Another way for medical care to become more expensive

KFF Health News published an article about some providers turning to a concierge medicine model, where patients pay a monthly or annual access fee; in exchange, providers limit their panel size (the number of patients that they see) so that their patients receive better service. The access fees "range from $1,000 to as high as $50,000 a year." One provider mentioned in the article charges patients at least $1,000 per year, and with the 800 patients that signed up, the extra $800,000 in revenue should go a long way towards alleviating the smaller patient base, perhaps even exceeding the loss of revenue from the other patients. The article also discussed the direct primary care model, which is similar to concierge medicine, but the providers do not accept insurance. One note is that by not dealing with insurance, the provider can avoid having to devote staff time to process insurance claims. Nevertheless, it is unclear whether such savings for the providers translate into savings for the patients.

In either of these models, the physician has less work and patients who can afford the access fee can enjoy a higher level of service. However, this model accentuates the shortage of primary care providers. Perhaps the emergence of this trend is not surprising given that newly trained doctors tend to gravitate towards more lucrative specialties, and that insurance companies have been using their leverage to squeeze out lower prices from providers, who in turn have been looking to higher volumes (shorter visits) to compensate.