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Explore This IssueSeptember 2014
Specialty care physicians have recently begun experiencing the same pressure on reimbursements that primary care physicians have been struggling with for years. Across the board, procedural and ancillary service revenues have been slashed or are at risk for reduction. Rheumatologists, in particular, are seeing overhead escalate and income stagnate, with a growing percentage earning less than in previous years.1
When faced with similar cuts to reimbursement and the overall challenges of a rapidly changing provider landscape, some primary care physicians turned to concierge medicine. Concierge medicine is a membership-based approach to patient care that directly funds physicians for additional time to perform non-covered or enhanced services.
Until recently, specialists, such as rheumatologists, didn’t see the need to explore alternative practice models. However, increasing demands and marketplace uncertainties, along with patient interest, are now leading a growing number to consider the potential of concierge medicine. But implementing such programs isn’t as simple as announcing a new program. Many specialists have found that with the need for continuing referrals, consultations and patients’ insurance needs, concierge practice often doesn’t provide the solution needed.
Over the past few years, some specialists have discovered that a hybrid model of concierge medicine gives them the opportunity to provide a stable source of revenue, while offering a practice option many patients today desire. In a hybrid program, physicians continue spending the majority of their time in a traditional relationship with their patients and a smaller portion of their time delivering the personalized services of concierge care.
Below are some questions and answers about how this new approach works for rheumatologists and other specialists, as well:
Q. What’s the difference between a full model & a hybrid model of concierge care?
A. In a full-model concierge care program, the entire patient panel pays a membership fee in order to see their physician. The patient panel size is kept small so the physician can offer extra time and personalized concierge services. Therefore, when a practice converts to a full concierge model, the physician must dismiss a large portion of their patients, including those on Medicare, who either can’t or don’t wish to pay the membership fee. This can prove ethically and personally challenging for specialists who would have to dismiss patients who in turn may find it difficult to find specialized care.
In a hybrid program, the physician offers an optional concierge care program for those patients who are seeking extra time, service and enhanced advocacy from their physician. Typically, only a small percentage of the practice joins the concierge program. The majority of the patients remain in the physician’s traditional practice. Physicians can maintain their full patient panel and don’t have to dismiss patients who cannot participate.
In a hybrid program, physicians continue spending the majority of their time in a traditional relationship with their patients & a smaller portion of their time delivering the
Q. Can a hybrid work for any specialist?