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With declining insurance reimbursements, increased paperwork, and an overwhelming number of rules associated with being part of an ACO, many physicians – especially those in primary care – are considering the switch over to concierge medicine, also known as direct care. This model of practice has become increasingly appealing to physicians throughout the country, with a 30% annual increase in the number of physicians practicing direct care. 

But is concierge medicine for everyone? And what do physicians need to know before making the switch? Below are four things physicians should know before joining a concierge practice – or converting their existing practice to a direct pay model.

1. Enjoy a Smaller Patient Panel with Longer Appointments

In traditional medical practices, physicians often maintain a patient panel of over 2,000 patients. With each patient, physicians often spend an average 15 minutes for each appointment. These rushed visits can keep physicians from forming relationships with their patients that can improve overall outcomes and patient satisfaction. However, with concierge medicine, physicians have a significantly smaller patient panel (usually around 400-600 patients), but will spend more time with each individual patient. This additional time comes in the form of longer exams as well as through other forms of communication (phone, email, and telemedicine applications).

 

2. Overhead Costs Will Probably Decrease

It’s estimated that the average practice spends around 15% of their overhead on billing insurers and collecting payments. These overhead costs are basially eliminated when physicians chose the direct care model. With concierge medicine, patients pay either monthly or annual retainers that are usually billed as a recurring charge on the patient’s credit card, with services often paid out of pocket by the patient. By removing the insurance payer, practices enjoy lower costs for billing and collection, allowing practices to increase margins and provide physicians with a comfortable income.

 

3. You Might Lose Some Patients

It’s easy to see why so many private practice physicians are making the switch to direct care, and many patients are following their physicians into the new care model. While the perks of concierge care are enough to bring over many of a practice’s existing patients when the change to direct care occurs, there are others who will go elsewhere once they learn that your practice won’t be accepting their insurance (or that there is an added fee for concierge access). Additionally, if many of your patients are on medicare there can be other hurdles. While medicare allows physicians to contract privately with patients, the physician would need to opt-out of medicare for at least two years after entering into such an agreement with a medicare patient.

 

4. It’s Not Just for Primary Care

While direct care models are most common with primary care physicians, many specialties can adapt to the model – especially those dealing with chronic conditions. Many endocrinologists, Urologists, and Obstetricians can adopt the concierge medicine model using either a cash-based payment or subscription model to patients.

Key Take Aways:

  • Concierge practices can help physicians provide higher quality care to patients through smaller patient panels and increased access.
  • Concierge practice can increase income for physicians by slashing the overhead costs associated with dealing with insurance companies.
  • While it’s most common in primary care, concierge practice can also be utilized for a variety of medical specialties, especially those dealing with chronic conditions.