Cost

How does it save money? An example of cost over a year:

Service

12 months at $69/month
Physical exam
Lipid panel
Basic metabolic panel
Prostate specific antigen test
One low complexity visit
Rapid strep test
Strep culture
One moderately complex visit
One low complexity visit
Four simple sutures
Total spent for the year

Direct care

$828
free
free
free
free
$10
free
free
$10
$10
free
$858

Traditional insurance

N/A
free
$110
$80
$140
$143
$25
$10
$206
$140
$400
$1254
The savings are even more dramatic for someone with diabetes who should be seen for four (usually moderately complex) visits a year for diabetic monitoring ($824). They would also typically have four hemoglobin A1c tests ($320), a CMP ($110), a urine micro albumin ($80), and a lipid panel ($110). This adds up to $1444 in annual costs assuming no unexpected sick visits or problems versus $868 for the concierge plan.

How does concierge care work with healthcare reform?

  • Direct concierge care plans such as this can be bundled with a high-deductible insurance plan and meet the requirement for insurance.
  • Legislation introduced last year will allow Medicare payments to these programs, meaning they will cover the entire cost of the program without extra charges to the patient. This legislation has not passed yet and this type of care is not reimbursed by Medicare at this time.
  • Concierge care solves problems with access to care that will likely be brought on by reform.
  • Unlike anything proposed by the current presidential candidates, concierge care bends the cost trajectory of healthcare instead of just shifting expenses.
  • This model epitomizes the idea of paying for the totality of care and for quality rather than fee-for-service.

Predictable expenses with no financial disincentives to seeking care

Medical care is notoriously hard to budget for as one could have a year with few health expenses and then get hit by a few large expenses in one year. There is a tendency to view ones health savings account as just another savings account that won’t have to be used. This can lead to delaying care until it may develop into a more serious and expensive problem. Primary care costs, however, can be budgeted for using direct care.Direct care simplifies your life.

  • The monthly charge is similar to what one might pay for cellphone service.
  • There are no surprise expenses.
  • Scheduled debit arrangements are made reducing the hassle of paying.
  • Knowing the total cost of a sick visit is only $10, there is little reason not to see your doctor if you need to.
  • Even services that are not included in the monthly fee may be less expensive. For example if an MRI is needed you might be sent to Smart Choice MRI or Open MRI of Delafield where an MRI is $600 versus a hospital where an MRI may be $2400.
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