Premium Healthcare Now

The wealthy know how to get premium healthcare and now so can you. America is rapidly evolving into a two-tiered healthcare system where the wealthy are moving far away from the travesty that is Obamacare. Top-rated medical professionals cannot possibly be compensated in the socialistic confines of O’Care and, thus, are opting out—far out.

State and federal exchanges, as well as Medicare and especially Medicaid patients, will be out of luck and far off the radar of the finest healthcare professionals. Cutting-edge clinics and stand-alone operating facilities will operate on a concierge, cash-only basis. These facilities will be staffed by entrepreneurs committed to offering world-class healthcare to cash-paying clients. The government as well as the insurance industry will be persona non grata in this cash-oriented entrepreneurial system. States such as Florida, Texas, Wyoming and New Hampshire will be leaders in welcoming digital-age, cash-based facilities. Healthcare entrepreneurs will treat burdensome tax and regulatory purgatories (New York, California, Rhode Island, Illinois) as unsuitable for location.

Grand Rounds is one of many health care startups offering on-demand, concierge-like services once reserved for the ultra-rich to the middle class — similar to what tech outfits like Google, Amazon, Uber, and Lyft have done with personal shopping andtransportation. These budding health care companies offer basic access to medical advice, appointments, and other assistance. Some operate regionally, others nationally. Their services and prices vary substantially, but all aim to fill gaps in the existing health care system, in part by using the internet.

Often, they charge monthly or annual subscriptions — say $50 a month or $149 a year for primary care services — although physical exams, surgeries, and second opinions from specialists can cost more. At Grand Rounds, an online second opinion runs $7,500 and an appointment with a specialist is $200. But Sommers only paid $30 because he was covered through his son’s employee benefit package, which includes access to Grand Rounds.

Generally, these startups say, consumers pay them less than the tens of thousands of dollars a yearthat wealthy clients pay traditional concierge physicians for immediate access to high-end primary care. These startups profit by selling their services directly to consumers or to employers. Some of the firms accept insurance or payment through health savings accounts.

In Silicon Valley, employers are already piling concierge medical services atop their traditional health insurance offerings. For bigger companies, these services are a natural extension of the other perks — free dry cleaning, meals, housekeeping, shuttles — they provide to save employees time. “The market for these vendors is huge,” says Lynne Collins, vice president of human resources at the file-sharing service Hightail, based in Campbell, California, which offers Grand Rounds and Bay Area-based One Medical as benefits. For her company, adding these was a “no-brainer.”

Tailored Health Care

With the benefit of technology, the concierge firms say they offer a more tailored, streamlined health care experience than consumers can get otherwise. They also contend they provide better quality. Grand Rounds, for instance, chooses its doctors from a list of 520,000 physicians based on an algorithm, plugging in variables such as research and publication history, patient outcomes, and how other doctors rate them.

It’s all part of a shift toward personalized consumer-centered health care — a trend facilitated by the internet and growing digital access to medical information. Obamacare has helped by spurring the creation of online marketplaces for health care consumers and accelerating reliance on electronic medical records and data. In recent years, the government has released previously vaulted datasets on pricing and quality into the public domain, allowing tech companies to create tools that help consumers access better, sometimes cheaper, care.