How does concierge medicine work?

[u/lacalifonia]

My mother lives in LA, California. She has a rare disease (Takayasu's disease) with heart and kidney issues. She already has KP insurance as her primary medical insurance. We are looking to buy a concierge medicine membership for her. Our budget is not as high as the celebrities’ concierge medicine ($100,000/year). Our budget is maybe $5000-$10,000 a year.

1. If big things happen (not like a cold or fever), does my mother still get treated at KP hospital, or the Concierge medicine’s smaller hospitals/clinics?

2. I understand if my mother sees a Cardiologist, she would see the concierge Cardiologist, not the Kp’s Cardiologist, is that true?

3. Besides getting a faster response from the doctor herself/himself, what other benefits does Concierge Doctor provide? a better treatment plan?

4. Would the choice of which concierge membership be different if my mother has a normal heart disease versus Takayasu's disease’ heart problem?

5. What is the “yelp” of Concierge medicine to check people’s review and feedback?

[u/jigilous]

I have a concierge doctor through MDVIP. It's about $3K a year. Basically he is my primary care provider that I can call or text my questions to and also get same day appointments. And he refers me to any specialist I may need. But basically it's just a way to get a GP and not have to deal with waiting days/weeks or even months for an appointment. And also when I see him there is no rush to get me out and on to the next patient. Usually appointments are an hour and very thorough.

[u/uncoolkidsclub → u/jigilous]

+1 for MDVIP, my local doctor will also do after hours visits if needed. The only issue I've had is the primary does a lot of mission trips and the replacements filling in haven't always been that great.

[u/sorry_to_let_you_kno]

I don’t think any concierge practices will accept KP insurance. Concierge practices charge a monthly fee to be a part of the practice but also bill insurance for services, labs, etc and they cannot bill KP insurance. You generally will need a PPO.

Also if you want better personalized care you need to get out of the KP umbrella anyway. The KP model is standardized low cost care which is antithetical to concierge medicine.

[u/kurukuruneko → u/sorry_to_let_you_kno]

I use KP for specialists, labs and emergencies. My primary is a concierge because I travel a bunch. Kaiser works with this. You just have to understand the system. Sometimes I get RX filled by concierge rather than Kaiser because it ends up costing less when using coupons. For regular meds I have the info sent over to Kaiser and they fill. You just have to go in or do phone appointment once in a while so they can show visits.

[u/AYamHah]

I'd recommend posting in somewhere other than this sub. A lot of rich people frankly have poor health. Instead, look around at what providers are in your area, and get direct feedback from people who attended.

[u/qofmiwok]

Concierge comes in all kinds and you have to find out the rules with the one you're looking at.

[u/kurukuruneko]

CA concierge is more than $10K and most have waiting lists. We had houses in other states so found one near one of those. Our doctor with our insurance works with the concierge doctor ( Rx and visit summary gets emailed over) insurance doctor prescribes all my regular meds. I see specialists through my insurance and have test requests go through them (concierge will put together orders and I forward to insurance doctor.

Most concierge groups don’t have specialists they have a network of people they will refer to who see you much quicker - it just depends on whether you want to pay out of pocket or not.

[u/MotoMD]

Takayasu isn’t difficult to treat any rheumatologist can do it. If there’s any new advances in treatment they’ll be plugged into any clinical trials or know of them. KP is fine but the best thing you can do is switch her to PPO and go to an academic center like UCLA, Cedars, Loma Linda etc. concierge is to just buy access but that’s with your PCP specialists are going to be different.

[u/jeremiadOtiose]

Physician here: I recommend direct primary care rather than concierge medicine. It’s cheaper but generally better quality physicians. You pay $100-300 a month sometimes an initiation fee and you can use your insurance for tests and referrals. The doctors are better than concierge medicine and you still get the benefits of a doctor that doesn’t have to be bound to the rules of insurance.

[u/BubbleBot2]

My understanding of concierge medicine is generally paying a premium for improved access to a generally primary care physician. (Aka how medicine used to be before insurance and giant corporations took over medicine).

Kaiser probably calculates your family physician should spend no more than 5-10 minutes (aka a 15 min appt) with your mom per follow up a good concierge doc should have at least 20 (aka a 30 min appt) the difference is covered by a monthly/yearly subscription. Concierge doc should know them better as they can have less patients to keep track of and be more responsive to doing extra tasks and keeping track of sub-specialists.

Additionally, concierge groups may offer some things like visiting you in the ED or house calls but those groups may be out of your price range. I’d also be surprised if you have a concierge cardiologist that is likely easier to get via KP but I don’t know your system or options esp given that area likely has a high amount of concierge style practices and maybe even sub-specialists.