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34% of Medical Practice Models Considering Membership Models

News  |  By Debra Shute  
   March 28, 2017

Practices that have incorporated concierge or direct-pay models find measurable benefits, including maintaining their independence.

Desiring better work-life balance, lower administrative burden, and more time with patients, 34% of medical groups are thinking about adding a new payment method within the next three years, according to a new survey from cloud-based technology company Kareo, conducted in partnership with the American Association of Private Physicians.

The options considered include concierge medicine, direct primary care, or another membership model, the survey found.

The findings are based on responses from 766 clinicians, practice managers, and practice owners surveyed during the second half of 2016.

Of these, 26% were in practices described as private (concierge medicine or direct-pay membership) versus 74% in conventional (fee-for-service) practices.

The survey reveals differences in practice life between the two groups:

  • Providers in conventional FFS practices spend 30 minutes or less with each patient, while most (79%) physicians using membership models spend 30-60 minutes on each patient visit.
  • Sixty percent of FFS providers have more than 1,000 patients, while almost all physicians employing membership models have panels of fewer than 1,000.
  • Conventional FFS physicians spend 11.25 hours per week on administrative work, versus 10.5 hours for concierge or direct-pay physicians. Overall, FFS physicians work about six hours more per week than their concierge/direct-pay counterparts.
  • While 30% of these practices have all of their patients enrolled in a membership program, 33% have 25% or less of their panel enrolled, and the rest fall somewhere in between.
  • Meanwhile, among those using some type of membership model, 57% participate in Medicare, 54% participate in health plans in network, and 58% are out-of-network with health plans.
  • The top challenge cited by FFS practices, at 35%, is financial viability, whereas 38% of the private groups see recruiting new patients as their biggest difficulty.

"The Practice Models Perspectives survey shows that many physicians working in solo and small practices are interested in testing alternate models to remain independent," the authors said.

"More importantly, those changes don't have to be complete. Providers can mix and match models to find the right balance and still experience some of the benefits of moving away from a fully fee-for-service practice."

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.

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