Concierge, Direct Pay, or Hybrid: Is One Right for You?

Leigh Page

Disclosures

April 06, 2016

In This Article

Converting to Concierge

Concierge is the most predominant kind of membership model, with an estimated 4000 physicians.[1] In return for a fee, ranging from $1200 to $3000 a year, concierge physicians typically provide same-day appointments, 24/7 access by phone or email, longer appointments, an annual physical, and help with prescriptions, referrals, and insurance claims. The typical panel is about 600 patients.

Concierge practices are usually converted from traditional practices, according to Roberta Greenspan, founder of Specialdocs Consultants, a company in Highland Park, Illinois, that assists with concierge conversions across the country. In these conversions, physicians ask their existing patients to join the new practice, and most of those who don't want to will have to find a new doctor.

Doctors can start concierge practices right out of training, but if you don't have existing patients, it can be a struggle, Greenspan says. The ideal candidate for a conversion, she says, is a physician who's been in the same place for at least 8 years. These physicians have strong personal connections with patients, which are key to persuading them to join the new practice, she says.

Recruiting patients, Greenspan says, is the most crucial step in starting a concierge practice. Specialdocs has created a detailed process to prepare patients. "You don't just send a letter to the patient," says Robert Lewis, executive vice president of the company. "You have to start introducing your patients to your plans 4 to 6 months ahead of time."

When presenting their case to patients for concierge, he says, doctors need to speak directly to each one of them. "They have to be comfortable looking the patients in the eye," Lewis says.

From the patient's point of view, he says, doctors who won't spend time explaining the new model to them will probably also ignore them in a concierge practice. "If you don't have the time to explain what you'll be doing, you're sending them the message that you'll never have much time for them."

Greenspan says that all of her clients bill Medicare, and most of them also bill commercial insurers. But with just 600 patients or so for each doctor, the billing function is much smaller than in a regular practice. She says that most solo concierge practices don't need a full-time billing person and often hand the work over to a billing company.

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