Thinking about starting a concierge practice?

Alternative models of healthcare delivery, including direct primary care (DPC) and concierge practices, are becoming more popular with independent physicians and their patients. The ability to provide personalized care and caring for a smaller patient panel are two of the benefits for healthcare teams who want a reduced administrative burden and improved relationships with their patients. If you’re thinking about starting a concierge practice, you’ll need to plan appropriately and keep some considerations in mind.

Many people confuse the DPC model with the concierge model and even use the terms interchangeably. Dr. Rob Lamberts, an Elation physician, explains the differences:

DPC providers:

  • Rely on a monthly fee of around $100 a month or less per patient
  • Do not accept insurance reimbursements
  • Have larger patient panels than a concierge practice
  • Tend to focus on saving money rather than offering premium services.

Concierge providers:

  • Charge patients a higher monthly fee
  • Often accept insurance
  • Have smaller patient panels, typically between 200 and 300 patients
  • Tend to focus on premium services, including extended office visits and executive lab panels.

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If you are thinking about starting a concierge practice, there are some legal and practical considerations to keep in mind.

In a concierge practice, you will need a patient agreement. Consulting an attorney when developing this agreement is important, particularly to ensure it does not violate any state laws. You do not want your patient agreement to seem like an insurance agreement. There are specific laws in most states that list requirements and prohibitions. Have your attorney review your state’s insurance licensure laws so that you both understand how the verbiage in your patient agreement needs to read to be compliant.

Other considerations for your patient agreement include detailing the amount the patient agrees to pay and the schedule of any additional fees that may be required for services not included in the monthly or yearly fee. Be prepared for any challenges your patients may face as they:

  • May not be able to afford the services under the patient agreement
  • May still try to pay with insurance rather than adhering to the patient agreement
  • Need to thoroughly review and understand the agreement to avoid breaching their contract.

If you are starting a concierge practice by transitioning current patients from a traditional model practice, you will also need to consider how and when those patients may follow you to the new concierge model. Understand that some patients may choose not to follow you but will decide to select another traditional practice for their healthcare needs.

You will need to provide adequate notice to your current patients regarding your plans to transition to a concierge practice. The patients who choose not to opt into the concierge model will also need adequate time to find and secure a new provider. Legally, you should review your state’s patient abandonment laws to make sure you remain compliant when transitioning to the new model of care.

Concierge medicine became increasingly popular during the COVID-19 pandemic and will continue to be a major factor in healthcare delivery in the post-COVID world. When you are thinking about starting a concierge practice, take the time to plan appropriately and prepare your patients for your new healthcare delivery model to help ensure your success.