Healthcare delivery evolves with technology, demand, reimbursement plan structures, and many other factors. However, sometimes independent physicians have a desire to return to the days of a simple delivery structure with no insurance involved and with more time to spend with fewer patients. Those physicians often start or convert existing practices into either a direct primary care (DPC) or concierge care practice.
The premise of both models is essentially the same, that is a return to the days of the family physician who has time to spend with each patient in the office and before and after visits. Each model offers the independent physician the opportunity to focus on the patient’s specific healthcare needs, without worrying about insurance reimbursement or meeting tight daily appointment schedules. The DPC and concierge care models both run on patient membership fees that cover a range of basic services.
What are the differences between a DPC and a concierge care practice?
- Monthly fees are typically less for a DPC. Patients pay between $50 and $100 a month, depending on the DPC practice’s membership fee scale. Many practices offer special rates for children or seniors. Concierge care patients typically pay between $100 and $200 month for their membership fees.
- DPCs offer basic primary care services, although membership fees may also cover x-rays or labs. Concierge care encompasses a much broader range of services.
- All of a DPC’s services are covered by the patient membership fees. Independent physicians in DPC practices may encourage patients to carry catastrophic insurance but do not accept insurance payments for their basic services. Concierge care physicians will generally accept insurance or Medicare.
- Patient panel sizes differ somewhat. In a recent survey of 5,000 physicians in DPC and concierge practices, 69% of the DPC physicians indicated their patient panel was between 50 and 550. In that same survey, 76% of the concierge care physicians stated that their patient panel was between 250 and 550.
- Although DPC physicians make themselves available for communication with patients before and after the visit, concierge care physicians are typically available to treat patients before and after office hours.
- Since DPCs do not accept Medicare or any other type of insurance, they are not subject to the Medicare regulations to which concierge care practices must adhere.
- DPC is indicated in the Affordable Care Act (ACA) as an acceptable form of healthcare coverage, while concierge care is not.
- DPC practices are more attractive to younger patients while the majority of the concierge patients are over the age of 50.
- Concierge care may be more attractive for patients with chronic or complex conditions, as they receive personalized attention, to the point of their primary care physician accompanying them to specialty provider visits or attending to them while they are traveling or on vacation.
- DPCs have less overhead, as they operate solely on patient membership fees and have the administrative burden of billing insurance companies for reimbursement.