While some physicians are considering early retirement or leaving primary care if reimbursements are cut further, others are turning to a hybrid model of concierge medicine.
Companies such as Concierge Choice Physicians have championed the hybrid concierge model and provide insights into alternatives designed to enable physicians to sustain their practices.
“Our phone has been ringing off the hook,” said CCP founder Wayne Lipton. “They believe there is a target on their backs. Physicians are truly concerned that health plans tasked by the administration with lowering healthcare costs are going to do so on the backs of primary care physicians by slashing reimbursement.”
If reimbursement is reduced further, healthcare advocates and industry analysts fear that thousands of physicians will no longer be able to maintain a viable practice. Their options might include closing their practice or refusing to see patients insured by low-reimbursing private or government plans.
To adapt to market pressures, some physicians are moving to full concierge practices. The model works well for physicians – and for patients who can afford it – but it often disenfranchises those patients who can’t afford or don’t want to move to such a model.
“The way the market is moving we may well create a system where millions of Americans no longer have access to primary care physicians,” said Lipton. “This creates a bit of a paradox as the administration and healthcare leaders are publicly highlighting what an important role PCPs play in providing and coordinating care for Americans.”
Physicians in 11 states with more than 250,000 patients are using the hybrid concierge model. With current interest in alternative models of practice, CCP projects more than 50 percent growth for the next year.
Hybrid practices offer a “distinct option” to full concierge. Under the full concierge model, if patients can’t afford or don’t want to join the service, they have to leave the practice and find a new physician. This further worsens the PCP shortage and disenfranchises thousands of patients. Under a hybrid model, the patients can join the concierge service or continue to see their physician in the same way they had before.
“The hybrid concierge model has been a real benefit for me and my patients,” said Bart Price, an internist in Sarasota, Fla. “I believe it helps me provide better care to all of my patients. Plus, because the economic pressure has been alleviated, I am able to continue to take care of a broad cross-section of patients from Medicare to private pay and have the ability to give back more to my community.”
With the concierge option, patients can obtain same-day appointments, extended office consultations or more extensive evaluations and often have 24-hour direct phone and e-mail access to their physicians. This model also offers medical services generally not covered by traditional insurance plans or Medicare, such as in-depth annual physicals with specialized tests.
Such medical services are available to patients for a fee that averages about $150 per month, less than the cost of a standard “executive” physical. In addition, under the CCP model, those up to age 25 can participate under their parents’ program at no additional charge. Because the hybrid model provides care for non-covered services, most patients continue to keep their traditional health insurance.
“CCP’s hybrid model is a solution that has tremendous potential for physicians and patients,” said Lipton. “No one wants to create a healthcare system that forces primary care physicians to drop health plans and patients. The beauty of the hybrid model is that by shifting a small portion of a practice to a consumer-driven healthcare model and providing fair reimbursement as well as a more reasonable work/life balance for physicians, it gives patients the ability to maintain their provider relationships and encourages doctors to stay in primary care.”