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Financial Incentives to Membership Growth

The steady decline in membership has been a chronic problem for medical societies. Over the years several programs have encouraged membership growth. These include physician-to-physician recruitment, and more recent campaigns that rely on messaging and demonstrating value to the membership.

Since the economic downturn of 2008, the Chicago Medical Society (CMS) and the Illinois State Medical Society (ISMS) have shown significant improvement in their respective financial pictures. It is now reasonable to return some of those savings back to members in the form of financial incentives to membership.

Our organizations have utilized two new financial incentive programs: the Partnership for Membership Growth (PFMG) to enhance membership recruitment, and the loyalty dues discount program to encourage membership retention.

Partnership for Membership Growth

The rationale for this program is straightforward. If physicians try out complimentary membership in county and state medical societies, these physicians are then more likely to become full dues-paying members. This type of recruitment strategy is not unique to medicine. All sorts of groups, from health clubs to Internet security providers, offer trial memberships. One ingenious weight loss plan waives fees for those who lose their first five pounds.

In 2011-12, the Partnership for Membership Growth was launched and about 1,400 trial members were recruited at hospitals and through mailings (Table 1). When asked to pay 20% of dues in the following year, 236 physicians participated. This group of 236 was actively recruited by CMS leadership for inclusion in CMS activities, including committees. Due to our active recruitment of these physicians, the conversion rate to full dues was 86 or 36.4%. The final number—86 new dues-paying members in 2014 through PFMG—is particularly significant given that in 2013, we gained only 82 new dues-paying members through all recruitment efforts combined.

Successful recruitment of these additional new members was gratifying. We hope to make the program more efficient next year. For instance, the early stage of the program was simply too unwieldy for individual physician engagement. Subsequently, the 236 partial-dues members were individually recruited, and the yield increased commensurately.

A PFMG-II program has been approved by CMS and ISMS, starting in 2014. A smaller group, perhaps 50 to 200 physicians, will be offered trial membership. The trial groups will include specialty and ethnic groups that are already working with our medical societies. Also, one large academic medical center has requested a trial group PFMG for 2014, raising the prospect of our attracting additional faculty members in 2015.

PFMG has become CMS’ largest new member recruitment program. The hope is that a focused PFMG-II program can be better integrated into the full recruitment effort.

Dues Discounts Programs

We critically evaluated membership retention data to identify challenges and opportunities for improvement. In 1998, ISMIE waived the CMS/ISMS membership requirement for liability insurance, resulting in the loss of 37.6% of dues-paying members between 1999 and 2002. More recently, the five-year trial period of dues centralization from 2008-2013 was associated with continued membership decline.

Finally, membership retention data revealed the effect of dues increases on retention. Specifically, the last three dues increases (2006, 2008, and 2011) were each associated with contemporaneous retention declines (Table 2). The largest dues increase of 9.7% in 2011 was associated with the largest retention loss of 4.6%.

Such a result should not be surprising. Basic economic theory states that high price is a deterrent to the purchase of goods and services. CMS and ISMS currently offer several dues discount programs; we offer discounts to students, residents, members in their first four years of practice, PFMG participants, and to groups with as few as three physicians.

In 2013 the CMS Board of Trustees approved a broad-based dues reduction. Specifically, physicians who had been members for five years were offered a 5% dues discount in 2014. About 1,068 (or 62.3%) of regular members were eligible. As hoped for, the dues discount was associated with a 2.4% increase in membership retention.

Budgetary concerns have been the primary impediment to dues reduction programs. The cost of the dues reduction was estimated in advance at up to $30,000 for CMS, but the actual cost came in at $21,360. Improved membership retention also saved CMS about $17,045. Much of the early hesitancy to reduce dues based on budgetary concerns has now been replaced with the desire to do more, to offer dues discounts that are: (a) larger, (b) more broad-based, and (c) matched by ISMS.

Ultimately, the success of any financial incentive program will be measured by the number of total dues-paying members. It appears that the long-term trend of membership decline has been mitigated, largely through financial incentives to encourage membership. The steep membership decline of the past three years, averaging 287 dues-paying members annually, has been replaced with a smaller loss to date of 98 members in 2014.

We have but eight months left to completely reverse that trend.

Robert W. Panton, MD
President, Chicago Medical Society

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