THURSDAY, MAY 22, 2014
In todays healthcare environment, the rise of concierge form of medicine has become an exploding trend. With the cuts of what insurance is allowed to pay for family doctors, and the tightening of networks, many family care type doctors are having to make the difficult decision if they are to keep their practice or leave their careers. With an insurance accepting doctor, then need to have more patients becomes more of a necessity. Their overhead is already high. They need to hire a large staff just to deal with the billing and coding of insurance claims. For a doctor to make any type of decent income, they almost have to see someone every 5 minutes. They basically need 2500 to 5000 or more patients to take care of. This takes away their real desire, which is to really know and focus on the patient. It also makes it where the doctor benefits more from all the procedures of the client, and not their well being.
This has opened up a perfect window for concierge medicine. Now, I must admit, it would have better if this was developed years ago. We could have saved millions of dollars in healthcare costs, and probably lower insurance premiums. Here's why. Insurance is basically derived in 3 parts.
1) Claims pool. The amount they are figuring that needs to be paid in the year.
2) Administration. The costs of administrating the claims and billing.
3) Reinsurance. This is the insurance coverage just in case they had claims larger than the claims pool.
The first 2 are what are affected the most in any insurance plan. The more people claim on the insurance, the more it affects the claims pool and administration. What is interesting is that what affects these 2 categories the most is doctors visits and emergency room. You might not have a major claim in your group, but there is always numerous claims for the doctor and ER. This is what has had the largest effect on the rising cost of insurance premiums. It really is scary to think how much money could have been saved in the last 10 years if we would have had these services years ago. Regardless it is here now, and it can really help.
Concierge medicine is a non insurance accepting form of family practice. In other words, you either pay cash for your services (which are deeply discounted compared to insurance claims), or they provide services with a cost of just a membership fee. Here are some benefits of these type of services.
1) Better service. These doctors tend to have a fraction of the patients that an insurance doctor has. This means little or no waiting in a waiting room. Have more time with your doctor.
2) Have time with you doctor. Your doctor can actually take time to work with you on your health and well being. You are not rushed through. The doctor can get to know you.
3) Drop your insurance usage. If no one uses the plan for their doctors visits, then the claims pool is not used, and the administrating costs goes down. This has benefitted to cost decreases with several group health benefits.
4) Your health information is actually private. An insurance accepting doctor has to code everything they do if they want to get paid, which means everything they do is put on your MIB report. This can affect you if you were trying to gain other insurances. Since there are no claims with a concierge doctor, there is nothing reported on your MIB report.
5) More personal service. You may tend to have more contact with your doctor. Many of these doctors can assist you through the means of phone, Skype, email, twitter, and some even house calls, and after hour service.
6) Major discounts. With these services, you may find they provide major cost savings for things like MRI's, CT Scans, Labs, and prescriptions.
Now at this point you may be wondering 2 things. Is this too good to be true, and how does this benefit with my insurance. To the former question, well, all I can say is it works. I personally do not know any person that uses these services that has any desire to go back to an insurance accepting doctor. The services are to good. To the second question, that is where we step in. We can design your health insurance to complement these services. Typically, we are looking to lower your premium costs, while providing as good and better coverage then before. We have found that most of the time we can design a plan that incorporates everything together with a decrease in your costs. The great thing about this is there is no cost to you to find out.