On resource allocation in health care: The case of concierge medicine

Area of Science:

• Health economics
• Healthcare policy
• Medical practice management

Background:

• Resource allocation in healthcare often balances efficiency and equity.
• Exclusive physician arrangements with non-linear pricing contribute to consumer segmentation.
• Concierge medicine, where patients pay a retainer fee for exclusive physician access, is a growing model.

Purpose of the Study:

• To investigate patient selection criteria in concierge medicine.
• To analyze the impact of concierge medicine adoption on healthcare spending and patient mortality.
• To understand the welfare implications of consumer segmentation in healthcare.

Main Methods:

• Utilized a matching strategy to analyze data from the staggered adoption of concierge medicine.
• Examined evidence of patient selection based on health status and income.
• Assessed changes in healthcare spending and mortality rates for affected patients.

Main Results:

• Found limited evidence of patient selection based on health status.
• Observed stronger evidence of selection based on patient income.
• Documented significant increases in healthcare spending for patients switching to concierge medicine.
• Found no statistically significant average effects on mortality rates for these patients.

Conclusions:

• Concierge medicine appears to segment patients primarily by income rather than health status.
• The shift to concierge medicine leads to increased healthcare expenditures without a demonstrable impact on overall mortality.
• Further research is needed to fully understand the long-term equity and efficiency implications of such healthcare models.