The next step became 288 more starts.

The challenge

The consultation was personal. The next step was uneven.

The group had built a reputation around thoughtful consultations and ongoing attention. Across three locations, the work after the consultation did not always move with the same consistency. A payment question could sit in one inbox while a reminder went out from another system. A person who wanted to start after a trip could receive another request to book. A clinical question could wait among routine messages until a coordinator found the right person to review it. The issue was not a lack of care from the team. Six coordinators were carrying the context, checking the records and deciding which conversation needed attention next, and that work became harder to see as the group grew. The patient still decided whether to begin, and the clinical team still decided what was appropriate.

The system

Every open question had a next step.

The first operation focused on one program journey at one location. Struq connected the completed consultation status with approved program information, recent messages, scheduling availability and the next step recorded by the coordinator. Administrative questions could move within the clinic’s agreed rules, a timing preference became part of the plan, and conflicting reminders were identified before another message went out. Clinical questions went to the clinical team with the conversation attached, and enrollment follow up paused where the agreed process required review. The system did not decide treatment suitability or persuade a patient to accept a particular therapy. Struq remained responsible for the agreed operation after launch: monitoring its work, resolving system issues, reviewing exceptions and improving the process with the clinic’s team.

The result

More people began. Less work depended on chasing.

The share of eligible consultations that became program starts moved from 40% to 50%. With 240 such consultations each month, that meant 24 additional starts per monthly cohort across the three clinics. Across twelve cohorts, 288 additional starts produced $748,800 in collected revenue during their first 90 days. Direct delivery costs of $403,200 left $345,600 in contribution before Struq and added operating costs. The six coordinators continued to own personal conversations and exceptions, and manual coordination in the defined workflow moved from 600 to 360 hours per month. That time was tracked separately and was not added to the financial result as payroll savings.

The owner’s experience

Why the scope expanded

The first location provided the place to test the workflow, review exceptions and improve the handoffs. Expansion depended on reliable operation, a sound business case and the other locations having the capacity and permissions to use the same approach. The broader rollout carried shared standards across the group while keeping local availability and ownership visible. Member engagement became a possible next scope, with its own baseline, comparison and economics; the enrollment results were not counted again as a retention gain.

How we measured it

The result starts with 240 distinct eligible consultations per month and compares a 40% start rate with a 50% start rate. The difference is 24 additional starts per cohort, and twelve cohorts produce 288 additional starts. Each added start contributes $2,600 in collected revenue during its first 90 days, after discounts and refunds, and direct delivery costs of $1,400 leave $1,200 in contribution. The resulting revenue and contribution belong to those matured cohorts, not automatically to one calendar year’s cash receipts.

Financial basis

Collected revenue, first 90 days per start

Period

Twelve monthly cohorts, each added start followed for 90 days