In recent years there have been multiple trends impacting how people receive medical care including practice methods such as Concierge Medicine and Direct Corporate Care, as well as the movement towards value-based care. Written by Victoria Chen, Charlie Almoney, Omar Aly, and Gwyn Alexander.
The healthcare system in the United States has long been centered on hospital care and private or group practice, all covered by both public (medicare, medicaid) and private health insurance. However, in recent years there have been multiple interesting trends that could have the potential to change the way healthcare is administered in the United States. Specifically, in this article I will discuss the growing market for concierge medicine and a new model for large scale employer healthcare.
Concierge Medicine is defined by WebMD as a healthcare model where doctors offer their services to patients directly in exchange for a fee that is usually paid monthly1. In this model insurance does not play as large a role because the monthly or yearly fee covers the services that the physician provides. Historically, this model has been restricted to wealthy patients who could afford the relatively expensive fees. However, specifically in family practice this model is becoming more popular amongst doctors and lowering costs are making it more accessible. Concierge physicians typically see 80–90% less patients per day, allowing them to spend more time with individual patients and reduce physician burnout2. Additionally, without the fee-for-service coverage model, physicians are more incentivized to provide the best possible quality of care. Patients benefit from this model as well, they are able to spend more time with their healthcare provider and have access to unlimited amounts of care throughout the year. Many large concierge practices are at the forefront of introducing technology into primary care as well. One example is concierge medicine provider Forward, who has introduced a new primary care model centered on advanced diagnostic testing and preventative medicine. Their biometric and blood tests are used to help treat and diagnose the early stages of chronic disease and help patients address preventable medical complications later in life. Overall, concierge medicine is a relatively expensive option for patients, but with a focus on preventative care and preventing physician burnout, concierge could become a more popular healthcare model in the coming years.
Another new trend in primary care practice is in employer centered coverage for large corporations and businesses. Employers historically have provided the health insurance for their employees who can then receive medical care from in network providers. There have been recently founded medical providers who are interested in providing direct, on-site care to large companies for a flat fee, similar to the concierge model. Employers pay a flat fee, usually based on total employees, and all of the employees of that company have access to direct primary care without billing through insurance. This simplifies the model for many employers and allows employees to have access to care similar to that of a concierge practice. Some of the largest tech employers in the country (Facebook, Linkedin, etc.) have shifted to this model because it is cheaper than providing health insurance for their employees and it simplifies the billing process by bringing the entire primary care structure in house at these large providers. This model has not yet reached small to midsize business, and it seems unlikely that major changes will happen at smaller employers soon because of the relatively smaller and easier to control healthcare costs. However, similar to concierge medicine this corporate focused model is changing the way that businesses and individuals are paying for healthcare and could mark the start of a transition away from the current insurance model that defines the American healthcare system.
In conclusion these new primary healthcare models are becoming more commonplace in the American healthcare industry. These trends present an opportunity for individuals and employers to escape the expensive and often inefficient healthcare that is paid for by private insurance. While major restrictions still exist in our healthcare system, these new models are able to provide consumers with more diverse options and the ability to choose how they receive primary care.
- “What Is a Concierge Doctor? What They Do, When to See One, and What to Expect.” WebMD, WebMD, 2020, www.webmd.com/a-to-z-guides/what-is-a-concierge-doctor.
- DocWire News Featured Reading, et al. “The Growth and Future of Concierge Medicine.” Docwire News, 4 June 2019, www.docwirenews.com/docwire-pick/the-growth-and-future-of-concierge-medicine/.