The term “medical concierge services” are often confusing in today’s healthcare landscape and sometimes means various things to different people.
One definition of the term may be a fee-based model of care where patients purchase a la carte services directly from providers. Another—the definition of what Carenet Health offers to health plans—stands for personalized, one-on-one assistance to consumers navigating the healthcare system.
Let’s dig into every of those to supply a transparent picture of the difference.
Fee-for-care concierge services also are called concierge medicine or primary care. The goal of those sorts of services is to supply an alternative to insurance. Medical providers directly charge their patients a flat fee (monthly, quarterly, or annually) that pays for routine office visits, lab work, and straightforward diagnostics. Patients receive no health plan assistance for those routine office needs. Patients do, however, often still got to carry insurance to hide specialist visits, hospital services, prescriptions, and catastrophic health events.
There is also a hybrid fee-for-care model during which a patient relies on Medicare or private insurance for routine care and a fee-for-care retainer covers specialized or value-added provider services. samples of those concierge services could be customized wellness plans or house calls.
At Carenet, we’re focused on the opposite definition of health concierge services, which is employed to explain a part of a replacement movement in healthcare on the payer side. It’s an answer that’s risen out necessarily thanks to an increasingly complex healthcare system. These sorts of services also are called health advocacy and health navigation services, or at Carenet, “healthcare advocacy and navigation.”
A health plan or employer that chooses to supply these sorts of concierge services is attempting to assist healthcare consumers to get the foremost out of their health and wellness benefits and make the fragmented and often-confusing business of healthcare simpler. The goal is for consumers to urge what they have to measure their healthiest lives, which is sweet for all … consumers, payers, providers, and employers.
Each health plan will typically customize its advocacy program, but a number of the components might include: the assignment of a private healthcare guide to every individual, holistic onboarding for brand spanking new members, personalized and actionable health risk assessment engagement, hand-holding through program enrollment, and physician selection, care coordination and follow-up support, tailored health coaching, treatment and drugs adherence assistance, and on-demand clinical and price decision support.
By providing this type of trusted, one-on-one support, very similar to delivering concierge services to guests at a high-end hotel, plans can create exceptional experiences.
Health concierge-level advocacy, when done well, strengthens the critical partnership among employers, clinicians, members, and health plans. And it empowers healthcare consumers to be a lively participant in their own care.
As the industry continues to shift toward consumer-driven, value-oriented healthcare, health plans are getting to need to rethink how they are doing business with both employer groups and consumers. to stay competitive, the foremost progressive plans are going to be adopting a customer-first mindset that elevates the general healthcare experience while curbing costs for all stakeholders.
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