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On-Demand Doctors: How Concierge Healthcare May Be the Future of the Managed Care Industry

By | August 17, 2016

As healthcare costs continue to rise, Americans have begun to look for new strategies to lower their medical expenses without sacrificing the level of care they receive.

Providers, on the other hand, want to remove insurance companies from the equation to cut administrative expenses in half. As a result, a new healthcare trend is growing as an viable alternative to this opaque and convoluted system: concierge healthcare.

So what is it? Concierge healthcare is when providers charge patients an out-of-pocket retainer fee for full access to their services. This means consumers pay a monthly fee to see a doctor for routine healthcare services like a physical or strep throat without sending a claim to insurance. In fact, most of these concierge practices don’t even take insurance, and instead, charge patients directly for a treatment alongside membership, “often posting menu-style prices for services and requiring payment up front,” as the New York Times reports.

This type of service may seem odd for the managed care industry, but concierge healthcare developed out of frustration. Over the years, physicians have felt that they have lost control of their practice and have had to listen to third parties like insurance companies on how they should run their business. Today, about 5,000 providers practice concierge medicine with that number continuing to increase according to the American Academy of Private Physicians. Providers are incentivized to switch to concierge healthcare because this type of practice promises a steady income with a decrease in the number of patients. On average, a doctor in a traditional practice may have 2,000 patients while a concierge doctor usually has 500 patients on retainer, which means they no longer rely on insurance companies to earn an income. They get paid at the time of service – no questions asked.

For patients, concierge healthcare is an option to get the care they need at costs normally less than what their insurance company would charge. The Wall Street Journal reports that out of all the concierge practices nationwide, about two-thirds charge less than $135 per month (about $1,620 annually). Through the Affordable Care Act, on average, a 50-year-old nonsmoker can sign-up for the least expensive full-coverage plans for no less than $307 a month, which is about $3,684 for the full year — that’s almost double what consumers pay for membership to a concierge practice.

In addition, since physicians who practice concierge medicine have less patients to manage, they’re able to spend more time with each individual. This not only means that patients can make appointments within 24 hours, but providers can also help their patients via phone, email or video because they don’t need patients to visit the office to get paid. They also establish stronger relationships with their patients as they have the time to do so, and as a result, they focus on preventative care instead of solely sick care.

For instance, Florida-based MDVIP, a company that has a network of more than 800 physicians who practice concierge medicine, puts the patient first and believes physicians should not only resolve any medical issues but also act as a wellness guide. MDVIP-affiliated providers teach healthy eating and fitness strategies to patients, on top of providing basic healthcare services. With this 360-degree care, MDVIP claims to have seen a 90 percent reduction in hospital readmission, according to Healthline.

However, since most large insurance companies don’t recognize concierge healthcare or even have plans built around concierge practices, Americans who want to participate in this system might have to pay for both their insurance plan and monthly retainer, which can be redundant and expensive. This is the reason why concierge-practicing physicians recommend that patients sign-up for a high-deductible insurance plan with minimal premiums for emergencies, and direct the money they save towards the concierge retainer, as the Wall Street Journal reports. In other words, concierge healthcare works best when patients use this type of practice for simple services and reserve insurance for inpatient procedures and emergencies.

Even though concierge healthcare brings some much-needed transparency to the managed care industry, this system just adds more expenses to Americans’ growing list of medical bills. At SingleCare, we don’t think consumers should have to pay for access to the competitive marketplace, so we don’t charge a monthly retainer, deductible or copay. Fees are built into the rates published on our website. Hop on our platform and shop for the healthcare services you need at rates 50 percent less than our competitors, regardless of your insurance coverage. With SingleCare, you can get the care you need without breaking the bank.