Concierge or retainer medicine, in which a patient typically pays a flat annual or monthly fee for access to extensive primary care, has grown rapidly in the United States. While to some extent it has been driven by patient demand for a simpler way to access care and to receive more personalized attention from a physician, doctors have been greatly attracted to the model, which significantly reduces the hassles of medicine, while increasing their patient interaction time. One of the promises of concierge medicine is that the greater primary care attention being devoted to a patient should help avoid hospitalizations and other care. Research reported in the American Journal of Managed Care examines hospitalization rates for patients in one of the leading concierge practice companies, MDVIP. (AJMC Article)
The study compared emergency and non-emergency admissions, as well as avoidable ones, those that should not have occurred if the patient was getting good primary care. Rates of readmission for Medicare patients were also calculated. There could be issues with the selection of the MDVIP and comparator populations, giving the data set limitations. MDVIP patients were 42% less likely to be hospitalized in 2006, rising to 62% in 2010. The trend was similar for commercial and Medicare patients. Medicare patients were also much less likely to have a readmission and for all patient types there was much less likelihood of an avoidable admission. While there could be issues with matching of patient cohorts the researchers performed some tests to limit this possibility. This reduction of hospitalizations represents both an improvement of care quality and a likely reduction in overall health spending. Sounds like a trend to be encouraged.