Hospitals cash in on a private equity-backed trend: Concierge physician care

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Nonprofit hospitals created mostly to service nan mediocre are adding concierge expert practices, charging patients yearly rank fees of $2,000 aliases much for easier entree to their doctors.

It's a inclination that began decades agone pinch expert practices. Thousands of doctors person shifted to nan concierge model, successful which they tin summation their income while decreasing their diligent load.

Northwestern Medicine successful Chicago, Penn Medicine successful Philadelphia, University Hospitals successful nan Cleveland area, and Baptist Health successful Miami are among nan ample infirmary systems offering concierge expert services. The fees, which tin transcend $4,000 a year, are successful summation to copayments, deductibles, and different charges not paid by patients' security plans.

Critics of concierge medicine opportunity nan believe exacerbates superior attraction shortages, ensuring entree only for nan affluent, while driving up wellness attraction costs. But for tax-exempt hospitals, nan financial benefits tin beryllium twofold. Concierge fees supply caller gross straight and service arsenic a instrumentality to thief enlistee and clasp physicians. Those doctors past supply lucrative referrals of their well-heeled patients to nan hospitals that employment them.

"Hospitals are attracted to physicians that connection concierge services because their patients do not travel pinch bad debts aliases a request for kindness care, and astir of them person backstage security which pays nan infirmary very well," said Gerard Anderson, a infirmary finance master astatine Johns Hopkins University.

"They are nan perfect patient, from nan hospitals' perspective."

Concierge physicians typically limit their practices to a fewer 100 patients, compared pinch a mates of 1000 for a accepted superior attraction doctor, truthful they tin committedness contiguous entree and longer visits.

"Every clip we spot these models expand, we are contracting nan readiness of superior attraction doctors for nan wide population," said Jewel Mullen, subordinate dean for wellness equity astatine nan University of Texas-Austin's Dell Medical School. The erstwhile Connecticut wellness commissioner said concierge doctors subordinate ample infirmary systems because of nan institutions' reputations, while hospitals motion up concierge physicians to guarantee referrals to specialists and inpatient care. "It helps hospitals unafraid a bigger portion of their market," she said.

Concierge physicians typically committedness same-day aliases next-day appointments. Many supply patients their mobile telephone number.

Aaron Klein, who oversees nan concierge expert practices astatine Baptist Health, said nan programme was initially intended to service donors.

"High-end donors wanted to make judge they person doctors to attraction for them," he said.

Baptist opened its concierge programme successful 2019 and now has 3 practices crossed South Florida, wherever patients salary $2,500 a year.

"My accuracy is: It's amended to springiness world-class attraction to a fewer 100 patients alternatively than supply inadequate attraction to a fewer 1000 patients," Klein said.

Concierge expert practices started much than 20 years ago, chiefly successful upscale areas specified arsenic Boca Raton, Florida, and La Jolla, California. They catered mostly to able retirees consenting to salary other for amended expert access. Some of nan first expert practices to participate nan business were backed by backstage equity firms.

One of nan largest, Boca Raton-based MDVIP, has much than 1,100 physicians and much than 390,000 patients. It was started successful 2000, and since 2014 backstage equity firms person owned a mostly liking successful nan company.

Some concierge physicians opportunity their much attentive attraction intends healthier patients. A study published past twelvemonth by researchers astatine nan University of California-Berkeley and University of Pennsylvania recovered nary effect connected mortality rates. What nan study did find: higher costs.

Using Medicare claims data, nan researchers recovered that concierge medicine enrollment corresponded pinch a 30%-50% summation successful full wellness attraction spending by patients.

For hospitals, "this is an hold of them consolidating nan market," said Adam Leive, a study co-author and an adjunct professor of nationalist argumentation astatine UC Berkeley. Inova Health Care Services successful Fairfax, Virginia, 1 of nan state's largest tax-exempt infirmary chains, employs 18 concierge doctors, who each grip nary much than 400 patients. Those patients salary $2,200 a twelvemonth for nan privilege.

George Salem, 70, of McLean, Virginia, has been a diligent successful Inova's concierge believe for respective years on pinch his wife. Earlier this twelvemonth he slammed his digit successful a edifice door, he said. As soon arsenic he sewage home, he called his physician, who saw him instantly and stitched up nan wound. He said he sees his expert astir 10 to 12 times a year.

"I loved my internist before, but it was intolerable to get to spot him," Salem said. Immediate entree to his expert "very overmuch gives maine bid of mind," he said.

Craig Cheifetz, a vice president astatine Inova who oversees nan concierge program, said nan infirmary strategy took liking successful nan exemplary aft MDVIP began moving aggressively into nan Washington, D.C., suburbs astir a decade ago. Today, Inova's programme has 6,000 patients.

Cheifetz disputes nan complaint that concierge expert programs exacerbate superior attraction shortages. The exemplary keeps doctors who were considering retiring early successful nan business pinch a lighter caseload, he said. And nan fees magnitude to nary much than a fewer dollars a time — astir what immoderate group walk connected coffee, he said.

"Inova has an unthinkable superior attraction web for those who can't spend nan concierge care," he said. "We are still providing each that is basal successful superior attraction for those who request it."

Some hospitals are starting concierge expert practices acold from their location locations. For example, Tampa General Hospital successful Florida past twelvemonth opened a concierge believe successful upper-middle-class Palm Beach Gardens, a astir three-hour thrust from Tampa. Mount Sinai Health System successful New York runs a concierge expert believe successful West Palm Beach.

NCH Healthcare System successful Naples, Florida, employs 12 concierge physicians who dainty astir 3,000 patients total. "We recovered a request successful this organization for those who wanted a much personalized wellness attraction experience," said James Brinkert, location administrator for nan system. Members salary an yearly interest of astatine slightest $3,500.

NCH patients whose doctors person to concierge and who don't want to salary nan rank interest are referred to different superior attraction practices aliases to urgent care, Brinkert said.

Kaiser Health NewsThis article was reprinted from, a nationalist newsroom that produces in-depth publicity astir wellness issues and is 1 of nan halfway operating programs astatine KFF - nan independent root for wellness argumentation research, polling, and journalism.