What Is Concierge Medicine?

Is concierge medicine right for you? Do you know how it’s different from a traditional medical practice?

For many people, the word “concierge” conjures an image of a uniformed or well-dressed employee at an expensive hotel who arranges tours and tickets for concerts for guests.

Concierge medicine is a health care model in which a patient pays a monthly, bi-annual or annual fee to see their physician, says Molly Moore, chief health plan officer at Decent, a startup based in Austin, Texas, that creates affordable health care plans for small businesses and self-employed professionals. Many of their clients have been hit hard by the economic downturn caused by the COVID-19 pandemic.

“It’s a type of retainer model of care,” says Michael Seavers, the program lead in Healthcare Informatics at Harrisburg University of Science and Technology in Harrisburg, Pennsylvania. Concierge medicine is similar to an agreement with an attorney on retainer, in which the lawyer provides legal services for a flat fee, rather than charging by the hour or case. A patient could call or see a doctor whenever he needed to, much the way a client could call a lawyer on retainer whenever he or she needed legal advice.

By contrast, patients at a doctor’s office in a traditional practice charge patients per appointment. Typically, when they see their doctor, people with health insurance are responsible for a copayment – a flat fee, which is a set amount for a specific service, like an office visit. Under this model, the patient typically also pays a copayment to specialists who are in his or her health insurance’s network of providers.

On the other hand, if a primary care physician in a concierge practice refers a patient to a specialist – say, a gastroenterologist – who is part of the service, there’s no additional charge. Patients can use their health insurance for referrals to specialists who are not part of the concierge group.

Zero or Shorter Wait Times

Doctors in concierge medicine groups typically have fewer patients than physicians who are in traditional medical practices. That means shorter waits for patients, who can access their doctor or another concierge physician immediately, even on holidays, Seavers says.

Patients can typically reach a doctor quickly by phone or text, and make an appointment the same day. Some concierge medical practices even make house calls.

“Concierge medicine is all about quickness of access,” Seavers says.

In the summer of 2017, Concierge Medicine Today published a piece that said 33{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4} of physicians in concierge practices reported having no wait times. Another 31{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4} said their wait times were less than five minutes.

An Option for People Who Are Uninsured or Underinsured

Many health care consumers have a high-deductible plan where nothing is covered until the deductible – in the thousands of dollars for some people – is paid out of pocket. Paying for a concierge plan might be less costly for these consumers than paying toward their deductible for their primary care needs, says Marc G. Riddick, founder of MedCierge, an app that provides telehealth concierge services to its subscribers. “This is especially true if they do not typically use any care beyond their primary care needs,” he says.

Concierge Medicine Gaining in Popularity

Concierge medicine has been around since at least the 1990s. This model has gained in popularity in the last five to 10 years, particularly among health care consumers in upper-middle class metropolitan and suburban areas, according to conciergemedicinetoday.org.

Overall, there are an estimated 5,000 to 20,000 private medicine doctors nationwide, according to the July/August 2017 edition of the periodical Concierge Medicine Today. The range is so wide because there’s no federal registry or database to track concierge physicians. The number of concierge physicians are a small percentage of the more than 920,000 licensed doctors in the U.S.

How Much Does Concierge Medicine Cost?

The annual fee to subscribe to most concierge medicine practices ranges between $1,200 and $3,000, according to conciergemedicinetoday.org. Experts say some high-end private medicine services that provide services to wealthy people can cost tens of thousands a year.

Overall, here is the breakdown of payment options that concierge medicine practices accept, according to conciergemedicinetoday.org:

  • Cash only, 51{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4}
  • Medicare or some insurance, 29{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4}
  • Medicare but no HMO or PPO plans, 14{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4}
  • Insurance but no Medicare, 6{b5d304c96e94113bdfc523ff4218a1efff4746200bdb9eeb3214a56a1302f2e4}

Pros and Cons of Concierge Medicine

If you’re considering becoming a patient of a concierge medical practice, it might be a good idea to weigh the pros and cons, says Dr. Dan Minior, medical director of Halo Health Mobile Concierge Doctors, based in Raleigh, North Carolina. Halo Health offers all typical concierge medical services either at the patient’s home or office. The physicians are on call 24/7 and provide immediate care.

Here are some pros of concierge medicine:

  • Doctors spend more time with their patients.
  • Unlimited number of annual doctor visits.
  • Access to your doctor via phone or text when you’re traveling.
  • Robust preventive care.

Some possible cons to consider include:

Copyright 2020 U.S. News & World Report

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