By Julia W.
File Under Uncategorized
Want to combine in-person and virtual therapy for better flexibility? A hybrid therapy practice allows you to offer both face-to-face and online sessions, catering to your clients’ needs while simplifying your operations. Here’s what you need to know:
- What is it? A mix of in-person and virtual therapy sessions, offering clients flexibility and access to care.
- Why use it? Helps clients in remote areas, saves therapists time, and expands reach. By 2023, 67% of psychologists worked in hybrid practices.
- Who can use it? Mental health professionals, physical therapists, school-based therapists, and more.
- How to start?
- Use HIPAA-compliant telehealth tools.
- Rent flexible office spaces to avoid long leases.
- Streamline workflows by integrating EHR and automation tools.
- Key tips: Focus on client onboarding, clear communication, and balancing virtual and in-person sessions.
This model not only meets growing demand but also helps therapists manage costs and improve efficiency. Ready to learn more? Let’s dive in!
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Setting Up Your Hybrid Practice Foundation
Building a hybrid practice starts with three essential pillars: robust technology, flexible spaces, and unified workflows. Together, these elements ensure smoother operations and help reduce overhead costs. Let’s break down how to establish each pillar effectively.
Selecting Technology Tools
Telehealth usage in the U.S. skyrocketed from 39.4% to 88.1%, making secure, HIPAA-compliant technology a must-have for hybrid practices. Managing sensitive data requires platforms with encrypted data transmission and built-in privacy features to meet HIPAA standards.
Top telehealth platforms cater to practices of all sizes, offering tiered pricing and integrated solutions for scheduling, communication, and Electronic Health Record (EHR) connectivity. For example, the Range Mental Health Center uses Enghouse Video, where users rate connection quality as "Excellent" or "Good." Similarly, Ochsner Health doubled its consultations over two years using telehealth.
"Doxy.me helped me seamlessly pivot my practice to the virtual space and has completely shifted my practice for the long term. It’s perfect to have such a wonderful and accessible tool for clinicians and clients alike."
- Sarah Murray, LCSW, Heart Wild Therapy, LLC
When choosing a platform, prioritize features like automated reminders, calendar syncing, and direct EHR integration. These tools ensure a smooth flow of information between virtual and in-person sessions, keeping your practice efficient and connected.
Finding Flexible Professional Spaces
Traditional office leases can be a financial strain for hybrid practices that don’t require full-time physical spaces. A more practical option is renting on an as-needed basis. For instance, 214 Counseling Group in Dallas offers therapy office space at $25 per hour, allowing therapists to pay only for the time they use.
When selecting a location, consider client convenience. Factors like proximity to public transportation, parking availability, and neighborhood safety are critical. Visiting the area at different times of day can give you a better sense of the overall client experience.
Your space must also meet privacy and security standards, including compliance with ADA requirements, while offering a confidential environment. Shared office spaces can provide a sense of community, which is especially valuable in a profession that can sometimes feel isolating.
"It’s so nice to have people around. Therapy can be a little bit isolating, but after my 50-minute sessions, I have 10 minutes in between to go out into the common spaces. I can’t always stop and chat, but I at least see other people, which is a nice mental break."
- Therapist client of Expansive
Companies like Humanly offer on-demand therapy and wellness spaces available by the hour, day, or month. These spaces not only provide flexibility but also foster networking opportunities, peer support, and even in-house referral systems.
"Renting a therapy room can be a practical solution for when you’re starting out. You don’t have to tie yourself into lengthy contracts. You pay for the space you need and when you need it, plus you gain the advantages and amenities of sharing a professional environment."
When renting, create a detailed list of your requirements, including location, budget, and specific space needs. Carefully review rental agreements, paying close attention to termination clauses, maintenance responsibilities, and included amenities.
Creating Unified Workflows
One of the biggest challenges in hybrid practices is ensuring that workflows connect virtual and in-person services seamlessly. Clients should receive the same level of care regardless of the session format.
Administrative tasks often take up significant time, with 84% of mental health providers reporting they spend more time on paperwork than patient care. Standardizing telehealth processes across your team – using the same platforms and methods – can help streamline operations.
EHR integration is another key to efficiency. It eliminates duplicate data entry and reduces the risk of missing important details. For example, Community Medical Partners implemented a hybrid cloud strategy with EHR integration, cutting IT costs by 32%, reaching over 2,000 patients via telehealth, and avoiding any security incidents.
Automation tools can further ease the burden of repetitive tasks like appointment scheduling, insurance verification, and document management. Virtual front desk systems can manage digital waiting rooms and pre-session tech checks, saving valuable time.
"The right virtual care solutions that effectively integrate automation of the clinical interview and clinician workflows can create a care framework that’s far more efficient, restores professional fulfillment, and leads to improved patient satisfaction and better patient health outcomes."
- Christina Chen, M.D., Medical Director at Bright.md
Daily team meetings can also improve communication and coordination, helping to address scheduling conflicts, client needs, and any technical issues before they disrupt care. Digital tools that collect patient information and guide clients to the appropriate services can make navigation easier for everyone involved.
The ultimate goal is to create workflows where technology operates quietly in the background, allowing you to focus entirely on providing excellent care. Once your workflows are in place, you’ll be ready to fine-tune the client experience even further.
Creating a Client-Focused Hybrid Experience
To create a seamless blend of in-person and virtual sessions, it’s essential to put the client first. A smooth onboarding process and consistent communication are the cornerstones of building trust and setting clear expectations for a successful long-term relationship.
Setting Up Client Onboarding
The onboarding phase is where clients form their first impressions of your practice. Every step during this stage reflects your professionalism and helps establish what they can expect moving forward.
Start by sending secure digital intake forms before the first session. These forms can include questionnaires, consent forms, and policy acknowledgments. By handling these administrative tasks upfront, you free up time during the initial session to focus on building rapport.
Make sure your forms are designed for both in-person and virtual sessions. Ask about clients’ comfort with technology, internet reliability, and preferred devices. This lets you address any potential technical issues early on, ensuring smoother virtual interactions.
For in-person sessions, provide clear directions and parking information. For virtual sessions, include step-by-step instructions for accessing the platform, along with backup contact information in case of technical difficulties.
Consider using a patient portal to enhance the onboarding experience. These systems allow clients to book appointments, fill out forms, access records, and join telehealth sessions, all in one place. Look for a portal that integrates with your electronic health records to avoid redundant data entry. Add helpful features like guided tours and automated reminders for unfinished forms or upcoming appointments.
Finally, be upfront about important policies. Clearly explain payment terms, cancellation rules, privacy protocols, and emergency procedures. Address common questions about transitioning between in-person and virtual sessions to avoid confusion later.
Maintaining Clear Client Communication
Once onboarding is in place, the focus shifts to maintaining open and consistent communication. Clients should feel equally supported, whether they’re meeting you in person or online.
Set boundaries early to avoid misunderstandings. Be clear about session times, how clients can contact you between appointments, and what qualifies as an emergency. Explain your response times for different communication methods and outline after-hours policies.
"With the expansion of telehealth for mental health services, the ability to reach clients in need has greatly expanded. At the same time, it is crucial to establish safe boundaries and guidelines for your clients and yourself when practicing remotely. Planning ahead of time how to handle disruptions in technology and any clinical emergencies is key to a successful telehealth practice." – Jill Daino, LCSW-R, BC-TMH
Offer multiple ways for clients to communicate, like secure video calls, phone sessions, and encrypted messaging platforms. Always have a backup plan in case of technical glitches.
When working virtually, pay close attention to subtle cues like facial expressions, tone of voice, and body language. Since nonverbal communication is more limited online, ask direct and clear questions to fill in the gaps.
"While it can be more challenging to not see the whole person as we usually would in an office setting, we can be more direct in our questions with our clients when assessing and looking for the non-verbal cues that we would naturally see in an office setting. Being transparent with our clients about the limitations of telehealth and open to these discussions sets it up for success." – Jill Daino, LCSW-R, BC-TMH
Use techniques like verbal affirmations, reflective listening, and summarizing to show empathy and understanding. Encourage clients to open up by asking open-ended questions. For virtual sessions, digital tools like screen sharing, whiteboards, and interactive activities can make the experience more engaging and collaborative.
Regularly ask clients for feedback on their comfort level with both session formats. Take note of any technical issues they mention and use this input to refine your processes.
Keep concise session notes to ensure continuity between in-person and virtual sessions. Document technical challenges and client preferences to improve future interactions. When communication flows smoothly, clients can focus on their goals without being distracted by logistical hurdles.
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Running and Improving Your Hybrid Practice
With the groundwork for your hybrid practice in place, the next step is to refine daily operations, meet compliance standards, and keep your finances on track. Balancing virtual and in-person sessions takes careful planning, legal awareness, and smart budgeting to ensure your practice thrives.
Managing Schedules and Time
A well-organized schedule is key to avoiding burnout and staying efficient. Start by creating a single master calendar that includes everything – client sessions, administrative tasks, personal time, and breaks. Using multiple calendars can lead to confusion and missed appointments. Scheduling all activities, not just client sessions, gives you a clear view of your time.
Time blocking is a great way to stay productive. Assign specific time slots to different tasks so you can focus without interruptions. For instance, you might schedule virtual sessions from 9:00 AM to 12:00 PM, in-person appointments from 1:00 PM to 4:00 PM, and leave 4:00 PM to 5:00 PM for documentation. Adding color codes can help you quickly see how your day is structured.
To maintain your energy, build in 15–30 minute buffers between sessions, especially if they’re emotionally demanding. Spread out your client appointments evenly across the week to avoid having overwhelming days followed by light ones.
Batching similar tasks can also boost efficiency by up to 15%. For example, group all your virtual sessions into one part of the day, reserve a block for administrative work, and handle tasks like insurance verification or treatment plan updates in one go.
"A form of decision-making used by individuals to structure, protect, and adapt their time to changing conditions." – Aeon and Aguinis (2017, p. 311)
Treat your calendar commitments as non-negotiable. Use timers to make sure tasks don’t run over their allotted time, and don’t forget to schedule breaks and self-care. Regular downtime isn’t just nice to have – it’s essential for staying focused and delivering high-quality care.
Once your scheduling is under control, turn your attention to meeting legal standards and managing costs to keep your hybrid practice running smoothly.
Meeting Legal and Compliance Requirements
Hybrid practices face unique legal and compliance challenges, especially when it comes to state-specific regulations. HIPAA compliance is mandatory for both virtual and in-person sessions. For telehealth, use a HIPAA-compliant video platform with a signed Business Associate Agreement (BAA). As John Torous, M.D., chair of the APA Committee on Mental Health IT, explains:
"Often you can use the same product (such as Zoom) without a BAA, but to make it HIPAA compliant, a psychiatrist needs to use the version of Zoom that requires the signature of a BAA."
Make sure all patient data is encrypted and protect your systems with strong passwords and multi-factor authentication. Regularly assess your technology for security gaps and address any vulnerabilities.
Licensure can get tricky when you’re working across state lines. You’ll need to be licensed in both the state where you practice and the state where your client is located during the session. The Interstate Medical Licensure Compact (IMLC) can simplify this process for some professionals, so it’s worth checking if it applies to you.
Privacy is another critical area. Ensure both you and your clients are in private spaces during sessions, and let clients know if anyone else is present. Document these procedures in your informed consent forms to reinforce your compliance efforts.
Billing regulations for telehealth services are also evolving. As of January 2024, 43 states, Washington D.C., and the Virgin Islands require insurers to reimburse telehealth services at the same rate as in-person visits. Medicare and other payers may have different rules, so it’s important to review billing guidelines regularly. Additionally, ensure your liability insurance covers both in-person and virtual care, as some policies require separate coverage for telehealth.
With compliance in check, focus on controlling expenses and increasing revenue to secure your practice’s future.
Controlling Costs and Growing Revenue
A hybrid model offers a unique opportunity to lower costs while increasing income. Instead of committing to a full-time office lease – which can cost $500 to $2,500 per month – consider renting office space on an as-needed basis. Platforms like Humanly let you pay only for the time you use, reducing fixed expenses.
Teletherapy also cuts costs by eliminating the need for extensive physical infrastructure. With fewer expenses like rent, utilities, and commuting, you can serve more clients and potentially improve profit margins. Well-managed practices often see margins between 10% and 20%.
Using virtual assistants for scheduling, billing, and other tasks can further reduce staffing costs. Additionally, adopting an Electronic Health Records (EHR) system can save you between $5,000 and $10,000 annually by improving administrative efficiency, even though it costs $50 to $150 per month.
| Cost-Saving Strategy | Annual Savings |
|---|---|
| Electronic Health Records | $5,000 – $10,000 |
| Online Scheduling Software | $1,000 – $3,000 |
| Telehealth Platforms | $2,000 – $5,000 |
Expanding your services can also boost revenue. Consider offering group therapy, workshops, or specialized virtual programs. A subscription-based model – such as monthly wellness check-ins or support groups – can provide a steady income stream.
Keep an eye on vendor rates, too. As Holly A. Hunt, PhD, advises:
"Companies are constantly competing with each other and generating new service plans and better rates. Even if you don’t get all of your fees reduced when you call, you are likely to get some discounts. And if you don’t periodically ask, you can be sure your rates will never change."
Streamlining your billing process can also improve cash flow. Collect copays and deductibles upfront, enforce a clear no-show policy, and use automated reminders to reduce missed appointments. Regularly monitor financial metrics like profit margins, operational costs, and revenue per client to guide your decisions. Urban practices, for example, often earn 20–30% more than rural ones due to higher demand and service prices.
Simple measures like using energy-efficient practices or buying used equipment can cut operational costs by 5–8%. Every dollar saved strengthens your bottom line and contributes to the long-term success of your practice.
Key Steps for Your Hybrid Therapy Practice
To fully establish your hybrid therapy practice, you’ll need to build on a solid foundation of technology, workspace, and workflow. At its core, success in this model revolves around three key elements: flexible planning, client-focused care, and savvy business decisions. These steps will help you create a practice that thrives in a shifting market and maximizes your earning potential.
Choose Your Business Structure
The first step is deciding whether to operate under a single business entity or multiple entities, depending on your service needs. A single entity is simpler to establish but might complicate managing both in-network and out-of-network patients. On the other hand, multiple entities require more legal work but provide clearer boundaries for operations.
Balance Your Service Offerings
A successful hybrid practice strikes the right balance between in-network insurance services and cash-based options like advanced therapies or wellness programs. This approach not only boosts revenue but also broadens access to care. When choosing insurance contracts, focus on those that align with your reimbursement goals and steer clear of agreements with high patient volume but low payment rates.
Use Integrated Practice Management Software
Invest in a unified practice management system that streamlines scheduling, billing, documentation, and client communication. This software should handle both insurance claims and cash payments seamlessly. As Jill Daino, LCSW-R, BC-TMH, highlights:
"With the expansion of telehealth for mental health services, the ability to reach clients in need has greatly expanded. At the same time, it is crucial to establish safe boundaries and guidelines for your clients and yourself when practicing remotely. Planning ahead of time how to handle disruptions in technology and any clinical emergencies is key to a successful telehealth practice."
Build Referral Networks
Strong referral relationships can be a game-changer for your practice. Patient testimonials, online reviews, and physician referrals work as effective marketing tools. Partnering with physicians who understand the benefits of your hybrid model can often yield better results than costly advertising campaigns.
Scale Smartly with On-Demand Office Space
Consider using on-demand office space to adjust to fluctuating client volumes. This flexibility allows you to grow sustainably while keeping costs in check.
Set Expectations and Gather Feedback
Clearly communicate session timing, payment policies, and cancellation rules to clients. Regularly collecting feedback will help you refine your services and improve the overall client experience.
Track Financial Performance
Keep a close eye on your financial metrics, such as profit margins, operational costs, and revenue per client. This ongoing analysis will help you identify which services are most profitable and allow you to adjust your offerings as needed to stay competitive.
As Clarity Cooperative puts it:
"The hybrid therapy private practice model is the future of the modern private practice business. This model gives mental health professionals the chance to maximize their earnings, enjoy the benefits of working in a variety of settings, and use a range of counseling skills."
FAQs
How can I ensure privacy and security in a hybrid therapy practice?
Protecting client privacy and ensuring security in a hybrid therapy practice calls for a thoughtful approach to both technology and physical settings. Start by using HIPAA-compliant tools for teletherapy, such as encrypted video conferencing platforms and secure messaging systems, to keep sensitive client data safe. Make sure to establish clear privacy policies and obtain informed consent from clients, explaining how their information will be handled and protected.
When conducting therapy sessions, choose private and secure locations to minimize the risk of unauthorized access or disruptions. Staying up to date on legal requirements and regularly refreshing your knowledge of privacy standards will not only help you remain compliant but also foster trust with your clients. Providing regular training on security protocols can further strengthen the safety and reliability of your practice.
How can therapists successfully balance virtual and in-person sessions in a hybrid therapy model?
To strike the right balance between virtual and in-person therapy sessions, it’s important to ensure a consistent and professional experience across both formats. Maintain the same tone and structure for each session type, and for in-person meetings, aim to use a dedicated, comfortable space that reflects the professionalism of your virtual setup. Platforms like Humanly provide fully equipped, on-demand therapy spaces, making it easier to deliver a polished in-person experience.
Clear communication is essential. Set expectations with your clients upfront about scheduling, session formats, and any technology requirements. For virtual sessions, encourage them to create a quiet, distraction-free environment with proper lighting and a reliable internet connection. These small steps can help maintain the therapeutic connection and keep sessions productive.
Incorporating tools like shared calendars and secure messaging platforms can simplify scheduling and communication in a hybrid model. By being thoughtful about both in-person and virtual approaches, you can improve accessibility while ensuring your clients receive consistent, high-quality care.
How can therapists navigate legal and compliance challenges when offering therapy across state lines?
Therapists providing services across state lines need to navigate legal and compliance matters with care to safeguard their practice and their clients.
Start by confirming that you’re licensed in both your home state and the state where your client is located during each session. This is a critical step, as licensure requirements can differ between states. Some states are part of interstate licensure compacts, which can make the process more straightforward, so it’s worth checking if this applies to you. Also, stay informed about the specific regulations and ethical standards in each state – you might be surprised at how much they can vary.
Another key consideration is using HIPAA-compliant telehealth platforms. These platforms are essential for protecting client confidentiality and ensuring you meet federal privacy rules. By following these guidelines, you can build a hybrid therapy practice that is both legally compliant and professional.