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Boutique Care
Benefits & Compensation
Boutique Care
Exchange ideas about health plans, retirement, work/life benefits, and employee assistance.
We have a self insured health plan and recently encountered the issue surrounding the physician fees for "boutique care." It seems the fees are not medical service fees but rather physician fees and n
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Boutique Care
posted at 3/26/2009 5:52 AM EDT
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Posts: 3
First: 3/26/2009 Last: 3/26/2009 |
We have a self insured health plan and recently encountered the issue surrounding the physician fees for "boutique care." It seems the fees are not medical service fees but rather physician fees and not covered under our health plan, has anyone encountered this subject? If so, can you share any information?
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Boutique Care
posted at 3/26/2009 6:25 AM EDT
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Posts: 2146
First: 2/15/2006 Last: 9/14/2011 |
I have encountered it in the following way. I manage two individual health insurance plans for two of our Board of Directors/owners. They pay the premiums but I help with claims/information, etc.
Their primary care physician just moved to a "boutique service" where he has decided to have x number of patients. Each patient has to pay an annual fee -- outside of health insurance. But for that fee, they were guaranteed two physical appts per year at no charge plus the ability to schedule other appts quickly and easily and be able to see that specific doctor. I don't remember the exact details. If we had a self-funded plan, we would not pay the fee, but would reimburse the employee for the 2 physical exams at market insurance rates (i.e. what have you paid the dr's offices for physical exams for other employees?) once they have proof that they took advantage of them. The other visits where there are regular costs, we would pay as normal. |
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Boutique Care
posted at 3/26/2009 11:39 AM EDT
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Posts: 3
First: 3/26/2009 Last: 3/26/2009 |
rrupert - thanks for the response. Same situation here with the physician. We do pay for services other than the appropriate deductibles. A top employee is suggesting amending our plan to cover those fees which are currently not covered as they as just physician fees that excludes fees for services and so I am looking into the matter but curious as to how many employers are encountering this issue. |
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Boutique Care
posted at 3/26/2009 12:04 PM EDT
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Posts: 2146
First: 2/15/2006 Last: 9/14/2011 |
I suspect that at some companies these are one of the many perqs that are given at an executive level. For example, if the company already give the exec the perq of two free medical physicals a year, this could be a good add on as an inexpensive benefit that means a lot. Because it also means that the exec doesn't have to worry too far in advance to schedule appts, etc. Honestly, based on other exec perqs, it makes sense in the fact that it isn't an expensive benefit to provide, but has a higher value.
I suspect that it is NOT occurring on the general employee population level. As employers are struggling to pay basic health insurance premiums, I can't imagine them adding on a willingness to pay this for "rank and file". |
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Boutique Care
posted at 5/13/2009 9:03 AM EDT
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Posts: 1
First: 5/13/2009 Last: 5/13/2009 |
I have seen the physician fees for boutique services as high as $10,000 per year not including standard care. FOr the annual fee the patient receives unlimited access to the doctor of their choice, for ANY reason, at any time, however these doctors generally do not participate in insurance in-network systems. All "charges" need to be submitted as out-of-network.
I would not consider paying the doctor's fee,for any employee, but would reimburse at the standard rate for actual services rendered. |
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Boutique Care
posted at 5/13/2009 9:30 AM EDT
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Posts: 1
First: 5/13/2009 Last: 5/13/2009 |
Our primary health plan doesn't cover this, however I was informed by my PCP that FSAs do reimburse the cost. My physician narrowed down his huge number of patients by going into this "boutique" or managed care practice by charging $1500 per patient to stay with him(which covered the spouse as well). This is like triple jeopardy insurance--you pay for health insurance and pay again to retain the doctor who'll end up charging you for services rendered in addition to an upfront fee. Where does it end? I also noted that most who stayed with him and paid the fee were elderly who didn't want to find a new doctor to discover their illness and write scripts to maintain their health. Another term for this is: Medical Blackmail. |
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Boutique Care
posted at 5/13/2009 12:20 PM EDT
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Posts: 1
First: 5/13/2009 Last: 5/13/2009 |
I recently ran into a unique "boutique" type of operation in Arizona. The annual fee is only $486 / Individual and $680 / Family. Members have up to 12 doctor visits available per year for individual and 16 visits per family. If you are interested let me know and I can hook you up with them. Our agency is a marketing arm of this firm and we have several large employers in AZ who are interested for all of their employees. 480-940-0070 (Ask for Steve) |
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Boutique Care
posted at 5/14/2009 6:53 AM EDT
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Posts: 464
First: 6/30/2004 Last: 11/22/2010 |
I have not heard about this practice.
While I don't particularly like it, I think it is a business response from the medical community being forced to accept all the low costs reimbursements from HMO's and the like. $10,000 per year? I cannot imagine that one. |
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