Concierge care taking hold at some large, urban hospitals
Skip to main content
MDHC_Logotype_white
Subscribe
  • My Account
  • Login
  • Subscribe
  • News
    • This Week's News
    • COVID-19
    • Providers
    • Insurance
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • People
    • Regional News
    • Digital Edition
    • Sticking to Mediterranean diet is good for the brain
      Joe Biden
      Revamp of the nation's vaccination effort may not be enough
      A man in a room with servers.
      Momentum grows to outsource hospital tech functions in 2021
      Firefighter walking towards forest fire.
      Wildfires producing more harmful pollution
    • COVID-19 hastens hospitals' revenue cycle outsourcing moves
      Operation Warp Speed Dr. Moncef Slaoui, Pfizer Group President Angela Hwang, Moderna CEO Stephane Bancel, CVS Health Executive Vice President Karen Lynch and McKesson CEO Brian Tyler participate in a panel discussion on the COVID-19 vaccine.
      Hospitals, drug companies strive to stand out virtually at JPM
      Dr. Bruce Siegel
      By protecting the healthcare safety net, Biden can put us on the path to a stronger country
      Joe Biden
      Revamp of the nation's vaccination effort may not be enough
    • The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      Trenda Ray
      Q&A: Arkansas nursing leader looking for creative staffing solutions as COVID cases surge
      Cook Lydia 4x6_i.jpg
      Northeast Ohio health systems increase community benefit values in 2019
      Vaccine rollout hits snag as health workers balk at shots
    • CMS approves rule forcing insurers to ease prior authorization
      COVID-19 still a big uncertainty for insurers in 2021
      Health insurers' outlook boosted after Dems' Georgia win
      humana_i.jpg
      Humana supports Ohio not-for-profits with $500,000
    • Joe Biden
      Revamp of the nation's vaccination effort may not be enough
      CMS will raise Medicare Advantage plan payments by 4.08% in 2022
      CMS approves rule forcing insurers to ease prior authorization
    • Operation Warp Speed Dr. Moncef Slaoui, Pfizer Group President Angela Hwang, Moderna CEO Stephane Bancel, CVS Health Executive Vice President Karen Lynch and McKesson CEO Brian Tyler participate in a panel discussion on the COVID-19 vaccine.
      Hospitals, drug companies strive to stand out virtually at JPM
      Intermountain, Trinity, Memorial Hermann behind $300M private equity fund
      Operation Warp Speed to bump up McKesson's stock price
      Reporter's notebook: J.P. Morgan's 2021 health conference
    • A man in a room with servers.
      Momentum grows to outsource hospital tech functions in 2021
      5 things to know about Google's $2.1B Fitbit acquisition
      Providence bets on machine-learning, consolidating data centers
      Mental health treatment was most common telehealth service during COVID
    • Sticking to Mediterranean diet is good for the brain
      Chance of COVID-19 triage care looms over Arizona hospitals
      U.S. ramps up vaccinations to get doses to more Americans
      367146427.jpg
      Should businesses mandate that staff get the COVID vaccine?
    • Cone Health CEO, CFO to depart amid pending Sentara merger
      Tower Health's finance chief resigning after years of steep losses
      AHRQ director Gopal Khanna resigns in response to Capitol riot
      Brigham president stepping down after Moderna controversy
    • Midwest
    • Northeast
    • South
    • West
  • Insights
    • ACA 10 Years After
    • Best Practices
    • InDepth Special Reports
    • Innovations
    • The Affordable Care Act after 10 years
    • New care model helps primary-care practices treat obesity
      doctor with patient
      COVID-19 treatment protocol developed in the field helps patients recover
      Rachel Wyatt
      Project to curb pressure injuries in hospitals shows promise
      Yale New Haven's COVID-19 nurse-staffing model has long-term benefits
    • Michellene Davis
      Healthcare leadership lacks the racial diversity needed to reduce health disparities
      Dr. James Hildreth
      How medical education can help fight racism
      Modern Healthcare InDepth: Breaking the bias that impedes better healthcare
      Videos: Healthcare industry executives describe their encounters with racism
      Quotes from rebadged employees
      Outsourcing IT, revenue cycle takes toll on internal culture
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      self service station
      COVID-19 pushes patient expectations toward self-service
      Targeting high-risk cancer patients with genetics
      A nurse holds up a phone with a message to a family member saying surgery has started.
      Texting, tablets help hospitals keep family updated on patient care
  • Transformation
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Highmark Health inks six-year cloud, tech deal with Google
      Study: 1 in 5 patients report discrimination when getting healthcare
      HHS proposes changing HIPAA privacy rules
      Android health records app launches at 230 health systems
    • California hospitals prepare ethical protocol to prioritize lifesaving care
      Amazon, JPMorgan Chase, Berkshire Hathaway disband Haven
      Digital pathways poised to reshape healthcare continuum in 2021
      Healthcare was the hardest hit by supply shortages across all U.S. industries
    • A woman with a wearable sensor talking to her provider.
      Wearable sensors help diagnose heart rhythm problems in West Virginia
      New care model helps primary-care practices treat obesity
      How hospitals are building on COVID-19 telehealth momentum
      Researchers: Hospital price variation exacerbates health inequities
    • MedPAC votes to boost hospital payments, freeze or cut other providers
      Most Next Gen ACOs achieved bonuses in 2019
      Congress recalibrates Medicare Physician Fee Schedule after lobbying
      CMS approves rule to encourage value-based drug pricing
  • Data/Lists
    • Rankings/Lists
    • Interactive Databases
    • Data Points
    • Health Systems Financials
      Executive Compensation
      Physician Compensation
  • Op-Ed
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
    • Wellstar CEO calls adapting for the pandemic her bold move
      Howard P. Kern
      Recognizing the value of telehealth in its infancy
      Dr. Stephen Markovich
      A bold move helped take him from family doctor to OhioHealth CEO
      Dr. Bruce Siegel
      Why taking a hospital not-for-profit was Dr. Bruce Siegel’s boldest move
    • Barry Ostrowsky
      Ending racism is a journey taken together; the starting point must be now
      Laura Lee Hall and Gary Puckrein
      Increased flu vaccination has never been more important for communities of color
      John Daniels Jr.
      Health equity: Making the journey from buzzword to reality
      Mark C. Clement and David Cook
      We all need to 'do something' to fight inequities and get healthcare right, for every patient, every time
    • Dr. Bruce Siegel
      By protecting the healthcare safety net, Biden can put us on the path to a stronger country
      Healing healthcare: some ideas for triage by the new Congress, administration
      Dr. Sachin H. Jain
      Medicare for All? The better route to universal coverage would be Medicare Advantage for All
      Connectivity: a social determinant of health that can exacerbate all the others
    • Letters: Eliminating bias in healthcare needs to be ‘deliberate and organic’
      Letters: Maybe dropping out of ACOs is a good thing for patients
      Letters: White House and Congress share blame for lack of national COVID strategy
      Letters: VA making strides to improve state veterans home inspections
    • Sponsored Content Provided By Optum
      How blockchain could ease frustration with the payment process
      Sponsored Content Provided By Optum
      Three steps to better data-sharing for payer and provider CIOs
      Sponsored Content Provided By Optum
      Reduce total cost of care: 6 reasons why providers and payers should tackle the challenge together
      Sponsored Content Provided By Optum
      Why CIOs went from back-office operators to mission-critical innovators
  • Awards
    • Award Programs
    • Nominate
    • Previous Award Programs
    • Other Award Programs
    • Best Places to Work in Healthcare Logo for Navigation
      Nominations Open - Best Places to Work in Healthcare
      Nominations Open - Health Care Hall of Fame
      Nominations Open - 50 Most Influential Clinical Executives
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Top 25 Minority Leaders
    • Top 25 Women Leaders
    • Excellence in Nursing Awards
    • Design Awards
    • Top 25 COOs in Healthcare
    • 100 Top Hospitals
    • ACHE Awards
  • Events
    • Conferences
    • Galas
    • Webinars
    • COVID-19 Event Tracker
    • Leadership Symposium
    • Healthcare Transformation Summit
    • Women Leaders in Healthcare Conference
    • Workplace of the Future Conference
    • Strategic Marketing Conference
    • Social Determinants of Health Symposium
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Minority Leaders Gala (2022)
    • Top 25 Women Leaders Gala
  • Listen
    • Podcast - Next Up
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
    • Carter Dredge
      Next Up Podcast: Ready, set, innovate! Innovation and disruption in healthcare
      Next Up Podcast: COVID-19, social determinants highlight health inequities — what next?
      Ceci Connolly
      Next Up Podcast: How to navigate the murky post-election waters
      Next Up Podcast: Saving Rural Health
    • An older man wearing a mask receiving a vaccine.
      Beyond the Byline: Verifying information on the chaotic COVID-19 vaccine rollout
      doctor burnout
      Beyond the Byline: How healthcare supply chain struggles contribute to employee burnout
      Beyond the Byline: Covering race and diversity in the healthcare industry
      Beyond the Byline: How telehealth utilization has impacted investor-owned company earnings
    • Leading intention promote diversity and inclusion
      Introducing Healthcare Insider Podcast
    • The Check Up: Trenda Ray
      The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
      The Check Up: Dr. Kenneth Davis
      The Check Up: Dr. Kenneth Davis of Mount Sinai Health System
      The Check Up: Dr. Thomas McGinn
      The Check Up: Dr. Thomas McGinn of CommonSpirit Health
      The Check Up: Mark Ganz
      The Check Up: Mark Ganz of Cambia Health Solutions
    • Video: Ivana Naeymi Rad of Intelligent Medical Objects
  • MORE +
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Providers
October 21, 2017 01:00 AM

Concierge care taking hold at some large, urban hospitals

Shelby Livingston
  • Tweet
  • Share
  • Share
  • Email
  • More
    Print

    The words "concierge medicine" can easily conjure an image of a private practice doctor in a swanky downtown office, providing care to only the most well-heeled patients able to afford an annual co-pay of tens of thousands of dollars. Perhaps a limousine picks the patient up for the appointment. Maybe the doctor's office comes equipped with a juice bar and world-class gym.

    Less frequently is concierge medicine associated with the nation's hospitals, which are more known for their care for the poor and uninsured. But major not-for-profit health systems are opening primary-care practices to cater to wealthy patients. Acclaimed systems such as the Mayo Clinic, Rochester, Minn.; Stanford Health Care, Palo Alto, Calif.; Duke Health, Durham, N.C.; and Boston's Massachusetts General Hospital, part of Partners HealthCare, are a few examples of the small but growing number of hospitals with concierge practices.

    THE TAKEAWAY

    A growing number of hospitals are offering concierge primary care to patients who can afford the services.

    While hospital-owned concierge practices don't necessarily offer the sort of luxury experience that may come with a high-end independent concierge practice, they do offer patients who can afford greater access to care—a commodity that is growing harder to come by as the primary-care physician shortage worsens and insurance deductibles rise.

    For patients with busy schedules or chronic conditions , an annual retainer ranging from $2,500 to $6,000 at hospital-owned practices may offer the ability to schedule a same-day appointment, or text a doctor day or night if a health issue arises. The annual fee typically is charged on top of any office appointments, which are billed to the patient's insurance company.

    For hospitals, offering concierge medical services is a way to attract and keep patients who would otherwise seek those services from the many independent concierge practices popping up across the nation. It also helps bring in extra revenue that the hospital can use to support services that benefit patients with lower incomes, some hospitals with concierge practices say.

    "We are not doing this just to make more money—we are doing this to make money to put back into the mission of the hospital and to support programs that otherwise would be difficult to support," said Dr. Paul Huang, a concierge doctor at Massachusetts General Hospital, which launched its two-doctor concierge practice in August 2016 and now serves 200 patients. The practice has plans to grow to at least six doctors in the next couple of years.

    The concierge medicine model surfaced in the mid-1990s, when some doctors, fed up with the pressure to see dozens of patients daily, charged high retainers to rich patients who wanted highly personalized care. Today, though, concierge medicine has spread to the middle-class for a much lower cost.

    Patients pay an annual fee for nearly unlimited access to their physician as well as care coordination with specialists. Health insurers do not cover that fee. Concierge physicians are able to provide heightened access by limiting the number of patients they see to a few hundred. Traditional primary-care doctors typically see 2,500 patients annually. Oftentimes, an independent concierge doctor can make as much or more in income as a traditional doctor even while seeing fewer patients, experts say.

    Physicians like the pace

    Doctors who have switched to concierge-style medicine sing its praises, claiming the smaller patient panel allows the doctor to build relationships with patients and spend more time on preventive medicine. Boca Raton, Fla.-based MDVIP, a concierge medicine network of 950 concierge docs in 44 states, claims its patients have better health outcomes and fewer hospitalizations. The group's doctors serve about 240,000 patients.

    The revenue from the program at Virginia Mason Health System in Seattle boosts the hospital's bottom line and "helps the hospital take care of those who are potentially less able to afford healthcare."

    Dr Leland Teng

    Virginia Mason's medical director for concierge medicine.

    Still, the number of practicing concierge physicians is small. About 7% of physicians practice some form of concierge medicine, and nearly 9% said they plan to switch to a concierge practice in the next couple of years, according to the physician staffing firm Merritt Hawkins' 2016 survey of 17,000 doctors.

    There is no data on how many hospitals own concierge medicine practices, though it is limited to well-known systems in urban markets with enough extra space and affluent patients to support the model. Healthcare industry experts have reason to believe the number will grow as patients, burdened by higher insurance deductibles, demand greater access to care, and doctors, bogged down by reporting requirements and administrative tasks, look for a way out.

    "It's not a bad strategy at all," said Paul Keckley, a healthcare industry consultant. "It allows (hospitals) to offset some of the costs in primary care that they're experiencing. Primary care is the least profitable in terms of higher operating costs."

    Not-for-profit hospitals' revenue grew by 6% in 2016, according to ratings agency Moody's Investors Service, but expenses widely outpaced revenue growth at 7.2%.

    "There are some people who can and will pay more, and organizations that are in the revenue struggle will do what they can to try to identify them," said Rulon Stacey, managing director of Navigant.

    Supports other services

    The prospect of a new, steady stream of revenue was Mass General's motivation for launching its concierge practice. That, and the fact that there was a high demand for primary-care services at the hospital and interest in concierge medicine, said Misty Hathaway, senior director of the Center for Specialized Services at Mass General. Patients pay an annual fee of $6,000 for the program.

    Because the Mass General physicians are salaried, unlike in private concierge practices, the margin from the practice goes to "support our core mission, so things like our substance abuse program, or other parts of primary care where the margin is a little bit harder to achieve," Hathaway said.

    There's a similar setup at Virginia Mason Health System in Seattle—believed to be the first health system in the nation to open a concierge practice, in 2000. The revenue from the program boosts the hospital's bottom line and "helps the hospital take care of those who are potentially less able to afford healthcare," said Dr. Leland Teng, Virginia Mason's medical director for concierge medicine.

    The concierge practice at Virginia Mason limits its five doctors to 300 patients each. Patients pay an annual fee of $3,300, or $5,500 for a couple. Neither Mass General nor Virginia Mason would say how much revenue their concierge practices bring in.

    Teng said Virginia Mason views its concierge program as a "test lab" for healthcare innovation, spinning off successful ideas to the broader system. With fewer patients, the doctors in the practice have more time to innovate. For example, to try to reduce hospital readmissions, the concierge team began calling each of its patient within three days of discharge. Over several months, the team developed a protocol and series of questions to ask each patient, and then helped roll it out to the rest of the hospital system, Teng said.

    Not all hospitals start concierge practices to raise extra money. Some experts say the small size and relatively low fees of a hospital-owned concierge practice mean any extra revenue would be minimal. Instead, "the primary driver is simply connecting more directly with these patients and becoming more relevant in their day to day life," said Tom Cassels, a consulting partner with the Advisory Board Co.

    The Mayo Clinic, for instance, says it launched its concierge practices in Arizona and Florida to fit the lifestyles of busy patients. "We don't serve all patients the same way because they don't have all the same needs," said Dr. Stephanie Hines, the physician leader in the health system's executive health division. "No two patients come to us that are alike, so we are trying to be flexible."

    There's a reason that few hospitals have launched concierge practices. For one, offering different levels of care to different patients in not in most hospitals' DNA. "It's a cultural learning curve, because most not-for-profit health systems are geared toward providing the same level of service to everyone in their community," Cassels said. "The fundamental model of concierge medicine is to price-discriminate."

    It's also a practical matter. Few physicians have the number of affluent patients necessary to support a concierge practice, said Will Waring, a partner at law firm Jones Walker, who has helped hospitals move into concierge medicine. Moreover, when a physician converts to a concierge model, patients unwilling to pay the retainer fee will spill over to other traditional doctors who are already overworked, he said.

    Controversy has followed concierge medicine since its inception. Observers question if it's ethical to provide what's arguably better care to only those who can pay for it out of pocket. Though, Mass General's Huang said that enrolling in concierge medicine doesn't allow a patient to "jump the line" in terms of how quickly a patient can see a specialist or be admitted to the hospital.

    "Should we allow people with money to buy a different level of care if they can afford that?" asked Navigant's Stacey. "Whether or not we should have that debate is irrelevant. We will have that debate."

    The American Academy of Family Physicians does not support concierge medicine, saying it could reduce the number of patients with access to primary care, but does support its close cousin direct primary care. Direct primary-care models place most of their emphasis on access and not so much on amenities, as concierge care offerings do. The AAFP also drew a distinction between the models in a news release, highlighting a comparative study that noted direct primary-care providers generally do not bill insurers for fee-for-service care and charge less than half per month on average than concierge care models.

    The American Hospital Association declined to comment.

    Because concierge doctors limit the number of patients they see, it could be argued that they are contributing to the primary-care physician shortage. Some experts dispute that theory, however, saying there are bigger contributors to the worsening shortage.

    Virginia Mason's Teng initially resisted the prospect of practicing concierge medicine, seeing it as something that "takes care of the spoiled wealthy." But he came around to the idea because Virginia Mason's program benefits patients who need it, he said.

    "It's not that high of a price," he said. "If we can help keep people out of the emergency room, if we keep them out of the hospital, if we keep them out of the nursing home, we more than pay for ourselves in terms of improved outcomes for the patient. . . . Honestly we think we're part of the answer to the healthcare issues in the world."

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Q&A: Arkansas nursing leader looking for creative staffing solutions as COVID cases surge
    Q&A: Arkansas nursing leader looking for creative staffing solutions as COVID cases surge
    The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
    The Check Up: Trenda Ray of the University of Arkansas for Medical Sciences
    Sponsored Content
    Get Free Newsletters

    Sign up for free enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today

    The weekly magazine, websites, research and databases provide a powerful and all-encompassing industry presence. We help you make informed business decisions and lead your organizations to success.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS
    • Instagram

    Stay Connected

    Join the conversation with Modern Healthcare through our social media pages

    MDHC_Logotype_white
    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2021. Crain Communications, Inc. All Rights Reserved.
    • News
      • This Week's News
      • COVID-19
      • Providers
      • Insurance
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition
    • Insights
      • ACA 10 Years After
      • Best Practices
      • InDepth Special Reports
      • Innovations
    • Transformation
      • Patients
      • Operations
      • Care Delivery
      • Payment
    • Data/Lists
      • Rankings/Lists
      • Interactive Databases
      • Data Points
    • Op-Ed
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Awards
      • Award Programs
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Top 25 Minority Leaders
        • Top 25 Women Leaders
      • Nominate
      • Previous Award Programs
        • Excellence in Nursing Awards
        • Design Awards
        • Top 25 COOs in Healthcare
      • Other Award Programs
        • 100 Top Hospitals
        • ACHE Awards
    • Events
      • Conferences
        • Leadership Symposium
        • Healthcare Transformation Summit
        • Women Leaders in Healthcare Conference
        • Workplace of the Future Conference
        • Strategic Marketing Conference
        • Social Determinants of Health Symposium
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Minority Leaders Gala (2022)
        • Top 25 Women Leaders Gala
      • Webinars
      • COVID-19 Event Tracker
    • Listen
      • Podcast - Next Up
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • MORE +
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing