Concierge Medicine For the Masses


An article last week in The Wall Street Journal discussed the pros and cons of concierge medicine and its impact on middle class Americans.  The Ritz Carlton stigma put on the term “concierge” forces people to associate it with high prices and high quality. The definition would lead someone to think that concierge medicine would never be something they could get with the “Affordable” Care Act.
The idea of having customized service available to you is common in the hospitality industry, but patients spending thousands of dollars a year on healthcare are not accustomed to that level of service.  Alas, times they are a’changing. No longer will the term “concierge” just be associated with high costs.  More and more patients are starting to see that electing to buy coverage as a member of a concierge plan can save them thousands of dollars a year.  A study in North Carolina, from North Carolina State University, pointed out that patients who opted into a concierge medicine plan with a primary care clinic (Access Healthcare Clinic) spent 12% less on out-of-pocket costs than they did with traditional insurance.

Cost of Care Chart from The Wall Street Journal Article

With a concierge medicine plan, not only are patients saving money and staying compliant with the ACA ruling, but they also have more exclusive access to high quality physicians. In light of the Affordable Care Act, patients will see big changes in their care, one of those changes being the accessibility of their physicians.  So, in addition to being required to purchase insurance coverage, it could be harder for patients to get appointments with the doctors they want.
Direct primary care plans do count as ACA-compliant coverage if it is bundled with a catastrophic coverage policy.  Unfortunately, while Cigna has an employee plan that is built in this manner, many insurance companies do not yet offer it as an option.  If your insurance company doesn’t build a plan around concierge practices yet, this could prove to be an unaffordable option, especially since the IRS doesn’t recognize concierge fees as eligible costs for health savings accounts.
So, how much do concierge medicine memberships like these cost and how does it work? Practices are charging anywhere from $40-$50/month to $125-$200/month for their concierge fees, depending on things like age and what services the fees cover. Some higher-priced memberships cover basic checkups, treatment of minor ailments and even EKGs.  These physicians also have connections with places for patients to get additional procedures like labs, scans and imaging at lower prices.
Doctors seem to like this arrangement as well, as seen by the 25% increase in providers that are accepting concierge membership and providing menu-style pricing systems.  Without accepting insurance plans or being concerned with tracking down patients’ payments; these participating physician offices have seen 40% cuts to their overhead costs. This could be a win-win, bringing concierge medicine to the masses.
Hear from  some real Concierge Doctors (video).
Original article: here