In exchange for the retainer, doctors agree to provide enhanced care, including commitments to ensure adequate time and availability for each patient.
The Fee for Extra Care ('FFEC') is similar to the FFC model, however, the additional services are charged to Medicare or the patient's insurance plan.
Some of the benefits and services typically included in these two retainer models are: same day access to your doctor; immediate cell phone and text messaging to your doctor; unlimited office visits with no co-pay; little or no waiting time in the office; focus on preventive care; unhurried atmosphere; cell phone, text message, and online consultations; prescription refills; and convenient appointment scheduling.
FFC or retainer plans may typically not be purchased with pre-tax dollars utilizing HSA and/or FSA accounts because it is not a fee incurred for a service.
There is also a hybrid concierge model where physicians charge a monthly, quarterly, or annual retainer or membership fee for services that Medicare and insurers do not cover.
These services may include: email access; phone consultations; newsletters; annual physicals; prolonged visits; and comprehensive wellness and evaluations plans.
The annual fees vary widely, ranging, on average, from US$195 to US$5,000 per year for an individual with incremental savings when additional family members are added.
[8][full citation needed] Lower-cost concierge medical business models have also been attempted, such as GreenField Health in Portland, Oregon, which charged an annual fee between $195–$695 depending on age.
The concierge medicine model, although not the term,[13] originated with MD² International, which was founded in 1996 in Seattle by Dr. Howard Maron and Dr. Scott Hall.
Advantages include very quick access to your personal physician as needed, and the ability to see doctors in any of 10 major cities at a greatly increased cost.
[18] MDVIP emerged as a competitor to MD² with a similar model, but they opted to bill insurance in addition to charging client fees and have patient loads of up to 600.
[14]: 153 In 2017, a new company named Forward, started by former Google and Uber employees with strong venture capital support, began offering concierge medicine services for equivalent to $190 in 2023 per month.
[23] The concept of concierge medicine has been accused of promoting a two-tiered health system that favors the wealthy,[24] limits the number of physicians to care for those who cannot afford it, and burdens the middle and lower class with a higher cost of insurance.
The GAO report, published in 2005, concluded that the "small number of concierge physicians makes it unlikely that the approach has contributed to widespread access problems".