WHAT IS A CONCIERGE PRACTICE?
A concierge practice (also known as direct care) is a relationship between a patient and a physician in which the patient pays an annual fee or retainer on top of the existing medical insurance. Concierge practices are a new and growing concept in the healthcare industry.
Concierge physicians care for fewer patients than conventional practices, ranging from 100 patients per doctor to 1,000 instead of the 3,000 to 4,000 the average physicians now see yearly.
Concierge practices seek to provide many benefits to concierge patients, and some of them include personalized and quality care, affordable care, etc.
WHAT TO CONSIDER BEFORE SWITCHING TO CONCIERGE PRACTICE:
Some physicians are changing their traditional office-based practices to concierge practices. They feel that treating a limited group of patients paying a monthly fee, who then get greater access to care, is a better situation for the doctors and the patients. Some physicians combine traditional and concierge practices, and others transition to exclusive ones. Procedures not covered in the concierge practices are billed to insurance companies.
Although concierge practices generally free a doctor from insurance contracts, it doesn’t free a physician from contracts in general. Here is what you need to do before going this route.
- Establish the fee arrangement and the services that will be included.
- Decide whether or not you’ll accept insurance, government payers, and other third-party payers.
- Notify existing patients about the transition to concierge medicine.
- Contract with participating patients.
- Comply with applicable federal and state laws.
- Physicians should have the infrastructure to bill and collect the concierge fees.
- When a decision is made to transition to a concierge practice and give adequate notice to existing patients, this should be a top priority.
After evaluating which patients will participate in your concierge practice, the next important step is to draft a retainer agreement.
Concierge practices are attractive for some physicians, but this model is not for everyone. Be sure to get the infrastructure and documents in place before offering this option to your patients.
We have physicians who transitioned to Concierge practices and are performing very well. You need to assess your patient base to see if you are in the right market for a Concierge practice.
If you want to discuss this in more detail or have any questions, please call us at 714-569-1000
Gregory N. Lewis, CPA
