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Switching from Private Practice to Concierge Medicine? What You Need to Know

Posted on November 25, 2020

The premise behind concierge medicine, also known as retained care or direct primary care medicine, is that physicians can provide higher quality care and more comprehensive visits with their patients when they reduce the size of their patient panel.  

Physicians can afford to do this when patient payments are received through an annual or monthly membership fee rather than through insurance payments and copays for each visit  This shift in payment type reduces time and administrative costs associated with managing patient insurance issues, and allows physicians more time to focus on their patients.

Most concierge practices can be categorized as a full concierge practice, a direct primary care practice, or a hybrid mix of the two.   But even within these categories, not all practices are alike.  Some practices may include executive-style annual medical exams or other services as part of the membership fee.  Other practices may be willing to bill insurance or Medicare.

If you are contemplating switching from private practice to concierge medicine, here are a few key action items:

  • Research concierge practices in your area so you have a benchmark of the competition, their target patients, and their business models.
  • Determine the demographics in your area and investigate which business model will work best for you, the patients you expect to retain, and new patients.
  • Put together financial projections to determine operating costs, cash flow, membership fees, and the number of patients you will need to sustain a viable business.

Next, you’ll need to talk with an experienced legal expert to fully understand the opportunities and risks for your new business model.  Consider the following:

  • Monthly or annual concierge medicine membership fees can expose practices to regulatory and legal risks.  Get educated on what services, if any, your practice can provide and still receive private insurance or Medicare payments. 
  • Your operations, policies and procedures need to be compliant with all state and national regulations.  Review and update all medical practice documents with an experienced attorney to ensure commercial liability, regulatory risk, malpractice, and HIPAA compliance.
  • The optimal type of business entity for your concierge practice and whether your practice will include other physicians or owners.

Once you’ve worked through the business and regulatory side of starting a concierge practice, here are a few more items to consider:

  • Develop a marketing plan to retain current patients and attract new patients.  Talk to your current patients about concierge medicine so that they can understand how it works and you can get a read on whether they will join you. 
  • Figure out how you can provide excellent service and medical care to your patients, keeping in mind that concierge medicine needs to provide a superior experience to other medical practices.  Communication, appointment scheduling, medical treatment, ease of physician contact, and billing practices need to be top-notch.

If you are seeking a legal professional to assist you in understanding the critical details of switching to concierge medicine, we can help.

ECanter Lawyers

Healthcare business owners as well as physicians face unique regulations as they form, purchase or sell practices or ancillary businesses. At ECanter Lawyers, we have the necessary legal expertise to properly assist clients with the purchase or sale of medical-related practices in Florida. In addition, our firm assists with the drafting, review, and the negotiation process of medical and healthcare related contracts, including: 

  • Entity Formation
  • Structural Compliance
  • Ownership Documents
  • Medical Directorships
  • Sales & Purchases – Space Leases
  • Buy-ins & Buy-outs

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