This emerging market is an alternative to traditional healthcare. With this type of arrangement, the patient retains the doctor with a fee and then they use major medical insurance for bigger health issues. The Affordable Care Act itself allows this type of practice to participate if it is paired with a wraparound insurance policy. The number of retainer medicine practices are increasing regularly since 2010.
Retainer-based care, also known as concierge medicine, boutique medicine and direct primary care, uses two retainer-based payment models. Some physicians choose to charge a retainer fee for services that are not covered by their insurance plan while continues to bill the insurer for covered services. While others charge a retainer fee for all services provides while eliminating insurance billing altogether (and lowering their overhead costs as a physician).
There are many common myths associated with retainer-based medical care, let’s debunk all of them here.
- Retainer-based models are for upper class patients only. Not true, this retainer-based practice offers affordable payment options, which attracts all type of patients, despite their economic status. Plans can fit in a variety of budgets.
- Retainer medicine is only for primary care physicians. Not true, many specialists have seen the benefits in this care and now offer similar models for their repeat chronic care patients such as endocrinologists and their diabetes patients.
- The opportunity to tap into a new market
This offers on-demand care access and transparent pricing, something that hasn’t happened in excess before. This retainer-based model caters to those looking for same or next day appointments, longer time with their physician and consistent rates.
- Reduction of Overhead Costs
This allows physicians to replace insurance billing costs with retainer fees which significantly lowers overhead costs and the number of patients needed to hit the bottom line.
- A More Clean-Cut Work Schedule
This business model allows physicians to focus on a set number of patients who pay for their 24/7 access. By limiting the number of patients in their practice, they can devote the time needed to provide personalized and preventative care to all patients without rushing.
Ultimately the model is simple, doctors charge patients a fee (monthly, quarterly or annual) to give them more time and attention. The idea started in the 1990s and has steadily grown in popularity since. Individuals who choose this type of medical care don’t want a production line experience with five minutes with their doctor and a rushed atmosphere. They pay a fee for round-the-clock access and on-time appointments. The fee will depend on the specialty, the number of people using the service and the practice itself.
These doctors can offer comprehensive annuals and physical exams as well as coordinate appointments with specialists related to each patient’s health. The concept is that everyone deserves to be healthy, but more personalized, direct care comes with a price. For those that seek the continuous contact with their medical professional, this fee is peace of mind.
Retainer medical fees cover:
- 24/7 access to one’s physician
- Comprehensive exams and time discussing results
- Personalized, preventative care
- Same or next day appointments
- House calls, when needed (depends on practice)
- Travel medical planning
Service: The hallmark of this model is the time spent between the patient and the physicians. This creates a trusting professional relationship. The patient has unfettered access to care and this prevents unhurried interactions. Decisions are made together on their long-term health and wellbeing. This practice also has extended hours and ready access for urgent care, offering convenient medical care to patients who pay this retainer fee.
Patient Choice: Patients can choose their physician. This helps them to feel that they can trust who is working with them on their health. They also are empowered by information from this point of care and involved in making their own medical choices. They have the right to access, transparent pricing and services provided at all times.
Eliminating the Need for Fee for Services Rendered: This type of arrangement eliminates this. This diminishes the need for volume over value for physicians to make money, which undermines the trust between the patient and physicians. By paying a fee, the physicians are pre-paid for their expertise and doesn’t feel the need to rush a patient in and out to make money. This simple, flat monthly, quarterly or annual fee covers all comprehensive primary care services.
Advocacy: The physician that one chooses and pays is their committed advocate. They have time to make informed referrals and support their patient’s needs at all times. This type of provider believes that healthcare must provide value to the patient.
With retainer medicine, the goal is health and well-being, not just treating disease. This type of medicine plan is changing the face of healthcare.
It’s important to understand that retainer medicine is not insurance, but a way for patients to get great primary care at an affordable rate. Patients will still need health insurance in order to cover the expenses of health care services not provided by their retainer medicine practice such as emergency room visits, surgery or hospitalizations.
With retainer medicine, you can still have whatever insurance you want; however, it cannot be used to pay for services from the concierge medicine practice you opted in. Individuals with Medicare can use this model too, just can’t use Medicare to pay for the services provided. Generally, medications such as narcotics are not a part of this type of care. A pain specialist can be used (referred by the patient’s chosen physician) for this type of care.
Ultimately, retainer medicine offers a personalized and preventative approach to one’s medical care. With the help of 24/7 access to one’s chosen physician, a patient can play a significant role in their health and the decisions associated with it.