What concierge medicine does and doesn’t buy

Concierge medicine is a healthcare model in which patients pay a membership fee for enhanced access to a physician, often including longer appointments, same-day scheduling, and more personalized care. The patient continues to rely on standard health insurance to cover those services not included in the membership fee. It is most commonly used for primary care, but can also be used by specialists -- such as cardiologists, dermatologists, psychiatrists, or endocrinologists -- for enhanced access, longer appointments, and care coordination.

In addition to the membership fee, a concierge practice may charge separately for self-pay "a la carte" services that are excluded from both the membership and your insurance, such as:

• A routine comprehensive physical, which is different from Medicare’s covered Annual Wellness Visit
• Elective, expanded, or unusually frequent laboratory tests and screenings that Medicare considers unnecessary or does not cover at that frequency
• Optional wellness, cosmetic, massage, or similar noncovered services

Many concierge practices also bill insurance for care covered by that insurance, and so patients may still owe deductibles, copays, or coinsurance. This illustrates how concierge medicine is built on top of health insurance and is not intended to duplicate the latter services, which the concierge doctor may actually use and charge.

The primary appeal is that many people experience standard primary care as rushed, fragmented, and hard to schedule. Under concierge medicine, there are fewer patients per doctor, longer visits, same- or next-day appointments, phone access, and more help navigating specialists or tests. For example, a 2005 study found that concierge-style doctors reported roughly half as many patients as non-concierge doctors, and were also more likely to offer 24-hour direct physician access and house calls.

Prices vary widely, and in the U.S. traditional concierge primary care commonly costs about $2,000–$5,000 per adult per year. Some practices charge $10,000 or more, while highly exclusive or executive-health programs can reach $40,000+ annually (link).

Direct primary care (DPC) is related but not identical to concierge medicine. DPC usually means direct payment for a defined set of primary-care services, often replacing insurance billing for primary care; many patients still carry insurance for specialty care and hospitalization. In other words, direct primary care replaces insurance billing for most routine primary care, whereas concierge medicine adds perks on top of insurance-billed care. Both models generally promise easier access, smaller patient panels, longer visits, and a closer physician relationship. 

Thus, the concierge membership fee is not the same as health insurance. For patients, the key distinction is between access and coverage. Concierge membership may make it easier to reach a primary-care doctor. It (typically) does not pay for emergency care, surgery, specialist treatment, hospital admission, advanced imaging, or expensive drugs. Doctors cannot use a concierge-based practice to get around health insurance (e.g. Medicare) payment limits, and tack on extra expenses (charged to insurance) for an insurance-billed office visit; these must be paid for by the patient.

So is concierge healthcare better? The evidence is mixed. A 2025 systematic review in the American Journal of Medicine concluded that evidence confirming concierge medicine's clinical-outcome benefits remains limited, while patient and physician satisfaction appear higher. A 2023 Journal of Health Economics article reported that when physicians switched to concierge medicine, there was stronger evidence of selection by income than by health, large spending increases, and no average mortality effect among affected patients (Figure 1). The latter study does not preclude the possibility of some sort of selection effect of doctors who eventually end up in concierge medicine, but it does argue that there is nothing intrinsically special about concierge medicine versus non-concierge medicine with the same doctor.

Yet there is indirect evidence that suggests that concierge medicine should improve medical care, at least in theory. First, access to primary care matters. In a large U.S. observational study from 2005 to 2015, every 10 additional primary care physicians per 100,000 people was associated with 51.5 additional days of life expectancy and 0.9% to 1.4% lower cardiovascular, cancer, and respiratory mortality. 

Second, continuity also appears important. A 2018 systematic review found that 18 of 22 observational studies reported statistically significant lower mortality with greater continuity of doctor care; 16 involved all-cause mortality. In this review, the authors define continuity of care as: "Repeated contact between an individual patient and a doctor." In plain language, this means that the same patient sees the same physician on multiple occasions over time, rather than receiving each episode of care from a different doctor. Continuity is one of the plausible mechanisms by which a smaller, more accessible practice might help some patients.

Finally, concierge practices often emphasize prevention which is a cornerstone of modern preventive medicine. However, the devil lies in the details. Screening can include physical exams, laboratory tests, imaging procedures, and genetic tests, but the National Cancer Institute notes that screening tests have risks: false positives can cause anxiety and lead to more tests and procedures, some cancers found by screening may never have caused symptoms or threatened life, and finding cancer early does not always help a person live longer (link). Good preventive care is not the largest possible test menu. It is the right test, for the right person, at the right interval, with a plan for what to do with the result. Whether or not concierge medicine can do this better than standard medicine is an open question.

In summary, concierge medicine may be worth paying for when the product is clearly defined: faster appointments, longer visits, reliable continuity, and help navigating care. It is most defensible when the practice still follows evidence-based medicine, explains billing clearly, avoids overselling unproven testing, and helps patients understand what the membership does not cover. It is more questionable when the pitch depends on vague "optimization," broad screening packages with uncertain net benefit, difficult cancellation terms, unclear insurance billing, or implied promises of better health outcomes that the evidence does not support.

Put simply, concierge medicine buys physician access, it doesn't buy additional healthcare insurance coverage, and the verdict is still out on whether it improves overall health. Finally, an important consideration is whether you can pay the concierge fee.

Figure 1. Kaplan-Meier survival curves for patients whose physician switches to concierge medicine (solid line) and their matched controls (dotted line). The curves denote the fraction of patients who are alive as a function of the number of years since the physician’s switch to concierge medicine. For the control patients, their physician will switch to concierge medicine at some point after the investigational study period, and so the plot represents years when the doctor was not yet practicing concierge medicine (Leive et al. Journal of Health Economics, 2023).