Concierge Medicine: Costs, Factors and Considerations

If you're thinking about joining a concierge primary care practice, there are many things to consider before signing up. Will you get along with physician? How much will it cost? What will you receive for the money you spend? Is the service compatible with your insurance?

Concierge practices operate differently than traditional primary care practices. In traditional primary care, patients join a practice and rely on insurance, copays and coinsurance to cover care.

Traditional primary care doctors have an average of 2,300 patients in their practice. That means your PCP may be seeing 20 to 30 patient a day, every day. Appointments are typically 15 minutes, which is fine when you just need a prescription refill or have a sinus infection. But those short appointments may be inadequate for lengthier conversations, preventive care, lifestyle coaching or discussion about chronic conditions.

If you're in a hurry and only need a quick visit, you may also be out of luck: Appointments may start late or be unavailable at a time convenient to you. Because you're just one of thousands of patients, your doctor is usually stretched thin. You may not even see your doctor when you go in for a sick visit, instead being shunted to another provider, a nurse practitioner or physician's assistant. 

How concierge practices work

Most concierge medicine practices solve for these inconveniences by seeing fewer patients. Concierge practices may only have a few hundred patients - and most have less than 1,000.

They're able to offer convenient appointments, often same- and next-day, and those appointments usually start on time. concierge doctors also have time to focus on prevention, develop relationships with patients, answer questions and offer coaching for lifestyle changes. They're staffs usually have more time to follow up with lab results. 

Some concierge practices offer advanced preventive testing. Others offer services beyond what most primary care doctors do, including assistance scheduling with specialists travel services and more.

The cost of concierge medicine

But the conveniences and services come with a price. Concierge programs can range from a few hundred dollars a year to $25,000 and more. There ay be fees for services outside the standard program like hormone treatments or aesthetics.

They may also not accept your insurance requiring you to pay a fee for every visit.

If you are looking at a concierge practice, it's helpful to ask a few questions:

• What are you looking for in a healthcare provider?

Most patients are looking for convenience; price transparency; access to health information without having to hold on a phone call; and a good doctor-patient relationship. They also want to be involved in decisions about their care and hear about options. And they want help navigating the health care system. Concierge doctors are more likely to have time to offer these perks as a matter of course; traditional primary care doctors may be too busy seeing other patients.

• Does the program provide what I'm looking for?

Concierge primary care programs are often very different. Some only offer conveniences. Others go beyond with premium preventive care programs and counseling. Make sure you find out what's included before you sign up. Ask if there are any additional fees. 

• Does my insurance work with the program?

Regardless of a concierge practice's structure, you will still need health insurance. Even if all services by your primary care provider are covered by the concierge fee, you will want insurance for hospital visits, specialist appointments and other healthcare costs. Many concierge programs still bill insurance for sick visits and follow ups. Others rely on the patient to file reimbursement for visits. Check with the practice you're interested in to find out if they accept your insurance plan. 

• Do I like the doctor?

if you're hoping to have a better doctor-patient relationship, you may want to talk to the doctor whose practice you're interested in joining. Interview them and make sure you're compatible. You don't want to pay to be in a bad relationship. Don't know what to ask? These questions can help. 

• Is it worth it?

For many patients, joining a concierge practice is worth the money. They report higher satisfaction rates than traditional primary care patients and studies report better healthcare outcomes in membership-based primary care practices.

While MDVIP is not concierge medicine (it offers many of the same conveniences, but the annual membership fees pay for an advanced wellness program), 97 percent of its members are satisfied with their doctor versus only 58 percent of patients in traditional primary care practices. 

Those members value the ability to contact their physician during the day and after hours. They appreciate the proactive approach to care and their physician's bedside manner, including the attention their doctor pays to questions they have. They also appreciate their physician's approach to personalized care versus traditional primary care.

There are more than 1,100 MDVIP-affiliated physicians in 44 states. Find one near you today.