High-Touch Care

MARY ROWLAND

 Chances are good that some of your clients have been spending long nights on the phone searching for health-care coverage after their plans were dropped by their insurers. What can you do to help?

It’s probably time to look more closely at what is called “concierge medicine service” or “direct primary care,” among other labels. Not all such practices label themselves in the same way, nor do they offer comparable services, making it difficult to compare them. Shopping for this type of plan by price is a worthless endeavor. That’s like shopping for a car by price and learning that a Smart Car costs a lot less than a Bentley.

Like many things we buy, such as whole life insurance, buying the cheapest product usually means you are getting the lowest benefits. And there’s probably no other place where the range and quality of benefits are broader than in the concierge health-care marketplace. I found no two practices that were exactly alike, although I certainly didn’t talk to all the concierge firms. Not by a long shot.

Analyzing products and services to find the best option for your clients’ needs is one of the most valuable services a financial advisor can provide. Prices differ widely and so does coverage. The label “concierge” gives the impression that these services are only available for the rich. But if that’s ever been true, it is rapidly changing. Most practices now offer a range of services from near-total coverage to scaled-down services for those who can’t afford a concierge.

An article in The Wall Street Journal on November 10 said that there are an estimated 5,500 concierge practices nationwide and that about two-thirds charge less than $135 a month on average, up from just 49% three years ago. Another incentive to look to the “concierge” alternative is the clause in the Affordable Care Act that allows direct primary-care to count as insurance compliant with the ACA, provided it is bundled with a wraparound catastrophic medical policy.

One of the best reasons to help your clients find the right policy is that it much improves the clients’ risk profile and creates a solid bond between advisor and client. Many—if I had done an actual poll, I think I could say “most”—of these practices do not accept insurance. Eliminating insurance billing cuts 40% of the practices’ overhead expenses, enabling them to keep fees low, doctors say. But one of the largest, MDVIP, founded 12 years ago in southern Florida, takes both insurance and Medicare. MDVIP now has 700 doctors and 200,000 patient members. The practice serves members “from Maine to Hawaii,” according to Dan Hecht, CEO. Ninety-four percent of these members renew every year. Like the other practices, MDVIP screens doctors and “nine out of 10 we don’t accept,” Hecht says.

To me, the screening of doctors, which most concierge medicine practices do, is a big benefit. At MDVIP, “the doctor receives the bulk of the concierge fee,” which runs from $1,500 to $1,800 a year, Hecht says. Each new patient selects a primary care doctor in his or her location from the list of 700 physicians and meets with that doctor for one and a half hours to get a complete executive physical, which is covered by the plan and might cost $1,000 otherwise. The results are sent to the Cleveland Heart Lab at the Cleveland Clinic, which prepares a detailed report along with recommendations, ranging from seeing a heart or cancer specialist to starting a gluten-free diet and everything in between. If the recommendation is for a gluten-free diet, the patient would be given a gluten-free menu and even a week’s shopping list to get the necessary supplies.

The annual fee does not include visits to specialists. So each member must have a wraparound catastrophic insurance policy. After this first visit, this primary care doctor will see your client once a year for 30 minutes; the visit will start precisely on time. When Hecht became CEO of MDVIP four years ago, his financial planner “was so excited because she was already a member of MDVIP,” Hecht says. As with many other services, members can be seen by an approved local doctor wherever they travel.

MDVIP has 14 “medical centers of excellence” such as the Mayo Clinic, Johns Hopkins, the University of Texas, Memorial Sloan-Kettering and the Cleveland Clinic. I am providing all these details about MDVIP not because I have judged it to be the best available plan for everyone but because it accepts insurance and Medicare, which is a rarity in this health-care sector and I know that would be a valuable benefit for some of your clients. Concierge doctors also negotiate with specialists and labs to secure discounts for patients who would otherwise pay out of pocket.

Skepticism Allayed
When I started reporting this article, I was a skeptic. But talking with these doctors and CEOs helped me realize how much pain and anxiety I might have avoided had I been a member of one of these practices. That’s particularly true of the access to specialists. For example, when our 6-year-old daughter developed a blinding eye disease, we went to the nearest emergency room in the middle of the night where the on-call doctor called her situation “modified bliss,” quoting The Mikado, because she was not dead. He had no idea what was wrong. Neither did the next six pediatric ophthalmologists we saw in Manhattan.

It was not until we found Dr. Michael Weiss, a uveitis specialist at Columbia Presbyterian Hospital in New York, that we could even put a name to the disease. Weiss treated her for 20 years until her health plan in Boston would no longer cover his care and then it was like starting over again. And when I was attacked on Fifth Avenue in Manhattan and crushed my hip, I had it wired together in the nearest emergency room. I wonder if I had been a member of one of these groups, I would still have needed two more hip replacements and endured continuing pain for nearly 20 years.

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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.

One Response to “High-Touch Care”

  1. Good read! you should post this on writement.com

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