There is no doubt that we have come a long way from the mid-twentieth century family doctor who cares for multiple generations and knows not only your medical history but much of your social life as well. With complexity, healthcare has become less personal, especially with millennials who have strong relationships with their hair stylists but often go without a primary care doctor.
The affluent have addressed the issue of the impersonalization of healthcare with “concierge care,” which is basically a doctor who treats you holistically and serves as a care advisor to simplify medical decisions, guiding a patient through the complexity of care access. Concierge care – which can cost as much at $20,000 per year – works within the traditional insurance system. Typically, while there are some uncovered costs, concierge doctors seek to be paid for their services by fitting into traditional fee-for-service billings. But this is only for the affluent.
Now, a rapidly growing trend is emerging which can address the needs of every American: subscription-based medical services which, for a monthly fee averaging around $100, will provide basic primary care without the need to use insurance. This care model provides unlimited office visits, same or next day care, greater access through email, video calls and text messages to your doctor. All of this can create a more satisfying experience and a closer relationship with the doctor. It is appealing to doctors and patients who are tired of the complexity of healthcare and the uncertainty of costs; and in some models, works outside any insurance reimbursement.
I think subscription medicine has the potential to explode and may be an area that CVS-Aetna is contemplating. I remember one of the earlier analogies which I have used for rising health insurance costs, contrasting these costs to auto insurance. Auto insurance remains affordable because routine costs like gas and oil are not covered. With direct primary care subscriptions, gas and oil for the human body will be done on your own – and if you don’t take care of the human car, you will suffer the consequences. I like this new direction.