concierge physician care • Oregon Capital Chronicle

The nonprofit hospital, founded primarily to serve the poor, has added concierge physician duties and charged patients $2,000 or more in annual fees to facilitate access to physicians. ing.

This is a trend that started decades ago in physician practices. Thousands of physicians are moving to a concierge model, allowing them to increase their income while reducing patient costs.

Large hospital systems that offer concierge physician services include Northwestern Medicine in Chicago, Penn Medicine in Philadelphia, University Hospitals in the Cleveland Area, and Baptist Health in Miami. This fee can exceed $4,000 annually, in addition to copays, deductibles, and other charges not paid by the patient’s insurance plan.

Critics of concierge medicine argue that the practice exacerbates primary care shortages, making it accessible only to the wealthy while driving up health costs. However, for tax-exempt hospitals, the economic benefit could be doubled. Concierge fees directly generate new revenue and serve as a tool to support physician recruitment and retention. These doctors provide high-paying referrals to hospitals that employ wealthy patients.

“Hospitals are attracted to doctors who offer concierge services because patients don’t have bad debts or need charity care, and most hospitals have private insurance, so they have more access to doctors who offer concierge services. Because they pay very well,” said hospital finance expert Gerald Anderson. Johns Hopkins University.

“From a hospital perspective, they are ideal patients.”

Concierge physicians typically limit their practice to a few hundred patients, compared to the thousands of patients of traditional primary care physicians, so they can promise immediate access and long-term visits.

“Every time these models expand, the availability of primary care physicians for the general public is shrinking,” said Jewel Mullen, associate dean for health equity at the Dell School of Medicine at the University of Texas at Austin. Ta. A former Connecticut state health commissioner said that concierge doctors join large hospital systems because of the facility’s reputation, and that hospitals also contract with concierge doctors to ensure referrals to specialists and inpatient treatment. He said that “It helps hospitals secure a larger portion of the market,” she said.

Concierge doctors typically promise same-day or next-day appointments. Many provide patients with cell phone numbers.

Aaron Klein, who oversees concierge physician operations at Baptist Health, said the program was originally intended to serve donors.

“High-value donors wanted to make sure they had a doctor to treat them,” he says.

Baptist launched its concierge program in 2019 and now has three clinic locations across South Florida, where patients pay $2,500 annually.

“My philosophy is that it is better to provide world-class care to a few hundred patients than to provide inadequate care to a few thousand patients,” Klein said.

Concierge physician practices began more than 20 years ago, primarily in upscale areas such as Boca Raton, Florida, and La Jolla, California. They primarily catered to wealthy retirees who were willing to pay extra for improved access to doctors. Some of the first doctors to get into the business were backed by private equity firms.

The largest, MDVIP, based in Boca Raton, has more than 1,100 physicians and more than 390,000 patients. Founded in 2000, private equity firms have held a majority stake in the company since 2014.

Some concierge doctors argue that better care leads to healthier patients. A study published last year by researchers at the University of California, Berkeley and the University of Pennsylvania found no effect on mortality. This study found that costs are high.

Using Medicare claims data, researchers found that concierge drug enrollment represented a 30% to 50% increase in a patient’s total medical spending.

For hospitals, “this is an extension of market consolidation,” said study co-author Adam Reeve, assistant professor of public policy at the University of California, Berkeley. Inova Health Care Services, located in Fairfax, Virginia, is one of the state’s largest tax-exempt hospital chains and employs 18 concierge physicians, each of whom serves fewer than 400 patients. is. These patients pay $2,200 a year for that privilege.

George Salem, 70, of McLean, Virginia, and his wife have been patients of Innova’s concierge business for several years. He allegedly slammed his finger on a hotel door earlier this year. As soon as he got home, he called a doctor who immediately examined him and sutured his wound. He says he only visits the doctor about 10 to 12 times a year.

“I used to love my internist, but it was impossible to meet him,” Salem said. Being able to see a doctor right away “gives me a lot of peace of mind,” he says.

Craig Cheifetz, Inova’s vice president and head of concierge programs, said hospital systems became interested in the model after MDVIP began expanding aggressively into the Washington, D.C., suburbs about 10 years ago. Currently, he has 6,000 patients in Inova’s program.

Cheifetz disputes accusations that concierge physician programs are exacerbating primary care shortages. He said the model continues to reduce the number of doctors who were considering early retirement. And the fees are only a few dollars a day, the same amount some people spend on coffee.

“Inova has a great primary care network for people who can’t afford concierge care,” he said. “We’re still providing everything that primary care needs to people who need it.”

Some hospitals have begun operating concierge physicians far from their home locations. For example, Florida’s Tampa General Hospital last year opened a concierge clinic in Palm Beach Gardens, an upper-middle-class neighborhood about a three-hour drive from Tampa. New York’s Mount Sinai Health System operates a concierge physician practice in West Palm Beach.

NCH ​​Healthcare System in Naples, Florida, employs 12 concierge physicians who collectively treat approximately 3,000 patients. “We found there was a need in this community for people who wanted a more personalized health care experience,” said James Brinkert, the system’s regional administrator. Membership at least he pays an annual fee of $3,500.

NCH ​​patients who don’t want to pay dues as doctors turn concierges are referred to other primary care practices or urgent cares, Brinkert said.