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Physician Law Current news, updates, & useful tips relating to legal issues affecting physicians & non-institutional providers in their personal & professional lives

Is Concierge Medicine Right for You?

Posted in Practice Management

As administrative burdens and costs associated with the practice of medicine continue to grow, many physicians are wondering out loud whether now is the time to make the leap to cash-only concierge medicine.  In its purest form, concierge medicine is a model where patients pay a recurring cash fee (e.g., monthly or annual) for expedited/enhanced access to medical and wellness care.  There are many possible variations on this concept ranging from a cash fee-for-service model to a hybrid model where the physician accepts cash for some services (non-covered) and bills insurance for others. 

While the concept may sound incredibly tempting, physicians are advised to proceed with caution.  To be sure, there are a host of legal considerations – most of which have to do with Medicare and commercial insurance contractual issues.  These are particularly tricky in a hybrid model where the distinction between covered and non-covered services is critical. 

There are, however, many business considerations that should be carefully evaluated before making this leap. Among other things, the practice needs to be in a market that will support a cash-only practice. Patients who get decent coverage through their employer’s plan and only have to pay minimal copays/deductibles may be reluctant to pay more. Some patients may be willing to pay for concierge level care but how many of those patients will you need to sustain a practice?  How will the practice operations and cost structure change under a concierge model?  How will the physician’s lifestyle need to change?

While concierge medicine may be a great fit for a handfull of doctors, it’s likely not a feasible model for many.  If you are considering making this change, be sure to do your homework first.