HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Friday, August 12, 2005

Concierge Medical Practice: New GAO Report

The Government Accountability Office has published a report (GAO-05-929) on concierge medicine, "an approach to medical practice in which physicians charge their patients membership fees in exchange for enhanced services or amenities. Concierge physicians typically care for fewer patients than do doctors in conventional practice, and they are more readily available to member patients, for example, by cell phone or same-day appointments."  Here's the abstract:

Concierge care is practiced by a small number of physicians located mainly on the East and West Coasts. Nearly all of the 112 concierge physicians responding to GAO’s survey reported practicing primary care. Annual patient membership fees ranged from $60 to $15,000 a year, with about half of respondents reporting fees of $1,500 to $1,999. The most often reported
features included same- or next-day appointments for nonurgent care, 24-hour telephone access, and periodic preventive care examinations. About three-fourths of respondents reported billing patient health insurance for covered services and, among those, almost all reported billing Medicare for covered services.

Two principal aspects of concierge care are of interest to the Medicare program and its beneficiaries: compliance with Medicare requirements and its effect on beneficiary access to physician services. HHS has determined that concierge care arrangements are allowed as long as they do not violate any Medicare requirements; for example, the membership fee must not
result in additional charges for items or services that Medicare already reimburses. Some concierge physicians reported to GAO that they would like more HHS guidance. The small number of concierge physicians makes it unlikely that the approach has contributed to widespread access problems. GAO’s review of available information on beneficiaries’ overall access to physician services suggests that concierge care does not present a systemic
access problem among Medicare beneficiaries at this time. In comments on a draft version of this report, HHS agreed with GAO’s finding on concierge care’s impact on beneficiary access to physician services and indicated it will continue to follow developments in this area.


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