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Concierge Medicine 101: The Facts on this Innovative Benefits Strategy

As costs continue to skyrocket in employee benefits, many HR professionals are looking for creative and innovative benefits strategies that can help control costs while providing a service employees will truly appreciate.  

“Concierge medicine” [also known as boutique medicine] is a growing trend in healthcare that has potential to be a major gamechanger for physicians, patients and employers alike.  In a concierge approach, a doctor charges an annual fee in exchange for providing highly attentive, 24/7 medical care.  While this style of healthcare is still in the minority, the benefits may be worth weighing when evaluating potential options for you and your company.  In any case, this is something every HR professional should be aware of.

How Traditional Medicine Works

Traditional medicine – healthcare as most of us know it – operates on a fee-for-service basis.  When a patient needs care, he makes an appointment, visits a doctor, and pays for the services delivered.  Since insurance companies can negotiate who is considered “in network,” doctors may have to defer to the insurance company’s fee schedule when deciding what to charge for their services.

The trouble with the traditional approach is that it prioritizes volume.  To make a reasonable profit, doctors usually have to schedule appointments every 15 minutes, and often serve upwards of 3,000 patients a year. 

The result for the patient isn’t very pretty.  Patients of a doctor stretched too thin may struggle to get an appointment when they need one on short notice.  They spend longer in the waiting room than they do with an actual doctor.  Worse still, if a doctor is rushing from appointment to appointment, they may not get the doctor’s full attention and have little medical advice around preventative care. 

How Concierge Medicine is Different

Concierge medicine takes a different approach.  In this system, doctors charge an annual fee in exchange for providing highly attentive medical care available 24/7.  Doctors work with many fewer patients, typically 10% of what doctors in a traditional practice would take on.

With fewer patients and a guaranteed source of income, concierge medical professionals can provide more comprehensive care for patients.  They may be able to promise any number of services that just aren’t possible in traditional medicine – such as same day appointments, access to the doctor after hours and via email, and even making house calls when the patient is too ill to travel.    

Beyond the added convenience, patients benefit from additional attention when it comes to discussing preventive health care and individual lifestyle issues.  Due to time constraints, these issues are often pushed aside in traditional medical practices.   

How Concierge Medicine Works With Group Insurance

Employers are increasingly recognizing that healthy employees are essential to a healthy business.  Reduced absenteeism and presenteeism have a major impact on profitability.  Additionally, in a time when competition of talent is high, providing an innovative benefit package can be a major differentiator.

Concierge medicine typically does not replace an insurance program, but is used to enhance a benefit package that an employer offers. Most concierge medical professionals accept group insurance to cover the services they provide, such as tests, lab work, etc.  Any services not covered by the insurance company are usually considered covered by the concierge practice’s annual fee.

Insurance companies rarely will pay for the annual fee itself, but this can usually be paid for from an employee’s HSA, HRA or FSA account.

So, should you consider concierge health care at your company?

Today's environment demands a creative approach to benefits programming, as cost shifting is not a sustainable way to manage health care spend.  If the health of your employees is important to your business operations, concierge medicine is certainly worth exploring.  

For more information on this and nine other "Innovative Benefits Strategies," download the free workshop recording.


Topics: HR / Employee Benefits