By Concierge Medicine Today | Last Updated: Summer 2023
Bringing History Back To Life.
Doctors carrying a medical bag and coming into a Patient’s home was standard into the late 1960s. Concierge Medicine is a modern day throwback now offered to Patients by a Physician, hospital program or group practice in a monthly or annual subscription.
Look at The Andy Griffith Show for example.
Remember Marcus Welby, MD?
Personal relationship between a Physician and individual (eg. a Patient) is what our grandparents knew as healthcare. Today, healthcare has become cumbersome, expensive and tedious, to say the least. The loss of the personal and individual relationship between Patient and Physician is rarely available and often felt.
Fast forward to today, the delivery of healthcare expertise and care by Physicians comes from many places and angles. In the past few decades the patient panels have increased on every Physician. Not too mention the ever-increasing oversight, legal, bureaucratic, regulatory and administrative challenges Doctors must face each day has changed the delivery of healthcare and removed the time necessary for Doctors and Patients to connect.
With that said, some Doctors in the past 20+ years have moved into healthcare delivery business models such as concierge medicine in an effort to have a smaller patient panel size and get back to the basics of asking better questions and treating patients in a more preventative manner.
The past two decades have seen some the most eventful moments in the space of Concierge Medicine, private-pay as news and headlines circulate across the media landscape. From The New York Times to The Wall Street Journal, Concierge Medicine is now a familiar term that people are learning to articulate and define for themselves.
This article is not meant to persuade or convince you that a subscription healthcare delivery business model or Doctor is for you. Each person and individual should decide for themselves the type of relationship and services you need and/or want from your Physician and/or care provider.
Each concierge medicine Doctor and/or program will provide unique services to Patients. They may have different services, price points, features and benefits. With all of this being our common ground or thesis, it should also be known that these are not insurance programs and not meant to replace your current insurance. When you find a concierge medicine or subscription program and/or office, ask them how they’re practice/services work or are compatible with your insurance. They’ll probably be glad to help you!
Understanding the Basic Terminology
First, if you have heard of concierge medicine you’ve probably been told through hearsay that it’s elitist or expensive.
Like any innovation at the beginning, it was when it first came onto the scene over two decades ago. But as it matured and grew, more and more Doctors, programs and programs soon drove the price down. Such as the competitive landscape of most business concepts.
Today, concierge medicine can be found offered by many Doctors offices in a monthly or annual subscription fee. Usually they’re internal medicine, primary care or family doctors but in the past 10-years, we’ve observed that more and more specialty practices have also started concierge practices as well. And, as of 2022, more Physician Assistants, RNs, MDs, DOs and even telehealth programs have emerged using such a subscription business model.
More Help Defining Concierge Medicine
According to WebMD, They’re often physicians who choose to form a private practice to limit the number of patients they’re responsible for — usually a smaller number compared to the volume of a more traditional office practice — and to minimize the amount of paperwork associated with insurance payouts. Concierge doctors can do everything a primary care physician can, including administer lab tests and conduct annual physical exams. They also typically provide diagnostic screenings and minor urgent care services like stitches or treatment for minor skin conditions. However, they can’t provide many specialized treatments or major medical procedures, like surgery. (Source: https://www.webmd.com/a-to-z-guides/what-is-a-concierge-doctor)
- According to Medicare.gov, You pay 100% of the membership fee for concierge care. Concierge care is when: A doctor or group of doctors charges you a membership fee. They charge this fee before they’ll see you or accept you into their practice. Concierge care may also be called concierge medicine, retainer‐based medicine, boutique medicine, platinum practice, or direct care. When you pay this fee, you may get some services or amenities that Medicare doesn’t cover. Doctors who provide concierge care must still follow all Medicare rules: Doctors who accept assignment can’t charge you extra for Medicare-covered services. This means the membership fee can’t include additional charges for items or services that Medicare usually covers unless Medicare won’t pay for the item or service. In this situation, your doctor must give you a written notice called an “Advance Beneficiary Notice of Noncoverage” (ABN) listing the services and reasons why Medicare may not pay. Doctors who don’t accept assignment can charge you more than the Medicare-Approved Amount for Medicare-covered services, but there’s a 15% limit called the ” limiting charge.” All Medicare doctors (regardless of whether or not they accept assignment) can charge you for items and services that Medicare doesn’t cover. The membership fee is governed by the contract or agreement you sign with the doctor or doctor group. Additional state laws and consumer protections may apply. For more information, contact your state’s insurance departmentor consumer protection bureau. (Source: https://www.medicare.gov/coverage/concierge-care)
- According to Forbes, For a flat monthly fee, you get unlimited office and telehealth visits that last as long as you need, as well as direct care from a doctor without worrying about copays and other charges. You also gain access to your doctor’s direct phone line for medical questions and simple diagnostic and blood tests in their office. And if you have a major health problem, your doctor coordinates specialist referrals and/or hospital care as needed. With concierge medicine, there’s no insurance or corporate health system interference—just doctors and patients. (Source: https://www.forbes.com/health/healthy-aging/concierge-medicine/)
- According to Definitive Healthcare, 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 price tag to match—with patients paying up to $25,000 per year for the boutique healthcare experience. What’s more, this cost was paid in addition to regular health insurance premiums and 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 a year—or between $125 to $200 a month. (Source: https://www.definitivehc.com/blog/what-is-concierge-medicine)
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