Membership Practices, Concierge Practices, and Direct Primary Care: Similarities and Differences

The terms “membership practice”,”concierge medicine,” and “direct primary care” are sometimes used interchangeably. While they have similarities, they have distinct differences too. It’s important to be familiar with the differences so you can help your patients understand them and be more comfortable with your new practice model.

If you’re among the many doctors seeking a better way to serve your patients, you may be considering a membership, concierge, or direct primary care practice model. To help you make the best decision for you and your patients, this post will outline what these practice models have in common and how they differ.

Membership Practice Model

A “membership practice” refers to any practice model that charges an annual or monthly fee or retainer to its’ patients. This umbrella term can be used to refer to several different practice models, including direct primary care, concierge, or boutique practices. The membership fee frequently covers a variety of services, procedures, or treatments, delineated by each office. Thus, a membership model is highly flexible and can be structured to suit the needs of the doctor, patients, and community.

 

Concierge Care Model

The mid-1990’s saw a rise of wealthy patients who wanted VIP care without the interference of insurance companies, and “Concierge Medicine” was born. The defining feature of concierge medicine is that it gives the patient nearly limitless access to the doctor, often including same day appointments, round the clock telephone access, and even house calls in some practices. While many concierge practices do accept insurance to pay for services or procedures not covered by the retainer fee, they’ve often negotiated better pricing, further reducing patient expense.

Direct Primary Care Model

In the mid-2000’s, the frustrations of patients and providers converged to create a “new” model of practice. Direct Primary Care, or DPC, seems to be a throwback to the bygone era of small town doctors who developed direct relationships with their patients without the involvement of a third party. DPC practices offer primary, preventative, urgent, and wellness care in addition to disease management. The defining feature of the DPC model is that the provider does not accept nor bill insurance. Payment is arranged solely between the doctor and his or her patient. Eliminating insurance allows doctors to spend more time caring for patients, and less time dealing with the hassles of insurance.

  The Similarities

• Both concierge and direct primary care practices charge a membership or retainer fee.

• Each practice model has much smaller patient loads than a traditional practice, thus allowing for longer patient visits and a higher level of care. These types of practices typically limit their patient panel to several hundred while a traditional practice can have as many as 2,500 patients.

• Both models provide greater access to doctors, including telephone and e-mail consultations.

• Concierge and DPC practices provide much faster access to the doctor including same or next day appointments, and little to no wait time upon arriving for an appointment.

• In a traditional model, doctors are only paid for office visits. Because membership practices don’t rely entirely (or at all) on insurance payments, follow up care can often be handled via telephone or e-mail. (How convenient is that?)

Another thing both models have in common is how little they are understood by patients. That’s why patient education is so vital to making either model a success.

The Differences

• The major difference is that while direct primary care practices don’t bill insurance at all, many concierge practices do.

• Direct primary care practices tend to attract younger patients, those in their 20’s-40’s who are middle class. Concierge practices attract an older and wealthier clientele, those in their 50’s-80’s who are considered upper middle class.

• Overhead between the two models is another key difference. Because DPC cuts out insurance companies, there’s less need for billing staff, software, EMR, and the other expenses typically incurred when a practice accepts insurance. Concierge practices often have higher overhead because they still bill insurance and because the patients may expect fancy extras for their annual fee like plush offices and private waiting rooms.

• DPC’s charge a lower fee, on average, $50-150 per month. While the average concierge practice’s monthly fee is higher, it’s surprisingly not that much higher, at $200 per month.

• While DPC offers faster access to doctors than traditional practices, many concierge practices offer 24/7 access every day of the year via the doctor’s personal cell phone number.

Which Model Is Best?

The answer will heavily rely on your patient demographic. Younger, middle-class, Gen X and millennials will favor the DPC model. Even with the advent of the Affordable Care Act, many people’s medical coverage is still tied to their employer, and it’s comforting for patients to know they can remain under your care with or without insurance.

If your patients are older and more affluent, they may be willing and able to pay for concierge medicine. For those in this demographic, health has become a matter of prime importance and they want to build a close relationship with a doctor they can trust.

Whichever model you choose, you can look forward to better serving your patients, improving their quality of life and your own, while reducing your own insurance-related frustrations.

For more information on building community connections, I encourage you to read my new book Community Connections! Relationship Marketing for Healthcare Professionals. If you want more valuable information about how to Connect with YOUR Community, you can find FREE healthcare practice marketing content, PowerPoint Presentation Jumpstart Kits, workbooks, blog articles, and my FREE “Practice Marketing Planner” Now!