We all know how it works — for a number of reasons insurance companies make it difficult for physicians to make money. By nature of the volumes of insured parties, insurance companies can essentially force physicians to accept insurance contracts at rates that, alone, won’t even keep the doors open to a medical practice. It’s a tough business, but physicians and other healthcare providers have to abide in order to stay alive.
So, physicians in recent years have become creative and decided to go after the pocketbook of the patient and have justified this by improving the level of service and personalized attention provided. This model, while chastised by some, makes a lot of sense. Called “concierge medicine,” critics claim that the model discriminates against those that can’t pay, and doesn’t provide care where it’s needed; only where it’s paid for.
Whether or not one agrees with these arguments, the finger needs to ultimately point back at the insurance companies who have extracted a reasonable level of profitability from many physicians; so much so that physicians have gone out and adjusted the playing field through business model innovation with the creation of concierge medical care.
Well, insurance companies are striking back — at least they’re beginning to. Some insurance companies simply don’t like the thought of concierge medicine competing with them for the patient dollar and have used “contract violation” as the grounds for dropping physicians from their contract panels based on the concierge model.
This post from “Repairing the Healthcare System” provides insight into the issue, citing Cigna and United Healthcare as opponents of the practice of concierge medical care.
Recently Primary Care Internists have attempted to decrease their stress by limiting their practice. They are converting their medical practice to Concierge Care Medical Practices. MDVIP has created a national network of 210 physicians so far who practice concierge medicine.
Several models of concierge care decrease the need for a physician to have a large panel of patients, decrease stress and paperwork while creating the ability for physicians to enjoy their medical practice once again.
Healthcare insurance companies are unhappy and are starting to become punitive to patients and physicians who use this innovative approach to medical practice.
“Doctors who charge an annual fee to patients in exchange for customized care including house calls are drawing the ire of some health insurance companies.”
“United Healthcare confirmed it is dropping four local doctors from its network in April because the company disapproves of their so-called “concierge medicine” model.”
“Cigna is also condemning the practice, in which physicians charge an annual retainer of $1,500 to $1,800 for patients who then receive more personal care. The claim is it is in violation of the physician’s contract with the insurer.”