According to a report from NPR and the Harvard T.H. Chan School of Public Health, more than one in five adults in the top 1% of the population pay an additional fee for direct access to their primary care physician.
This care delivery model, called concierge medicine or membership medicine, is a more exclusive form of care that involves 24/7 physician access, same-day appointments, and highly personalized, comprehensive care. This premium service, of course, comes at a cost.
But in the past decade or so, this tailored healthcare delivery model has gained widespread traction outside of the top 1% of patient populations, too.
Why is this?
No matter what you call it—concierge care, membership medicine, platinum practice—they all share the same common goal: radical, high-quality hospitality in healthcare. In this blog, we’ll discuss what concierge medicine is and how it is transforming the primary care world.
What is concierge medicine?
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 higher price tag. In fact, patients paid up to $25,000 per year for this luxury membership medicine experience on top of their regular health insurance premiums and it 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 annually—or between $125 to $200 a month.
In the past decade or so, the emergence of direct primary care (DPC) practices has introduced other lower-priced models of on-demand and high-quality subscription-based care. DPC is a similar care delivery model that charges patients a flat-rate retainer for readily accessible, highly personalized primary care.
Unlike concierge medicine models, DPC physicians do not accept insurance payments or participate in government programs like Medicare. Instead, their funding comes directly from patient fees. Direct primary care practices offer greater pricing transparency because of this, with patient membership fees averaging between $30 to $100 per month for unlimited doctor visits.
What are the advantages of concierge medicine?
This premium care delivery model offers several advantages over traditional healthcare models, both for patients and physicians.
Patients receive convenient, enhanced access to their doctors. Membership practices limit patient numbers, leading to same-day or next-day appointments and minimal waiting room time. Some practices offer direct contact with a physician via phone or email, and many groups accommodate extended hours, providing patients with 24/7 access to their doctor. Smaller patient panels also mean that physicians can spend more time focusing on personalized wellness plans and preventative care to help manage chronic conditions and avoid future health issues.
For physicians, the notion of practicing medicine on a retainer is an enticing prospect for many considering an alternative to the traditional care delivery model. The flat-rate, subscription-based payment structure guarantees a predictable revenue based on member volumes and eliminates the potential stresses of a fee-for-service practice.
Additionally, as healthcare continues to embrace value-based care, many doctors are compelled to re-evaluate their approach to care delivery. With this in mind, most physicians cite improved doctor-patient relationships as their leading motivation for transitioning to membership medicine.
What are the disadvantages of concierge medicine?
Despite its attractive benefits, concierge care does come with some key drawbacks to acknowledge:
- It’s expensive. The biggest hurdle for many is the membership fee, which can be prohibitive for those with limited budgets and infrequent healthcare needs.
- Availability is limited. Concierge practices tend to be concentrated in affluent areas, making them geographically inaccessible for many people. Additionally, doctor slots in these practices often fill up quickly due to the smaller patient panels.
- It’s not a replacement for insurance. Membership fees don't cover everything. You'll still need health insurance for emergencies, hospitalizations, specialist care, and other major medical expenses.
- There are ethical concerns. Doctors in concierge practices may have a healthier patient population due to the cost factor. This can skew their experience, potentially impact treatment decisions, and raise concerns about creating a two-tiered healthcare system where better care is only available to those who can afford it.
Overall, concierge care offers a premium healthcare experience with increased access and personalized attention. However, the high costs, limited accessibility, and potential drawbacks mean it's not suitable for everyone.
Will concierge medicine be the future of primary care?
Probably not, given the considerable issues and concerns described earlier. The limited scope and problems around accessibility and sustainability create barriers for many people and do little to address the broader healthcare needs of the general population.
The future of primary care is likely to be a blend of different models catering to diverse needs and budgets. Concierge care can be a valuable niche option, but addressing affordability and accessibility will be crucial for ensuring equitable healthcare for everyone.
That said, membership medicine is another example of the continued shift in patient care preferences in the past several years. Alongside rising numbers of ambulatory surgery centers, outpatient and home health options, telemedicine, remote patient monitoring devices, and much more, concierge care indicates that patients want to take a more proactive approach to their care—one that is convenient, accessible, personalized, and (hopefully) affordable.
Get a new perspective on primary care
Are you interested in understanding how concierge medicine and alternative care delivery models will impact healthcare delivery in 2024 and beyond? Check out our podcast with Beth Holmes of Hint Health.
Beth discusses topics such as DPC’s success with smaller employers and underinsured regions, how DPC reduces reliance on emergency care, and why family doctors may be less likely to leave the field in a DPC model.
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