Concierge Medicine IN PRIMARY CARE CONSTANTINE GEORGE, M.D. BOARD CERTIFIED INTERNAL MEDICINE / PEDIATRICS CHIEF MEDICAL OFFICER & FOUNDER EPITOMEDICAL & THE VĒDIUS APP epitomedical.com | vediusapp.com

Traditional Medicine System is based on a fee-for-service system Doctor(s) must be in network to see patients Insurance company fee schedule is followed Current system prioritizes volume

Traditional Medicine Usual appointment time averages 15 minutes 2,500-3,000 patients per year on a primary care panel Appointments may not be available same day Longer waiting room waits

Concierge Medicine Doctor(s) charge an annual fee Have fewer time constraints with patients Same day appointments Accessibility of doctor via text / phone call or email 24/7 House call availability

Concierge Medicine Physicians have less volume of patients Able to provide more attentive care Better able to discuss and address preventative care and lifestyle changes Concierge vs Direct Primary Care ????

Retainer Based Medicine Physician charges an annual retainer fee This is not a substitute for health insurance Fee is not reimbursable by private health insurance, Medicare and / or health savings accounts Fee is variable as are the “benefits” of the fee

Retainer Based Medicine Annual fee may cover for primary care services not customarily covered by their health insurance plan such as annual comprehensive / executive physicals and labs and physician continues to bill health insurance plan for covered medical services and patient is responsible for copays and / or deductibles Some physicians have an annual fee that covers all primary care services therefore eliminating health insurance

Retainer Based Medicine Annual fees will not cover hospitalizations, surgeries, radiographic examinations such as MRI or CT scan, emergency room visits Retainer fee offices statistically have higher rates of house calls, 24/7 physician access, same day appointments, better coordination of care, quicker access to specialists

Direct Primary Care Have lower monthly fees Physicians charge this fee and it does cover all primary care services in the office and does not limit the number of visits No health insurance plan is involved in this set up Monthly fee may be paid by an employer or the patient “Concierge” services are not always provided

Differences Between the Two? DIRECT PRIMARY CARE CONCIERGE MEDICINE Monthly fee < $100 Generation X / Millennial < $100,000 / year income No insurance involved Fee paid by employer or patient Monthly fee > $100 Baby boomers > $125,000 / year income Insurance may be involved Fee paid by patient

Similarities Between the Two? DIRECT PRIMARY CARE CONCIERGE MEDICINE Decreased patient panel Longer office visits Monthly fee Insurance is not involved Decreased patient panel Longer office visits Monthly fee Insurance may or may not be involved

Concierge Patient Advantages Longer office visits Shorter waiting room times Preventative care Physician availability Same day appointments House calls Coordination of care

Concierge Patient Disadvantages Priced out Physician no longer takes insurance Patients are used to the standard fee for service health care model and resistant to change

Concierge Physician Pros Smaller patient panel Longer appointments Less waiting room time Less overhead Customization

Concierge Physician Cons Loss of your base of patients More demanding patients with higher expectations Pricing yourself too high or too low Perception to the community

Concierge Medicine Statistics Better outcomes and cheaper overall expenditure for health care Primary care more so than specialists As of 2016 7% of physicians are in concierge medicine with another 13% planning on transitioning Younger physicians more likely to consider concierge medicine Retention rate of patients from traditional medical practice to concierge is about 25%

Thank You CONSTANTINE GEORGE, M.D. EPITOMEDICAL 8859 West Flamingo Road Las Vegas, Nevada 89147 844 693 7486 constantine.georgemd@epitomedical.com epitomedical.com | vediusapp.com