Concierge Care: the healthcare model of the future
Despite being in a period of political stagnation, the far right and left agree on one issue: they are both wary of Obamacare.
Most Republicans rebuke the Affordable Care Act for infringing on the free market economy, while Democrats believe that it doesn’t go far enough to provide affordable healthcare for all. The ACA successfully reduced the uninsured from roughly 16% of the population before 2010 to 9% in 2016. However it comes at a price that adversely affects all Americans: an increase in insurance deductibles as the insurance marketplace struggles to absorb millions of newly eligible individuals.
The Side-Effects of Obamacare
Paying for your healthcare is complicated. In addition to co-pay, monthly premiums, and anything not covered by your insurance plan (which unfortunately tends to be a lot), your insurance also requires an annual deductible. Nine years ago, the average deductible for an individual was under $600. It has since doubled, to a little over $1,200. Workers, who are covered by their employers, ironically pay a little more — $1,300. Insurance was expensive before Obamacare, and it continues to be for the average person.
The hope is that when individuals face catastrophic events — whether it be caused by a car crash, gun violence or any form of freak accident, won’t be slapped with a hospital bill the size of their student-loan debt because they are insured. Obamacare also seeks to encourage individuals to be engaged in preventative care, by actually getting routine check-ups by their physician and be able to address any health issues that may arise early.
Obamacare, however, has its side effects that are driving individuals to seek alternative forms of healthcare. In addition to the dramatic increase in insurance deductibles, patients are experiencing longer wait-times to see their physician. The “silent exodus” of physicians after the implementation of Obamacare in 2010 is having egregious effects on patient-access to healthcare.
The Wall Street Journal reports that the United States faced a shortfall of 60,000 physicians in 2015 alone, which will likely rise to an estimated 90,000 shortage by 2020. Coupled with declining reimbursements, physicians feel compelled to base their practices on a volume-driven model; more patients means more money, and consequently the quality of healthcare becomes increasingly irrelevant.
Physicians have as many as 2,000 patients, and see as much as 30 of them daily in 15-minute allocated time-slots. Patients feel rushed, and cheated. As a result, some are turning to another form of healthcare that actually allows patients to spend more time with their physician, while ultimately spending less.
Concierge Care: No longer only an option for the rich
Concierge care — it’s no longer a luxury reserved for the rich and famous. For many patients across income brackets, it is a more attractive option. And for good reason. Under the concierge model, patients pay a monthly and/or annual premium to receive direct access to their physician. As previously mentioned, a typical physician has around 2,000 patients. Concierge-physicians on the other hand have on average just 500.
This means an end to 15-minute, rushed consultations. Physicians can take their time with their patients and actually get to know them. This helps them develop better relationships which studies show will ultimately lead to improved health outcomes. Physicians take responsibility over their patients healthcare. It’s easy to schedule appointments with concierge care practices — even in just 24 hours for dire situations, which would be difficult with a physician who tends to 2,000 patients.
Concierge care also serves as a gateway for physicians to enter the 21st century of technology. Physicians under the traditional model do not speak with their patients by e-mail, phone, nonetheless over text simply because they are not paid to. Volume-driven models depend on actual consultations and services, not the success rate of patients. Concierge medicine however encourages physician to provide the best care for their patients, in order to keep them as patients in the future.
Communication between physicians and patients is at the crux of concierge care. Technology can foster greater communication in many ways. Through apps like Curogram, a HIPAA compliant web-based SMS app, patients can communicate directly with their physicians, and likewise. Technology already reduces overhead for concierge practices, which is why they have become more affordable and attractive among income brackets — and no longer just a privilege for the rich.
Does concierge care work? Current statistics suggest it does. In a five-state study conducted by the American Journal of Managed Care, 56% of concierge-patients experienced less non-elective admission, 49% fewer avoidable admissions, and 63% fewer non-avoidable admission than patients of traditional practices. Even more remarkable is that 95% of patients less frequently underwent congestive heart failure, and 91% less for pneumonia.
Is it affordable? Annual membership typically ranges from $137–150 a month. That’s between $4–5 a day, or the cost of a Starbucks frappuccino — which you should probably nix anyway since we’re on the topic of health. Concierge care eliminates the need to choose a plan with high deductibles. If it’s the only option, then you’re already paying thousands of dollars out-of-pocket anyway. Might as well spend it on care that will improve your health. The American Journal of Managed Care also found that concierge care typically saves the government $2,551 per patient precisely because of fewer hospitalizations. It’s a win-win situation for all.
Concierge care doesn’t render insurance obsolete. After all, under Obamacare, it is mandatory to have a minimum level of health insurance. It’s necessary for those worst-case scenarios mentioned earlier — a car accident, gun violence, or a freak accident. It happens, and the best preemptive healthcare won’t be able to stop it.
For everyday healthcare however, you ought to be able to have direct access to your physician. That should mean being able to have worthwhile routine visits where your physician can get to know you and your lifestyle. It should also mean having the ability to call and text your physician with questions if you have any health concerns — and not having to schedule a visit every time you do. If you do end up in a catastrophic scenario that sends you to the ER, wouldn’t you want your physician by your side, who knows your health better than anyone?
Concierge care will continue to become more appealing in the face of rising insurance deductibles, and in general as more people become aware of it. The number of concierge practitioners is already increasing at a rate of about 25% a year to accommodate the growing demand. The value that concierge physicians hold for their patients’ health, coupled with innovative technology aimed at improving inter-personal communication serves as an ideal model for how basic healthcare should be provided. Considering that it can actually be more affordable than traditional care, it’s only a matter of time until a majority of patients and physician alike begin switching over.
Additional Sources
https://www.thehappymd.com/blog/bid/285923/Concierge-Medicine-will-get-Massive-Boost-from-Obamacare
http://www.huffingtonpost.com/ilana-jacqueline/concierge-medicine_b_4267372.html
http://www.healthline.com/health-news/the-future-of-healthcare-could-be-in-concierge-medicine-063015
http://www.ibj.com/articles/27114-reform-could-create-more-boutique-doctors
http://www.wsj.com/articles/SB10001424052702303471004579165470633112630
