Switching to concierge? Don’t short-change existing patients

Why This Topic Matters

Practice conversions can affect existing patient relationships, payer participation, and regulatory exposure. Understanding the broad legal and operational issues helps practices plan a transition while reducing complaints and contract-related risk.

Article Sections

1. Transitioning an existing practice to concierge care

   Introduces the basic concerns that arise when a practice considers moving from a traditional insurance-based model to a membership or concierge model. The section frames the issue around existing patients and potential objections.

2. Insurance participation and payer concerns

   Covers how commercial payer relationships may affect a concierge transition and discusses the broader concern of unequal treatment among patient groups. It also addresses general contract and benefit-design issues that can arise with added fees or priority access.

3. This is what CMS says

   Summarizes the article’s discussion of Medicare-related enrollment and opt-out considerations. It also touches on structural options that practices may consider when separating concierge services from other business activities.

4. Self-pay OK?

   Discusses non-insurance concierge arrangements, patient agreement terms, and the need for written policies governing included services and other contract provisions. The section also notes notice, referral, and record-transfer considerations when changing practice models.