usage pays for the card processing and the storage that ride on it.

Where the answering service charges per call because people cost per call, I charge per minute because minutes are what I actually buy. The practice sees the same thing I see, marked up by a fixed and published amount.

What I am not claiming

That Care Connect is cheaper than Spruce on features. It is not, and it should not try to be. Spruce does video, fax, team chat, and a lot more. Care Connect does the after-hours call, the record of it, and the schedule that made it ring the right phone, for a tenth of what the practice was paying the answering service. If that is the problem you have, it is the whole product. If it is not, Spruce is right there.