According to Victoria Stagg Elliott, American Medical News: Practices develop new payment system for uninsured

Some offices, in an attempt to make office based charges more affordable and more transparent, are developing concierge style billing and services. Patients pay a monthly, quarterly or annual fee and in return receive basic primary care services.   The 'concierge' fees are lower and the services more basic, primary care.

Practices develop different approaches to this method...Some require an office co payment to shift some of the costs. Some practices require a one year commitment to plan on some revenue.

Most practices set a maximum number of visits and some require a sign up, initiation fee.  Practices must be careful not to structure services in a way to assume risk,  this would be too similar to insurance.

Creating a discount membership program for the uninsured is a marvelous way to fulfill your commitment to caring for people who cant afford insurance.  

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