FROM THE FOUNDATION

Redefining the Safety Net

Should California establish a Basic Health Program for certain low-income residents? CHCF's Marian Mulkey captures a recent policy conversation in a Health Affairs blog.

Accountable Care in Action

A new post on the Health Affairs blog details how CalPERS kept costs down in Sacramento through a "virtual" ACO with insurers and providers.

Career Opportunity: Senior Program Officer

This position will play a major role in furthering the goals and objectives of the foundation's Better Chronic Disease Care program.

Health Care Costs

Friday, February 02, 2007

Pay, Practice Size Fuel Rise in 'Boutique Medicine'

Three hundred to 400 physicians nationwide, including California, are limiting the size of their practices and providing more personalized care, the Contra Costa Times reports.

The service, referred to as concierge or boutique medicine, continues to grow as physicians face low reimbursement rates and a lack of independence because of restrictions from insurance companies.

Many services charge patients an annual fee of about $1,500 to $2,000, although some services charge up to $15,000. The fee does not include office visits or hospital stays, which still are covered by health plans, Medicare or other options. However, health plans and Medicare generally do not cover the annual fee.

Patients receive a complete annual physical, a mini CD containing their medical records, a personal wellness plan, same- or next-day appointments lasting 30 minutes or longer and the personal physician's cell phone or pager number and permission to reach the physician at any time.

Many physicians practicing the service are affiliated with firms such as Florida-based MDVIP. The firm, founded in 2000, has 143 affiliated physicians in 16 states serving more than 50,000 patients. Patient enrollment grows by about 2,500 monthly, according to the Times.

The Government Accountability Office in 2005 studied the service and concluded that enrollment is not high enough to impact access to health care. Federal officials said they will monitor the trend, the Times reports (Kleffman, Contra Costa Times, 2/1).



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