Concern about lower reimbursement sparks MD interest in concierge practice model

Fear about the far-reaching consequences of healthcare reform-and the potential for dramatic reductions in physician reimbursement-has triggered a surge in physician participation in concierge medicine.

Concierge medicine, sometimes also called boutique medicine, has been around since 1996. However, with healthcare reform now eminent, more doctors are choosing this option. A New York Times article published in 2005 estimated that 250 doctors with 100,000 patients participated in concierge medicine at that time. Today, approximately 5,000 U.S. primary care doctors operate a concierge practice, according to the Society for Innovative Medical Practice Design, a professional association of concierge physicians.

Florida-based MDVIP, a third-party provider that helps doctors organize and market concierge practices, expects to add more than 80 doctors to its network of 300 this year, according to a recent New York Times article. Despite the depressed economy, MDVIP reports that annual patient renewals remain at 93%.

With concierge medicine, patients pay an annual fee, or retainer, that typically is in the range of $1,500, but can go up as high as $25,000. For this annual fee, patients receive special treatment, like a comprehensive physical, longer office visits, greater follow-up care, home or same-day doctor visits, and direct access 24/7 to a physician by phone or email. Physicians often continue to bill insurance companies for care provided at contracted rates.

Concierge medicine, however, is not without controversy. Two insurers, United Healthcare and Cigna, have denounced the practice, according to a report in the Houston Chronicle, warning that doctors charging extra for access to care are in violation of their contracts and may be dropped from these insurer networks. An analysis of the impact of concierge care’s impact on the healthcare system, published in The Journal of the American Osteopathic Association , notes that most legal experts agree the risks of violations of law arise when a clinical practice continues to seek reimbursement from Medicare and private insurance companies for services already paid for by retainer fees.

Physicians participating in concierge medicine programs usually do so exclusively, as the idea is to reduce the patient load to have more time to devote to patients-MDVIP limits a practice to 600 patients. But concerns about access denial and possible disenfranchisement of certain groups have some physicians considering a hybrid model, in which they continue to see a cross-section of patients but a portion of their practice shifts to a concierge model.

Concierge Choice Physicians, a third-party concierge medicine provider base in New York, champions this business model. The service, which claims physicians in 11 states with 250,000 patients, expects to grow its physician base by 50% this year, according to a recent report in Healthcare Business News. Rather than an annual fee, patients pay $150 per month for extra service, which covers the whole family.

Growth in concierge medicine could be favorable for clinical laboratories, because it allows the physician to choose his/her laboratory provider. Since these practices promise patients premium care and service, concierge physicians are likely to be very selective when choosing a laboratory. They will want to pick a clinical lab that demonstrates consistent quality and great service.

Related Information:

Impact of Concierge Care on Healthcare and Clinical Practice

VIP Medicine Makes Prime Time

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