Some Health Insurers Dropping Coverage, Withdrawing Support in Reaction to Concierge Medicine
Customized care, or concierge medicine, is "drawing the ire of some health insurance companies," which have dropped coverage or withdrawn support of the practice, the Houston Chronicle reports.
According to the Chronicle, in concierge medicine, which is a "relatively small movement" in the U.S., physicians charge an annual retainer of between $1,500 to $1,800 for patients to "receive more personal care." Concierge medicine physicians typically make house calls, concentrate on specific health issues including weight management and depression, and some give clients their cell phone numbers.
United Healthcare recently announced that in April it will drop four Texas-based physicians offering concierge care services from its network, while Cigna is "condemning the practice," according to the Chronicle. Cheryl Randolph, a spokesperson for United Healthcare, said that the customized care service "directly conflicts" with the company's agreements with physicians, adding, "Consumers and employers already pay premiums. These doctors say their fee goes toward extra services, but, for the most part, they're already covered." Gwyn Dilday, a Cigna spokesperson, said, "Charging membership fees to guarantee access is a violation of our contract terms and may result in termination."
However, other health insurers -- including Aetna, Humana and Blue Cross and Blue Shield of Texas -- do not oppose concierge care as long as patients understand that retainer fees will not be reimbursed.
Darin Engelhardt -- president of MDVIP, a national network of 210 physicians that offer customized care -- said exams patients receive include various other screenings and services that are not covered by insurers. According to the Chronicle, supporters of customized care say the service is a protest against the current health care model, in which lower Medicare and insurance reimbursements have "forced doctors to herd dozens of sick patients through their offices in five-minute increments every day" (Cook, Houston Chronicle, 3/13).
