Understanding Concierge Medicine Contracts

Concierge medicine has been gaining traction in recent years, and more and more physicians are exploring the benefits of membership medicine.

By serving patients who are willing and able to pay a premium for personalized, high-touch care, implementing a concierge medicine model can be a lucrative and fulfilling way to practice medicine.

One of the most critical components of a successful concierge medicine model  is retainer medicine contracts.

Well-crafted concierge medicine contracts establish clear expectations, protect your interests as a membership medicine doctor, and foster a smoother, closer patient-provider relationship.

This blog post will delve into the legal considerations with concierge medicine, exploring the key elements, benefits, and best practices for physicians like you.

A Concierge Medicine Legal Checklist: How to Create a Concierge Medicine Contract

Because concierge medicine contracts are a formal agreement between a doctor or practice and their patients, it is important to get good at how to draft a concierge medicine contract.

A concierge practice patient agreement is a legally binding document that outlines the terms and conditions of a doctor-patient relationship in a concierge medicine model. This sets the boundaries of what a patient can expect from their physician, and vice versa.

When crafting concierge medicine contracts, there are several key elements to consider:

1. Clearly defined scope of services: This is the most crucial component of a concierge practice patient agreement as it clearly outlines the services you provide and don’t provide.

• Service inclusions: A comprehensive list of services covered by the membership
• Preventive care (annual exams, wellness programs)
• Chronic disease management
• 24/7 access via phone, text, and/or instant messaging
• Extended office visits 
• House calls and hospital visits (if applicable)
• Telemedicine consultations (if offered)
• Exclusions: Clearly state what services are not covered under the membership. For example, hospitalizations, surgeries, or specialist visits may not be included. Be specific to avoid misunderstandings.
• Insurance clauses: If your concierge medicine practice accepts insurance, clearly state what services are eligible for insurance coverage.

2. Duration: Defining the duration of a concierge practice patient agreement can be critical for both your business operations and patient expectations.

• Contract length: Start and end date of subscription
• Renewal terms: Indicate whether your retainer medicine contracts automatically renew or patients need to sign a new agreement each year

3. Payment terms and membership fees: What sets private pay medicine apart from traditional healthcare is that no middlemen are involved when it comes to payments. This makes interactions genuine, straight to the point, and more efficient.

• Subscription pricing: A valuable industry trend in concierge medicine is tier pricing to better accommodate a wider range of patients.

Define payment terms that are considerate to the patients who can afford that level of subscription, including fees, payment schedules, and any discounts or promotions.

• Payment schedule: Clearly define when payments are due—whether monthly, quarterly, or annually—and whether patients can pay in installments or must pay upfront.
• Additional fees: Make sure to be honest about which services are not covered by the membership medicine subscription. These could include lab tests, specialist referrals, imaging, or procedures like physical therapy. 
• Refund policy: Outline the circumstances under which a patient may receive a refund if they choose to cancel or leave the practice early. Also, clarify whether there are any cancellation fees.

4. Patient responsibilities: Apart from your responsibilities as a physician, part of  membership medicine contract requirements is the patient’s role in concierge medicine.

Outlining these responsibilities can foster closer doctor-patient relationship and clarify the role of patients to ensure the concierge medicine arrangement is a success. These patient obligations can include:

• Providing accurate health information
• Attending scheduled appointments
• Adhering to treatment plans
• Notifying the practice of cancellations or changes in contact information 

5. Availability and access: Patients who subscribe to concierge medicine expect more direct access to their physician.

Retainer medicine contracts define what ‘direct access’ really entails and will prevent misunderstandings between doctor and patient.

• Office hours: Specify your regular office hours and how patients can contact you outside of those hours (e.g., by phone, email, or through a patient portal).
• Emergency access: If you offer 24/7 access, detail how this works—whether patients can call you directly or if they need to contact an after-hours service.

6. Liability and dispute resolution: Concierge medicine contracts protect both you and your patients by way of stating what steps to take should there be liabilities or disputes down the line.

7. Termination clauses: Identify the conditions under which the contract can be terminated.

For example, a patient may choose to cancel their contract if they move out of the area, while you, as the physician, may end the agreement if a patient is non-compliant or violates the terms.

8. Confidentiality, privacy, and ethical considerations: Patient privacy is paramount to establishing trust in membership medicine.

Following HIPAA guidelines, a concierge practice patient agreement should include provisions to protect patient confidentiality and safeguard medical records.

• Data security: Explain how patient data will be stored and protected, whether through secure electronic medical records (EMRs) or physical files.
• Patient consent: Seek prior consent of patients in using their information in compliance with healthcare regulations.

Concierge Medicine Contract Benefits for Doctors

Detailed boutique medicine contracts offer a wide array of benefits for doctors. These include:

1. Clear and transparent expectations: Concierge medicine contracts, as well as direct primary care agreements, establish clear expectations for both the doctor and the patient.

This keeps the relationship transparent and reduces misunderstanding and miscommunication between the two parties.

2. Financial protection: Concierge medicine contracts help outline your practice’s financial structure - how much revenue you can expect to come in every month, when payments are due, and whether there are increases over time.

This can help ensure a steady stream of revenue for private pay medicine practices.

3. Legal protection: Retainer medicine contracts protect the doctor and practice from potential legal issues.

This important document lays out your potential liabilities and sets limitations on your practice’s scope of work and responsibilities.

4. Improved doctor-patient relationships: Because concierge medicine contracts outline responsibilities and expectations between doctors and their patients, this can help foster a more collaborative and respectful patient-provider relationship.

A concierge practice patient agreement makes it clear to patients what they are entitled to and what is excluded from their concierge medicine subscription.

It also clarifies your availability, office hours, and communication methods as a physician, reducing the likelihood of patients expecting more than you can provide.

5. Flexibility: Concierge medicine contracts can be tailored to meet the goals of the practice as well as the unique needs of the patients you serve. This allows for greater flexibility and customization in private pay medicine.

Read more about: Understanding the Concierge Medicine Business Model for Physicians

Concierge Practice Patient Agreement Best Practices

Taking the time to craft comprehensive and effective concierge medicine contracts and direct primary care agreements can do wonders for your practice. Retainer medicine contracts serve as the blueprint of any doctor-patient relationship.

It also serves as a strong foundation in providing exceptional care to patients. That being said, here are best practices to keep in mind when drafting your concierge medicine contract agreement templates:

1. Seek professional guidance: Consult with a lawyer or contract specialist to ensure that your concierge medicine contract agreement templates are legally binding and compliant with relevant regulations.

2. Keep it clear and concise: Use clear, concise language to avoid confusion and make sure your boutique medicine contracts are easy to understand.

3. Be flexible: Every now and then, some patients will request to tweak certain terms or include additional clauses they deem necessary. Be open to negotiating contract terms and making adjustments as needed.

It also helps to bounce off ideas and experiences with fellow doctors and healthcare attorneys, so you are in the loop regarding industry practices and concierge medicine contract negotiation strategies.

4. Comply with legal and ethical standards: The structure and legal requirements around concierge medicine contracts differ per jurisdiction.

Properly drafted concierge medicine contracts should include applicable laws and regulations, including those which are related to telemedicine, medical malpractice, and consumer protection.

5. Stay informed: Because it is quickly becoming the preferred option in healthcare, private pay medicine is undergoing major progress in the space of regulatory clarity.

It is important to turn to the following industry leaders for regulatory updates, new industry procedures implemented, or any bills that have been passed in government:

• DPC Coalition
• Health Rosetta
• American Academy of Private Physicians (AAPP)
• American Medical Association (AMA) 

These industry changes can directly affect how you draft your concierge medicine contracts and certain terms and conditions may be required to be reflected across all retainer medicine contracts.

6. Regularly review and update: Regularly review and update your retainer medicine contracts to ensure they remain relevant and effective.

7. Communicate with patients: Clearly communicate the terms and conditions of the contract to patients so they gain a better understanding of their responsibilities as well as what they can expect from your practice.

Need Help With Your Concierge Medicine Contracts? Here’s How Much It Will Cost

The cost for doctors to have concierge medicine contracts prepared by healthcare attorneys can vary based on a few factors, like location, the attorney’s experience, and how customized the agreement needs to be.

Here's a general breakdown of what you might expect:

1. Flat Fees (Most Common)

• Range: $1,500 – $6,000+
• Basic Agreement: Around $1,500 – $2,500

Covers standard concierge membership contracts, with limited customization.

• Custom or Complex Contracts: $3,000 – $6,000+

Includes integration with existing practice policies, HIPAA compliance review, state law nuances, or special business models.

2. Hourly Rates

• Rate: $250 – $600 per hour (depending on the attorney and region)

A full concierge contract might take 5–15 hours, depending on complexity, so this could land in the $1,500 – $9,000 range.

3. Package Deals or Legal Subscription Services

• Some healthcare law firms offer packages that include:
  • Contract drafting
  • Compliance consultation
  • Regulatory guidance (Stark Law, Anti-Kickback, etc.)
  • Packages may range: $5,000 – $15,000 depending on the depth of service.

It is important to note that these are only ballpark figures. The following factors may affect the actual cost of having retainer medicine contracts prepared by legal professionals:

• Solo practice vs. group practice: Group contracts are more complex.
• Level of customization: Adding specific payment terms, retainer models, service tiers, or telehealth provisions increases time and cost.
• State regulations: States like California or New York may require more legal tailoring due to stricter laws.
• Whether a patient is having their contract converted from traditional healthcare to concierge medicine: May involve extra documents like patient transition notices or termination of third-party payer agreements.

A cost-saving tip we can suggest is to look into concierge medicine contract agreement templates as a baseline, then you can pay for additional legal services should you come across contracts that require customization or official legal counsel.

Appreciating the Value of a Well-Crafted Contract in a Concierge Medicine Business Model

A concierge medicine model offers physicians an opportunity to provide more personalized, patient-centered care while reducing the administrative burden of dealing with insurance.

However, the success of this model depends on having a well-defined, legally sound concierge medicine contract.

By ensuring that legal considerations with concierge medicine are in place, you can avoid many potential pitfalls, protect yourself legally, and build strong, trusting relationships with your patients.