UPDATE: Concierge doctors no longer just for the rich.

By Jen Wieczner


When Samir Qamar practiced concierge medicine at Pebble Beach Resorts in Monterey, Calif., the hotel’s “A-list clientele” paid $550 to see him and as much as $30,000 a month to keep him on retainer.


But last year, Dr. Qamar decided to abandon VIP medicine and pursue a no-frills version of his practice, charging just $59 for monthly membership to his MedLion clinics (16 locations in five states) and $10 a visit–and never billing insurance.


Dr. Qamar is part of a new and growing generation of concierge doctors who, in this era of health reform, see more opportunity in the middle class than they do in the jet set. The trend has bifurcated the retainer medicine industry: On one end, patients pay thousands of dollars a month for lavish celebrity-type treatment at traditional concierge practices. On the other, pared-down clinics charge roughly $50 to $100 a month for basic primary-care medicine, more accessible doctors, and yes, money savings for those looking to reduce their health spending.


Of the estimated 5,500 concierge practices nationwide, about two-thirds charge less than $135 a month on average, up from 49% three years ago, according to Concierge Medicine Today, a trade publication that also runs a research collective for the industry. Inexpensive practices are driving growth in concierge medicine, which is adding offices at a rate of about 25% a year, says the American Academy of Private Physicians.


Unlike high-end concierge practices, which typically bill insurers for medical services on top of collecting retainer fees, the lower-end outfits usually don’t accept insurance. Instead, they charge patients directly for treatment along with membership, often posting menu-style prices for services and requiring payment up front, which is why it is called “direct primary care.” Eliminating insurance billing cuts 40% of the practices’ overhead expenses, enabling them to keep fees low, doctors say.


On the cusp of the Affordable Care Act mandating most Americans to have health insurance next year, a rise in doctors who don’t take insurance might seem paradoxical. But health-care experts say the two forces go hand in hand, as patients may find concierge doctors more accessible, especially if traditional doctors get flooded with more patients. Also fueling the trend is a little-known clause tucked into the health-care law that allows direct primary-care to count as ACA-compliant insurance, as long as it is bundled with a “wraparound” catastrophic medical policy to cover emergencies.


“All of a sudden our market went from the uninsured to everybody,” Dr. Qamar says.


Think this type of medicine might be right for you? find out here


About Concierge Medicine Journal

Concierge Medicine Journal (CMJ) curates breaking concierge medicine news, and editorial opinion on a wide variety of topics relevant to the practice of Concierge Medicine.

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