Despite Affordable Care Act Individual Mandate, Concierge Medicine on the Rise

Thursday, November 21, 2013
By Lance O. Leider, J.D., The Health Law Firm

Despite the Affordable Care Act's (ACA) mandate that individuals acquire healthcare coverage, concierge medicine is on the rise in recent years.  Concierge medicine is a type of medicine where patients pay a physician practice a retainer or membership fee and then pay a la carte for discounted services offered by the physicians.

In times past, concierge medicine was primarily for the wealthy with patients paying thousands of dollars a month for the "royal treatment" when they went to the doctor.  However, recent developments in the insurance and healthcare industry have led to new reduced cost business practices.


Concierge Medicine Can Mean Big Savings for Physicians.

These cost reductions have permitted concierge practices to offer services at substantially lower costs than traditional practices that bill insurance companies and the government.  Some physicians report that avoiding insurance billing allows them to reduce overhead by nearly forty percent (40%).  Offering lower cost alternatives to the traditional premium/deductible/copay model has allowed concierge practices to grow at nearly twenty-five percent (25%) annually, according to the American Academy of Private Physicians (AAPP).


ACA Permits Concierge Practice Membership.

The new face of concierge medicine is a low fee, low-cost treatment options with no insurance billing whatsoever.  On the cusp of the ACA mandating most Americans to have health insurance, a rise in doctors who don’t take insurance might seem ironic.  However, there is a little-known provision in the ACA that permits a concierge practice membership to count as ACA-compliant insurance, as long as it is paired with a catastrophic medical policy to cover emergencies, according to an article in the Wall Street Journal. To read the entire Wall Street Journal article, click here.

Concierge medicine is also being pursued by large companies like Expedia to establish clinics at their headquarters as a means of reducing overall healthcare costs.


Getting Involved in Concierge Medicine.


Setting up a concierge practice is not as easy as hanging a sign on the door.  Concierge practices must be compliant with all state and federal insurance regulations.  Additionally, concierge practices need to be aware of the services that they provide so as to avoid running afoul of state patient brokering and anti-kickback laws.

If you are looking to set up a concierge practice, make sure you consult with an experienced healthcare attorney to ensure your business model is compliant with all applicable laws and regulations.


Contact a Health Care Attorney Experienced in Setting Up Corporations, Limited Liability Companies (LLCs) and Concierge Practices.

At the Health Law Firm we provide legal services for all healthcare providers and professionals. This includes physicians, nurses, dentists, psychologists, psychiatrists, mental health counselors, durable medical equipment suppliers (DME), medical students and interns, hospitals, ambulatory surgical centers, pain management clinics, nursing homes, and any other health care provider.

The services we provide include reviewing and negotiating contracts, preparing contracts, helping employers and employees enforce contracts, advice on voiding contracts, litigation of contracts (in start or federal court), business transactions, and setting up corporations, LLCs, partnerships, new practices, concierge practices and other business entities.
 
To contact The Health Law Firm, please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.


Comments?

Have you noticed an increase in the demand for concierge medicine? Does your practice offer it? Please leave any thoughtful comments below.


Source:

Wieczner, Jen. “Pros and Cons of Concierge Medicine.” Wall Street Journal. (November 10, 2013). From: http://online.wsj.com/news/articles/SB10001424052702303471004579165470633112630


About the Author: Lance O. Leider is an attorney with The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com  The Health Law Firm, 1101 Douglas Avenue, Altamonte Springs, Florida 32714, Phone:  (407) 331-6620.


Tag Words: Affordable Care Act, ACA, concierge medicine, physician, doctor, concierge doctor, concierge physician, converting to concierge medicine, physician retainer, physician membership fee, discounted healthcare, concierge practice, boutique medicine, retainer-based medicine, direct fee-for-services practice, American Academy of Private Physicians, AAPP, no insurance, ACA compliant insurance, reducing healthcare costs, how to set up a concierge practice, insurance regulations, anti-kickback laws, concierge practice business models, insurance payers, insurance issues, prior authorization, rejected insurance claims, health law attorney, health lawyer, health law firm, The Health Law Firm



"The Health Law Firm" is a registered fictitious business name of George F. Indest III, P.A. - The Health Law Firm, a Florida professional service corporation, since 1999.
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11/21/2013

Comments:

Response to: Despite Affordable Care Act Individual Mandate, Concierge Medicine on the Rise
Monday, December 9, 2013
Raymond McNealy says:

I'm a 4-year full time resident of Ocala, Florida originally from the Bethesda, Maryland area. With all this new healthcare law debacle and unsure of my current physicians plan on the future, I've always been on the lookout for a Boutique Physician in the Ocala area. If you have any suggestions, I'd be most happy. Happy Holidays ..

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