Will a Hybrid Concierge Medicine Model Work for Rheumatologists?

A. We’ve found the concierge model doesn’t work well for specialists providing predominantly episodic care. It does work well for rheumatologists whose patients see them on an ongoing, recurring basis and whose medical needs strongly relate to their rheumatologic health needs. Many of these patients typically consider their rheumatologist their go-to doctor, sometimes spending more time with their specialist than their primary care physician. Note: This is not about transforming a specialist into a primary care physician. It is about providing a greater consultative and advocacy role for specialists who seek this opportunity.

Q. What do patients receive for their membership fee?

A. The membership fee typically covers services that are not covered by insurance, such as an annual comprehensive screening exam. For rheumatologists, this means a 60- to 90-minute exam that includes a comprehensive patient and family history, and a collection of screenings customized to each particular patient. It often includes a discussion about nutrition, exercise and mobility planning, as well as lifestyle issues. The actual elements are tailored to the practice and the patients. The fee also includes enhanced services not available in the traditional practice. These may include off-hour emergency access via cell phone, dedicated office staff and phone numbers, relaxed office visits, advocacy and coordination with other healthcare professionals and transferable electronic medical records.

Q. Will my concierge patients be overly demanding?

A. Hybrid programs tend to be limited in nature, with most practices consisting of 25–100 members. This represents a small percentage of time each day dedicated to the concierge program. Physicians have reported that because patients know they can reach their physician whenever needed, they are much less likely to be overly demanding or make unnecessary calls or request after-hours visits.

Q. What does a program like this cost for the patient?

A. The annual fee to join a concierge program varies, but generally the range is between $1,600 and $3,000 per year.

The physician offers an optional concierge care program in a hybrid model.

Q. Does the hybrid concierge model work in group practices?

A. Hybrid concierge programs work well in group practices in which some or all of the physicians can choose to offer the program. The practice’s traditional program remains intact and continues to accept insurance plans as before, allowing for flexibility among the participating physicians.

Q. How does this affect my relationship with payers?

A. The concierge membership fee is only for non-covered services. Insurance plans continue to pay for procedures and covered services as before.