90% Reduction in Hospital Admissions

MDVIP is the largest and most organized company practice wide scale retainer medicine today. Their business model is fee for non-covered services, which basically means that the retainer fee is for additional care, not covered by CMS, but Medicare is still billed when appropriate.

One of the common arguments against direct medical practices is the belief that if all doctors converted, then this would greatly exacerbate the physicians shortage, thus doing more harm than good. A reasonable concern. However, analysis of the MDVIP hospital admission rates tells a different story.

Medicare vs. MDVIP Hospital Discharges / 1000

(State Reported Data Jan 1 Jun 30, 2005)

Now, I appreciate that in general the population of MDVIP might be more affluent than your typical medicare patient. However, it is logical that when doctors spend vastly more time with their patients, clinical improvements are bound to result. (pay for performance anyone?) Perhaps the numbers would change if more doctors practiced this model, but the trend would likely remain the same.

Such a reduction in admissions would go a long way in decreasing the burden of a physician shortage.

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  • blogborygmi

    Please provide more data to support that chart. Right now I can think of a dozen reasons why MDVIP admission rates are lower, besides the “more quality time with MD” argument.

    Specifically, I’m thinking about that “innovative” Brooklyn doctor, Jay Parkinson, that makes housecalls and manages patients on his iPhone. Buried in all his interviews is the fact he only sees patients under 40 with no comorbidities.

    OK, sure — but if I only saw healthy rich young patients, my admission rates would drop by 90% as well.

  • JoshMD

    You’re absolutely right, there are numerous reasons to argue against those statistics. No stat is bullet proof.

    I’m not a spokesperson for MDVIP, but I do agree with their position (obviously). I’ve put in a request for more info from them.

    One important point, is that they are comparing their medicaid pts verses other medicaid patients. So in this sense, they aren’t cherry picking “young healthy” pts. This isn’t to say that they don’t have a lot of “old healthy” pts.

    Of course, its hard to sell expensive VIP-care to healthy individuals. Its reasonable to assume that people with chronic illnesses are more likely to see unlimited visits as a commodity than your avg pt.

    Thanks for the great question, we’ll see if MDVIP’s CEO responds.

  • Anonymous

    Josh, is this the only thing you care about…pushing concierge medicine and ranting against universal coverage? Boring!


    I am hearing similar ppropaganda from a partner who is planning on joining MDVIP–the covered physical has no more true substance than my 30 minute physical (a hearing test and a mental acuity test given by an MA).
    Certainly, there will be fewer hospitalizations from a population who is affluent (the majority of whom are working full-time).

  • Anonymous

    I was recently abandoned by my physician of 15 years because the group he is with decided to switch over to this form of elitist healthcare. In this case, the greedy third party outsider that brought this all about is MDVIP. If I wanted to continue on with my physician, I would have to sign a contract and pay MDVIP $1,500.00 per year simply to have access to my doctor. My primary insurance company would still be forced to pay for all office visits, lab tests and any in-house procedures. In retrospect, I never needed a third party outsider to get quality care from my physician and I’m not about to line the pockets of some greed driven outsider who has absolutely no interest in my well being. This concept is very unethical and patients are the real losers under this particular business model. Medicare and all insurance companies should refuse reimbursing physicians who adopt this approach to patient care.

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