What is concierge medicine?

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According to a 2020 report from NPR and the Harvard T.H. Chan School of Public Health, more than one in five adults in the top 1% of the population pay an additional fee for direct access to their primary care physician.

This type of care delivery model, called concierge care or concierge medicine, is a more exclusive form of care that involves 24/7 physician access, same-day appointments, and highly personalized, comprehensive care. This high level of care, of course, comes with a cost.

But in the past decade or so, this tailored healthcare delivery model has gained widespread traction outside of the top 1% of patient populations, too.

Why is this?

No matter what you call it—concierge care, membership medicine, platinum practice—they all share the same common goal: radical, high-quality hospitality in healthcare.

How does concierge medicine work?

When the concierge medicine model first appeared in the mid-1990s with Seattle-based MD2 International, it introduced the idea of “luxury medical care” and came with a higher price tag. In fact, patients paid up to $25,000 per year for this luxury healthcare experience on top of their regular health insurance premiums and it didn’t cover the costs of hospitalization or specialist consultations.

Though some patients still pay a five-figure fee for their care, the average fee for membership in a concierge practice nowadays is between $1,500 and $2,400 annually—or between $125 to $200 a month.

In the past decade or so, the emergence of direct primary care (DPC) practices have introduced other lower-priced models of on-demand and high-quality subscription-based care. DPC is a similar care delivery model that charges patients a flat-rate retainer for readily accessible, highly personalized primary care.

Unlike concierge medicine models, DPC physicians do not accept insurance payments or participate in government programs like Medicare. Instead, their funding comes directly from patient fees. Direct primary care practices offer greater pricing transparency because of this with patient membership fees averaging between $30 to $100 per month for unlimited doctor visits.

Advantages of the concierge care model

The notion of practicing medicine on a retainer is an enticing prospect for many physicians considering an alternative to the traditional care delivery model. The flat-rate, subscription-based payment structure guarantees a predictable revenue based on member volumes and eliminates the potential stresses of a fee-for-service practice.

Additionally, as healthcare continues to embrace value-based care, many doctors are compelled to re-evaluate their approach to care delivery. With this in mind, most physicians cite improved doctor-patient relationships as their leading motivation for transitioning to concierge medicine.

What is the difference between a concierge doctor and a regular doctor?

From the perspective of training and ability, concierge doctors are just like any other doctor. There are no special licensing requirements to perform concierge medicine, and concierge doctors attend the same medical schools and residencies as their traditional counterparts.

But to the patient, the experience associated with a concierge doctor may feel more personalized and engaging.

With the ability to see 20 or fewer patients a day and have more thorough appointments ranging from thirty minutes to an hour depending on patient needs, concierge care physicians can devote more time and energy to each patient.

More than that, many practitioners feel that they’re able to deliver a higher quality of care than they might otherwise be able to at a fee-for-service model where they might be scheduled to see 30 or more patients in a single day.

Without the performance pressures, scheduling conflicts, and administrative burdens of a traditional primary care practice, concierge physicians report feeling more satisfied with their work and, thus, more able to provide the best possible care to their patients.

Physicians aren’t the only ones to benefit from this model

Flexible scheduling and unfettered access to a physician with an intimate knowledge of their patients’ personal health histories make concierge medicine particularly well-suited to the needs of those living with long-term or chronic medical conditions.

While the flat fee for concierge care doesn’t cover specialty care services that some patients with chronic illnesses may require, the 24/7 physician access—whether on the phone, virtually, or in the doctor’s office—provides these patients with the support that they need.

Disadvantages of the concierge care model

According to Concierge Medicine Today , there are between 10,000 and 25,000 physicians or subscription-based programs across the U.S. and abroad. That accounts for a small fraction of the roughly 1 million licensed physicians and allied care professionals in the U.S. For most of these physicians, leaving their patients behind was a primary concern in considering the switch to concierge medicine.

A concierge care or direct primary care practice typically see fewer patients, averaging between 450 to 600 patients per year, while a typical primary care practice might average closer to 2,500 patients. This reality could make the problem of increasing physician staffing shortages worse due to declining interest in primary care specialties.

Membership-based care services also pose the potential to limit care access for low-income patients, or for patients in rural areas. Given the nature of small, membership-based medicine, physicians can be more selective in choosing which patients to take on, creating the potential for implicit bias to find its way into the care delivery model.

Though the industry-wide transition to a value-based care system means that providers are, on the whole, focused on helping their patients and high-quality care delivery, the simultaneous growth of alternative models like concierge medicine is quickly changing the face of the U.S. healthcare system.

Get a new perspective on direct primary care

Are you interested in understanding how concierge medicine and alternative care delivery models will impact healthcare delivery in 2023 and beyond? Check out our podcast with Beth Holmes of Hint Health.

Beth discusses topics such as DPC’s success with smaller employers and underinsured regions, how DPC reduces reliance on emergency care, and why family doctors may be less likely to leave the field in a DPC model.

Need deeper commercial intelligence on the entire healthcare system? Sign up for a free trial today and see how our platform helps you understand and succeed in this evolving market.

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