Anybody's dr dealing with Obamacare by going VIP?

[Luvchefmic]

Spring 2008 when we still lived in NY my primary care physician located eastern Long Island handed me the sheet and explained the VIP costs so not a new idea...I thought they were nuts...still think the idea is crazy

 

[ZephyrHawk]

Concierge practices have been a 'thing' since long before Obama even ran for president, it's not a reaction to Obamacare. I remember hearing about it...oh, geez, maybe 10 years ago. And I don't think it was new then.

Concierge has been around for a while, but ultimately, was not worth it for most practices because of the interference with the ability to take government payors. Now, with "Obamacare" (Which, by the way, is a terrible title. Those in the legal profession call it PPACA, and those who are not would be better to call it "Healthcare Reform"), the system by which physicians receive benefits from governmental payors is changing. Basically, we are cutting out all the excess, and moving towards a more person-centered system that will reward preventative care and penalize those practices which traditionally ordered a lot of tests and treatments which were not necessary. Although there will be more people on governmental programs because of PPACA, there will also be changes to commercial payor requirements and to requirements for traditional Medicare recipients' care which are intended to lower the costs spent on healthcare in general. Since Medicare billing rates are going down and/or providers are being audited on a greater basis for potential fraud/mistakes in billing, this results in a double whammy of 1) governmental payors being slightly less profitable and 2) more concerns about potential violations and paperwork. These issue are encouraging physicians to change their practices. Some - not many - are considering concierge. Many others are selling their practices to hospital systems and taking direct employment from the hospitals (it's a pay reduction, but they don't have to worry about paperwork). And some (most who weren't already making a ton of money through questionable means) are waiting to see what happens and if it really will impact their practice so substantially that they can no longer viably perform as a solo practice. Yes, rates are going down, but soon everyone will have health care coverage (either through the government or through commercial payors), so more people will, in fact, be looking to obtain primary care that they were otherwise just skipping.

 

[Simba's Mom]

Wow! This is the first I've heard of this. And you say that in some parts of the country "concierge medicine" has been around for several years? Interesting what we can learn here on the DIS.

 

[BGK]

Concierge practices have been a 'thing' since long before Obama even ran for president, it's not a reaction to Obamacare. I remember hearing about it...oh, geez, maybe 10 years ago. And I don't think it was new then.

You fool! Facts have no place in this debate!

 

[Hrhpd]

None of the doctors that I know of are going to this.

But then, I rarely see my PCP. I only have her listed on my insurance because we are supposed to have one. My insurance does not require referrals, so if I have something more than a sore throat or cold, I just go to a specialist.

My insurance also has a PA that will coordinate your healthcare much like a PCP. And no, they don't make medical decisions, just give suggestions.

 

[Christine]

I live in the DC metro area and we have areas of wealth, average incomes, and poverty. I have heard of concierge medicine for quite sometime; however, I noticed that it tends to be practiced by physicians who patients feed in from affluent areas. For instance, I live in a solidly middle class suburb of DC and none of the doctors in my city do this. Yet 15-30 miles away, closer to the city, there are several concierge practices.

 

[SandiR]

Good luck to your doctor finding people willing to go for this. No, none of our doctors have gone VIP, nor have any of the medical professionals in my own family.

 

[JessicaR]

Although I have not received anything along these lines from my Internist of over 25 years, I have received postcards in the mail soliciting this service from other doctors. In the past months I have 3 postcards. Never before that did I get anything like it.

 

[Simba's Mom]

I live in the DC metro area and we have areas of wealth, average incomes, and poverty. I have heard of concierge medicine for quite sometime; however, I noticed that it tends to be practiced by physicians who patients feed in from affluent areas. For instance, I live in a solidly middle class suburb of DC and none of the doctors in my city do this. Yet 15-30 miles away, closer to the city, there are several concierge practices.

That explains why I haven't heard of it then. No affluent areas here. Where I live, in the Rio Grande Valley of Texas has by far the highest poverty rate in the US.

 

[GAGirlInVA]

A practice back home has gone to straight pricing.

If our PCP went to true concierge (everything office included), we'd consider it.. and we aren't made of money.

I think the model is intriguing.

 

[DznyCrzy11]

Would some of that $1800 cover the office visits? Or, is it a flat $1800/year but you don't pay for any other medical expenses? Now that I would do. So basically it would equate to $150/month and you would have no other medical expenses. But I'm guessing the $1800/year is in addition to tests, labs, etc. That would mean that dr would get $1,080,000 from all 600 patients.....that's insane!!!

 

[shortbun]

Nothing here in central Ohio. People wouldn't go for it. I did hear a story on the TODAY show many years ago about some doctors in NYC doing it. That was at least 10 years ago though. Those doctors were asking 100K, one time then most routine services were free. For that fee, the docs agreed to be available on a daily basis because they limited their clientelle.

 

[Luvchefmic]

when it was "offered" to me in NY it was the cost annually for the "priviledge" of being his VIP patient ( if I recall it was about $1,800. also quoted to me) than it would be financial business as usual, still take my insurance still take the co-pays, still had to pay anything I would normally have to pay for anything else...honestly I can't see how they can get away with this

I had GREAT insurance that paid him well, through Suffolk County Police Dept in NY, but he was located in an affluent area Southampton Long Island

 

[POPCITY]

DS's pediatrician went to a concierge practice about 5 years ago. We pay $700/yr, but no other charges from the doctor's office. We are on a high deductible health plan, $5000 deductible, so we used to pay everything except annual checkups. We don't go to the doctor very often, so it's still more expensive than just paying per visit would be, but I love it. Doctor appointments are guaranteed the same day, the nurse practitioner does house calls, and the visits seem more thorough. And it's just a very different 'feel" to it. I never feel rushed, it's very laid back, like they are on my schedule, I'm not on theirs. I wish my PCP was concierge. Not sure if I'd pay $1800 for it, though!

 

[sonnyjane]

I'd be more upset with my doctor for making what seems to be a greedy move than with politicians.

 

[powellrj]

I'd be more upset with my doctor for making what seems to be a greedy move than with politicians.

I don't think its a greedy move, I think its just a different way to practice. You get more time with patients who have the funds and are willing to pay for it.

My former doctor went to this type of practice before Obamacare. I had the choice to go with him or stay with the new doctor that took over his practice. I chose to go with the new doctor and have never regretted it.

Isn't that what the TV show on USA called Royal Pains is about? I have never seen the show, but I have seen the commercials for it.

 

[sbtrfly74]

Sorry but I think anyone who would pay for concierge service is a complete nut case. On call... google, or er. Are you kidding me? next day appointments. Really? someone must have money to burn? are you that new not to know what to do with a child that it could wait until the doc appt? If its not then go to the ER. But I guess thats not fast enough either.

I will say Im sorry for the families that have to pay so much out of pocket of a deductible. I guess Im fortunate to have no deductible and only 20% out of pocket.

Luckily my pediatrician has been practicing for almost 40 years. With my ex-dh, all 3 of my children and even if he pulled this bs I would find somewhere else.

 

[carrie1626]

I'm in HC.
I may have a more objective view than others.
No blame on ObamaCare here.
Your Dr. is doing this on his own accord.

 

[eliza61]

Not a huge fan of the health care bill (don't totally hate it though) but why in the heck are you blaming the President?

This isn't any thing new? Heck, in the well to do suburbs around Philly this has been going on for at least 19 years. That's when my youngest was born and his pediatrician started a practice with 2 other doctors that they called premium.

They were getting up and age and said they wanted a smaller practice with a select group of patients.

Non issue. It's been done

 

[Luvchefmic]

I think when the OP opened this thread she/he didn't realize its nothing new to many of us and jumped to the conclusion (assumed you know how that goes) it had something to do with our current President Hopefully they realize now it has nothing to do with him or the previous administration