PATTY MURPHY
HNI Health Systems Consultant

Affluent customers for years have turned to “concierge” medical care to escape crowded waiting rooms, receive more personalized attention, and gain access a wider range of treatments without long waits and bureaucratic runaround.

Concierge care also frequently includes longer and more comprehensive doctor visits to address all health care questions or concerns. Fortunately for the rest of us, lower-cost models for concierge medicine have emerged.

What is Concierge Medicine?

Physicians who practice concierge medicine limit themselves to a few hundred patients, rather than a few thousand. Concierge doctors see about half the number of patients daily compared with a doctor in a traditional primary care practice. The result? Concierge doctors can provide highly personalized care.

In concierge medicine, patients pay the provider an annual fee ($1,000 to $20,000) for services including customized wellness programs, same-day appointments, and even house calls and pharmacy runs. The patient still pays for insurance coverage, and concierge services usually do not include hospitalization, surgery, medications, or visits to specialists.

Patients are encouraged to email, call, or text their doctor with questions and follow-ups, and many concierge medical practices offer 24/7 access to a doctor or a nurse.  

Some early data suggests concierge medicine supports fewer emergency room visits and hospitalizations and decreased prescription drug usage.

Expanding the Scope: Can We All Be VIPs?

Today there are 4,400 concierge doctors in the U.S., with 1,000 practices expected to have opened in 2012 alone. Experts predict that number will double in the next three years, as concierge medicine becomes an option for everyone, not just the rich. Retainers are becoming less prohibitive, with some doctors charging as little as $150 per year.

Concierge medicine practice models vary. Not all physicians charge a retainer or opt out of accepting insurance altogether. Many have unique practice models while others contract with large medical management organizations. For example, MDVIP, the nation’s largest concierge-style network, has 450 affiliated physicians serving more than 150,000 patients.

Following is a closer look at concierge medicine:

• Concierge care may be a good option for frequent travelers, as doctors can be reached by email and phone.
• Concierge care may be appropriate for elderly and chronically ill patients who would benefit from house calls.
• Annual concierge care fees typically are out of pocket for the patient. Health savings accounts can help with these costs.
• Fees for concierge medicine may be tax deductible, depending on annual income and health care expenses.

Concierge Medicine and Employers

While concierge medicine can work under a self-pay model by individuals, it is also gaining popularity under an employer-sponsored model with employers paying the monthly fee on behalf of their employees.

In a employer-sponsored concierge model, the focus continues to be on improved access by employees to preventative services, wellness, chronic disease management, urgent care, and episodic sick care provided by physicians and other health care professionals on a 24/7 basis. 

Many employers have established convenient on-site offices, resulting in increased employee satisfaction and productivity. This approach reduces emergency visits, specialist visits, and hospital admissions often associated with delays in care or unmanaged diseases. The result is reduced claims for the employer.

A concierge medicine program is one part to consider as part of a total health plan design, and also may be eligible for favorable tax benefits.

What is your experience with concierge medicine? Is this something you'd consider incorporating into your plan?  Please share in comments!

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