Concierge medicine is generally a membership model of physician care that gives physicians the platform to dramatically increase their time, bolster their connectivity, and grow the nature of their relationship with patients. In this business model, patients tend to pay an annual membership fee for services that are not covered by third parties (insurances or government plans).
For an annual membership fee, physicians make available numerous enhancements to their services, like same-day/next-day appointments, expanded appointment windows, annual examinations that extend far beyond covered services, and other amenities that enhance the relationship between the provider and the patient.
This model does not in any way replace insurance plans but instead serves as an addition. Physicians can always leverage this model in part via a hybrid model or entirely, known as the full model. Initially, this style of medicine was limited to adult primary care physicians, but in recent years it has successfully expanded into various specialties as well.
It is imperative to state that the number of hours a week a physician who leverages this model spends practicing medicine varies. If a physician chooses the full-model approach by converting the entire practice to the concierge, then they will probably see 200-700 patients; therefore, the workload should lighten—there is less pressure to see as many patients as possible.
If a physician decides to adopt a hybrid model, then they will continue their traditional practice, attending to all patients, but will block several hours a week to care for concierge patients. Note that the number of hours devoted for concierge patients will depend on membership, which tends to range from 50-100 patients.
Most often, the time apportioned to concierge patients allows the physician to work at a more relaxed pace, spending more time with each patient.
Note that the salary of a concierge physician will increase anywhere from 10% to 100%, depending on whether they are a full or hybrid concierge physician and the number of patients in their program. Physicians speculate that they can triple or quadruple the amount of revenue they earn per patient when they convert to the concierge.
How Does the Concierge Medicine Business Model Work?
First, you have to understand that not all concierge practices are the same, but they share a good number of similarities. In concierge medicine, just like it was noted above, a doctor charges an annual fee that can be paid in full or split up, but the contract is for the whole year.
This annual fee sees to in-depth comprehensive care with screenings that go past what traditional insurance or government programs would cater for. Also, note that a good number of concierge medicine physicians still continue to accept insurance plans and government programs, and patient visits are charged in the traditional manner, aside from the annual fee.
From many physicians’ perspectives, concierge medicine offers greater autonomy, a viable platform to return to a more manageable patient load, and the opportunity to grow their incomes that have declined owing to increasingly lowered reimbursements for their services.
However, from many patients’/consumers’ perspectives, concierge medicine offers more instant, available, and beneficial access to their primary care physicians and, irrespective of their physician’s annual retainer fee, does away with third-party insurance coverage costs and troubles.
Note that the main criticisms of the concierge medicine model still float from some health care policymakers and experts, who insist that concierge medicine is solely for the upper class and its widespread implementation will heighten the shortage of primary care physicians.
Another primary issue especially with doctors eager to make the switch to concierge direct care is patient education. Have it in mind that patients are used to the standard model of healthcare and tend to shy away from the unfamiliar.
How Does Concierge Medicine Business Make Money?
A concierge practice is built on service. It is the job of the physician to do anything within their power to help their patients. However, note that the key difference remains the fact that compensation doesn’t flow through medical insurance; which can be very complex, murky, with so many loopholes and regulations that make it difficult for transparency.
However, just like with business models, there are 3 primary ways concierge medicine businesses make money. Although variations of these models exist, most models tend to fall into one of the following categories.
The Fee for Care (‘FFC’)
This revenue model is simply an annual retainer model, where the patients are charged a monthly, quarterly, or annual retainer fee by the physician. Note that the retainer fee covers most services made available by the physician in his/her office. But services like vaccinations, lab work, x-rays, and other services are not included and charged separately on a cash basis.
However, in recent times, there has been a shift away from fee-for-care payment models and towards value-based payments that reward medical providers based on efficiency and patient outcomes, rather than the volume of services provided.
The Fee for Extra Care (‘FFEC’)
This revenue model is quite similar to the FFC model, however, the extra services are charged to Medicare or the patient’s insurance plan.
Some of the services included in these two retainer models include same-day access to your doctor; instant cell phone and text messaging to the doctor; unlimited office visits with no co-pay; little or no waiting time in the office; priority placed on preventive care; calm atmosphere; cell phone, text message, and online consultations; prescription refills; and considerate appointment scheduling.
Here, physicians charge a monthly, quarterly, or annual retainer or membership fee for services that Medicare and insurers do not cover. Note that these services may involve: email access; phone consultations; newsletters; annual physicals; prolonged visits; and extensive wellness and evaluations plans.
For all noted services, these providers will charge Medicare and insurance companies for patient visits and services handled by the plans. According to reports, this model gives room for the physician to continue to see their non-retainer patients while charging their “concierge” patients a fee for the necessary or “special” attention.
Also, note that a good number of concierge practices are cash-only or ‘direct’ primary care practices and will not accept insurance of any form. Owing to that, these practices can ensure that overhead and administrative costs stay low, thereby making available affordable healthcare to patients.
Top 20 Companies Operating Concierge Medicine Business Model
- Concierge Choice
- Inova Concierge
- Specialdocs, Inc.
- Latady Physician Strategies
- Cypress Concierge
- AnthroSonoma Integrative
- Savant Wellness
- Dignity Health Medical Group
- My Doctor Medical Group
- Concierge Medicine Today
- Austin Concierge Medicine
- Concierge Family Doctor
- Diamond Physicians
- Healthcare Success
- Pinnacle Concierge Medicine