By Michael Tetreault, Editor
JULY 10, 2014 – Like one very large Mexican fast food chain and the creator of the ‘value menu’ concept, a lot of modern health care business centers and private physicians working independently of hospitals and insurers across the U.S. are now actually starting to show their prices to their customers (ie patients) before they see their doctor. Up until recently, primary care and health care practices were one of the only business segments in the U.S. that rarely, if ever, listed how much their fees were for their time, services and products.
Throughout the past decade-and-a-half, retainer based health care clinics, membership medicine programs, boutique and pharmacy chain retail doc-in-box stores and direct-pay business models are changing the way we look at paying for and excuse the play on words, ‘value’ our healthcare. Value Menu Medicine is becoming widely popular trend among a diverse population of people young and old.
“We recognized back in 2000 that health care was moving from personal to a more institutionalized form, and it wasn’t what we wanted to do,” said Dr. John Blanchard of Premier Private Physicians, a concierge medicine practice with offices in Troy and Clarkston. “We felt we needed to have time with our patients, to have the excellence to have the time with patients. Health care has been cutting reimbursement to doctors, which has forced doctors to see more patients, so the time doctors have with their patients have declined. The average time today with patients for most doctors is only 10 minutes.”
However, there is a population of people, mainly those in the media, who understand these types of medical delivery models being offered by some physicians across America are exclusive, elusive and let’s say it, flat out wrong.
“Young doctors are refusing to go into primary care medicine,” notes Dr. Steven Knope of Tucson, Arizona in his writings about The Myths of Concierge Medicine. “This is due to the fact that practicing primary care medicine in our current broken system, seeing 30 patients per day, making only one-third to one-fourth of what a specialist makes, have created an understandable shortage of doctors willing to practice primary care medicine. Over the long run, the only way to increase the number of qualified primary care doctors is to make the profession more attractive, both from a professional and financial perspective. It is our current broken system that has caused a shortage of primary care doctors; and if we stay on the old path, it will only get worse.”
A third-party evaluation of recent data shows that these types of membership medicine and cash-only patients had over 61 percent fewer hospitalizations when compared with similar patients in commercial insurance plans. Not to mention, 74 percent fewer hospitalizations when compared with Medicare patients of similar gender, age, and disease risk.
“This primary care business model [DPC] gives these types of providers the time to deliver more personalized care to their patients and pursue a comprehensive medical home approach,” said a spokesperson at Qliance Medical Management based in Seattle, Washington. “… In which the provider’s incentives are fully aligned with the patient’s incentives.”
Services typically offered by most of these style doctors offices might include: physical exams; blood work; flu shots; unhurried appointments; pediatric visits; unlimited office visits and other routine services for a flat fee.
On the Membership Medicine side of doctors offices, membership fees typically cover basic services that include preventive care, routine physicals, longer appointments, next-day appointments, 24-hour-a-day phone access and e-mail, house calls, coordination of care when you travel, and a CD with your medical records. If you have health insurance, your concierge doctor may submit claims for treatments that are not covered under your membership. Some of the most common services include: On call 24/7 access; House calls; No waiting; Unlimited appointments for your membership fee; “Executive physical exams” that include a full body scan, screening for over 180 diseases, blood tests for rare conditions and time spent with a physician going over every aspect of your medical history. These comprehensive exams can cost well into the thousands through traditional channels; Lab tests; X-rays; Coordination of care if you become ill while traveling; Mental health services; Well-baby checks; Acute care visits; Online access to medical records; Home delivery of medications; Hospital visits from the doctor; Transportation to appointments; Coordinated care with specialists during travel; Hotel reservations for family during a medical crisis; Wellness, fitness and lifestyle screenings; Weight management; Nutritional counseling; and more.
Why Is A Cash-Only, Membership Medical Practice A Win-Win For Patients & Family?
Plain and simple, when patients have more time with their doctor to discuss recent issues, the exchange of information and treatment provides better outcomes.
Hospital utilization data also find rates are lower, even when you try matching demographic variables from one age to another. In 2006, many concierge practices, for example, had a total average hospitalization rate of less than 120 admissions per one thousand admissions. In non-concierge medical practices, the rate was over 226 per one thousand admissions. On average, a huge population of concierge medical patients had 107 fewer admissions per one thousand than people in standard insurance plans. It’s appropriate to say ‘wow’ at this point. That’s a 47 percent reduction in hospitalizations.
“Instead of viewing the status quo PCP model as the center of the universe. Maybe we should take some plays from the Retail Clinic playbook before we become obsolete,” said Direct-Pay Physician, Dr. Robert Nelson of Cumming, GA.
Additional data when studying concierge medical practices over the past few years has shown that preventable hospitalizations are lowered by 40% in concierge medical practices. In fact, one source shows that avoidable hospitalization rates average less than 17 admissions per one thousand people. In standard health insurance plans with completely comparable patient populations, the rate is over 28 admits per one thousand patients.
All We See And Hear In The Media Is That All of These Types of Medical Practices Are Exclusive And Really, Really…Expensive. Come on…Really?
Hard Data Analyzed Over Years Shows Almost 62% of Membership Medical Programs and Direct Primary Care (DPC) Programs Cost Less Than $136 per month, and most average between $50-$100 r month. This should be a wake up call for all of those critics and cynics in the marketplace thinking this is high-priced, luxury medical care for the rich.
We recently submitted data to a prominent financial publication and found that when utilizing a blended rate based upon national averages for current fees charged for concierge medical care, an estimated 9,285,714,286 people could be provided concierge medical care with the 13 trillion dollar debt. Carrying this out 928,571,429 people could be provided this care for 10 years.*
NOTE: *The figures shown and facts shown here have been analyzed, published and collected internally by information and resources obtained and conducted by Concierge Medicine Today.