A number of insurers aren't too pleased with the small but growing trend of "concierge medicine." For an annual retainer fee, patients can have more personalized care, which may include house calls and more access to their physician. By charging the up-front fee, doctors can afford to cut their caseload and spend more time with fewer patients.
But United Healthcare and Cigna both say the concierge model violates their contracts, and United Healthcare is dropping four Texas physicians because of the practice. Insurers say that doctors may charge patients for co-payments or co-insurance, but not additional fees. Some practices have cut insurance out entirely, while others still have patients relying on insurance to cover most of their visit, which the insurers don't like that at all. However, Aetna, Humana and Blue Cross Blue Shield of Texas say they will accept the concierge model as long as patients don't expect reimbursment for their doctor's retainer fee.
For more on the concierge/insurer conflict:
- read this article from the Houston Chronicle