Concierge and direct primary care models charge patients an annual or monthly membership fee for more personalised primary care. Concierge practices keep billing insurance for visits and procedures, while direct primary care usually operates outside the insurance system.
Researchers from Johns Hopkins Carey Business School, the Johns Hopkins Bloomberg School of Public Health, Oregon Health & Science University, and Harvard Medical School reported their findings in Health Affairs. They analysed a national sample of more than 6,000 practices from 2018 to 2023. In that period, practice sites rose from 1,658 to 3,036 and clinicians increased from 3,935 to 7,021.
The team found clinicians are moving into these models partly because they often have smaller patient panels, less administrative burden, and greater autonomy, which can reduce burnout. The study also notes a large rise in corporate-affiliated practices and recommends policymakers monitor these trends to protect broad access to primary care.
Difficult words
- concierge — a primary care practice with extra paid services
- direct primary care — primary medical care outside the insurance system
- membership — a regular payment to belong to a service
- clinician — a healthcare professional who provides medical careclinicians
- patient panel — the group of patients a clinician cares forpatient panels
- administrative burden — extra work from paperwork and insurance rules
- autonomy — freedom to make professional decisions at work
- policymaker — a person who makes public health or policy decisionspolicymakers
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Discussion questions
- Would you consider paying a membership fee for more personalised primary care? Why or why not?
- How might smaller patient panels and greater clinician autonomy affect quality of care?
- What could policymakers do locally to protect broad access to primary care as these models grow?
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