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Does Concierge Care Improve Outcomes? What the Studies Show and Who Paid for Them
Patients ask it, and so do reporters. The honest answer takes more than one sentence. This brief maps every outcomes study CMT could open, labels each by design and funder, separates the continuity research from the concierge research, and gives you a checklist for reading the next claim that lands in your inbox.
New in October 2026. A companion to Brief No. 26, Answering the Critics, which covers cost and equity in more depth.
Start here: the questions this brief answers
Tap a question for the short answer, then jump to the evidence.
No independent study has shown that concierge membership helps patients live longer. The strongest independent study, of Medicare patients whose physicians converted, found higher spending and no change in average mortality. Four peer-reviewed studies linked to MDVIP, the largest concierge network, report fewer hospital admissions or emergency visits among members. Each was funded by MDVIP or co-written by its staff, and none can fully rule out that healthier, wealthier patients chose to join. Separate research on continuity with one doctor links it to fewer admissions and lower mortality; that work did not study concierge practices. A physician can honestly promise access and point to high satisfaction among members who stay. Longer life has not been shown, and the hospital findings should always be quoted with their funder.
Does concierge care improve health outcomes?
It has not been shown to extend life. The independent Journal of Health Economics study found no average mortality change and higher spending. MDVIP-linked studies report fewer hospital admissions and ED visits, with designs that cannot fully rule out selection.
Go to the full answer ↓Can I trust studies funded by MDVIP?
Read them as evidence with a disclosed interest, not as proof or as propaganda. They are peer-reviewed observational studies. The better ones used matched comparison groups; the weakest compared members with outside benchmarks.
Go to the full answer ↓What about the research on continuity of care?
A 2018 systematic review found that 18 of 22 studies linked greater continuity with a doctor to lower mortality, and a Norwegian registry study of 4.5 million people found a dose response. Neither studied concierge practices.
Go to the full answer ↓Are concierge patients more satisfied?
Company-run surveys report satisfaction above 90%. They survey current members, who chose to stay, and no independent satisfaction study of concierge patients turned up in CMT’s search.
Go to the full answer ↓What can I honestly say when someone asks about outcomes?
Describe what the membership buys, cite the studies with their funders, and do not promise better outcomes. Part 4 offers wording for each audience.
Go to the full answer ↓How do I check an outcomes claim quickly?
Use the nine-question checklist in Part 5. Funder, comparison group and pre-membership data answer most of it.
Go to the full answer ↓The strongest independent study found more spending and no mortality change
If a physician says concierge care improves outcomes, the first study a skeptical reporter will raise is this one. It belongs at the top of any honest answer.
Economists Adam Leive, Guy David and Molly Candon studied patients whose physicians switched to concierge practice. Using the staggered timing of those switches and a matching strategy, they reported “large spending increases and no average mortality effects for patients impacted by the switch to concierge medicine,” along with limited evidence that patients selected in on health and stronger evidence that they selected in on income. The paper appeared in the Journal of Health Economics in 2023.1 Population Data
An earlier conference version describes the data: claims from a 20 percent sample of Medicare beneficiaries who were patients of physicians working with one of the largest companies managing retainer practices.2 Penn’s Leonard Davis Institute, which summarized the final paper, reported that enrollees’ total spending was more than 25% higher than a comparison group one year after the switch, and that enrollees were slightly older, had fewer chronic conditions and were more likely to be white.3
The study measured spending and death among Medicare patients over a follow-up of a few years. One commentator noted that a five-year window is a small slice of a 65-year-old’s remaining life, and that the study was limited to Medicare beneficiaries because their data were easiest to get.4 It did not measure function, quality of life, continuity or patient experience, and its physicians all worked with one management company. CMT’s reading: the study is careful and independent, and it shows that concierge care has not been shown to save lives or money for Medicare. It does not show that members gain nothing. Brief No. 26 covers its equity findings in more depth.
Notice what the numbers in the last tile imply, if the commentary has them right: roughly four in five patients of converting physicians did not join. Any outcome claim about members is a claim about a self-selected minority of a physician’s former panel.
Every concierge outcomes study CMT could open, with its funder
Most of the favorable evidence comes from MDVIP, the largest national concierge network. MDVIP’s website cites hospitalization rates 79% lower for Medicare members and 72% lower for privately insured members, citing the American Journal of Managed Care; the figures match the 2010 results of a 2012 article by MDVIP authors.5 Industry Research Here is that article alongside the rest of the record.
The rows run from the strongest comparison design to the weakest, in CMT’s editorial reading. A strong comparison follows the same patients before and after joining and matches them to similar patients who did not join.
| Study | Design and comparison | What it found | Funding and ties | Main limit | Evidence type |
|---|---|---|---|---|---|
| Leive, David and Candon, J Health Econ, 20231 | Medicare claims; patients of physicians who switched, matched using staggered switch dates2 | Large spending increases and no average mortality effect; selection tracked income more than health | Not stated in sources CMT could open; authors are university economists | Medicare only; one management company; spending and death are the only outcomes | Population Data |
| Morefield et al., Am J Manag Care, 20206 | Traditional Medicare patients with diabetes; propensity matching and difference-in-differences; 3 years before to 5 years after joining | Unplanned admissions about 10% lower and ED visits slightly lower; total spending not significantly different over 5 years (about $1,000 lower in year 5 only) | Funded by MDVIP, which commissioned the evaluators; one author was its chief medical officer and held stock | Authors note exposure to unobserved changes over time; diabetes patients only | Population Data |
| Musich et al., Am J Manag Care, 20147 | UnitedHealthcare Medicare Advantage, 2007 to 2012; 2,320 members matched to former patients of the same physicians who did not join | Significantly fewer ED visits and admissions; savings of $86.68 per member per month in year 1 (approaching significance) and $47.03 in year 2 | Funded by MDVIP; one author an MDVIP officer | Small sample; one insurer; savings not clearly significant | Population Data |
| Musich et al., Popul Health Manag, 20168 | Employer-sponsored plan data, 2009 to 2014; 10,186 members and matched nonmembers, ages 35 to 849 | Less ED and urgent care use; share of members with cost savings grew over 3 years | Not stated on the record CMT opened; co-author was MDVIP’s chief medical officer | Observational; nonmembers drawn at random from plan data, not from the same practices | Population Data |
| Klemes et al., Am J Manag Care, 201210 | Hospital discharge database in five states, 2006 to 2010; members identified by attending physician; no patient identifiers | Members 42% to 62% less likely to be hospitalized by year; Medicare readmissions 91% to 97% lower than Dartmouth Atlas rates | No external funding; authors employed by or affiliated with MDVIP | No patient-level data or baseline; readmissions compared with outside benchmarks, not matched patients | Population Data |
| NORC and Georgetown for MedPAC, 201011 | Literature review and interviews with 16 retainer physicians | Found “a dearth of independent studies comparing outcomes”; noted MDVIP’s utilization data were not risk adjusted | Federal (prepared for MedPAC, which does not endorse its views) | Predates every study above | Practice Insight |
The case against these studies is simple. People who pay a membership fee, and keep paying it, differ from people who do not, in income and in health habits. Matching on claims history cannot capture all of that. All four were funded by MDVIP or co-written by its executives or employees, and the most dramatic figures, the 91% to 97% lower readmission rates, came from the weakest design, which compared members with national benchmarks rather than with similar patients.10 Federal contractors flagged the risk-adjustment problem as early as 2010.11
The response. Industry funding does not make a study wrong, and these were peer-reviewed with their ties disclosed. The 2014 study used the same comparison the independent economists used, patients of the same converting physicians who did not join, and still found fewer ED visits and admissions.7 The 2020 study, the most rigorous of the group, reported that total spending did not change significantly over five years, a result that cuts against the sponsor’s interest.6
One more contrast is worth naming. The 2014 MDVIP-funded study (Medicare Advantage) and the independent 2023 study (traditional Medicare) used similar comparison groups and reached different conclusions about cost. Different insurance designs and study years could explain the gap. CMT’s reading is that both can be partly right: members may use the hospital less while the system still spends more on them overall. Nobody has tested that directly.
The continuity evidence is stronger, and it is not about concierge medicine
Concierge physicians often argue from continuity: a smaller panel means patients see the same doctor, and seeing the same doctor is good for health. The second half of that argument has real support. The first half has not been measured.
Read every study in this part as research on continuity with a regular doctor. None of them studied membership or concierge practices.
Of 22 studies from nine countries, 18 found that greater continuity with doctors was significantly associated with lower mortality. Every included study was observational; no randomized trial met the criteria. The authors note small effect sizes and possible reverse causation. No specific grant funding.12
Registry study of 4,552,978 Norwegians with a regular GP. Compared with a one-year relationship, a relationship of more than 15 years carried lower adjusted odds of acute admission (0.72) and of death (0.75), with a steady dose response. Funded by a Norwegian research institute.13
Among about 1.2 million Medicare beneficiaries, patients of physicians in the top fifth for continuity had 14.1% lower adjusted spending and 16.1% lower odds of hospitalization than those in the bottom fifth. One year of data. Funded by the American Board of Family Medicine Foundation.14
No study CMT found measured whether concierge membership raises continuity on a standard index such as the Usual Provider of Care score. Until someone does, the continuity literature supports the idea of a long relationship with one doctor. It does not show that a membership fee delivers one.
If continuity is the mechanism, a practice can measure it. What share of each member’s visits last year were with their own physician, and how many members have stayed five years or longer? Those two numbers would say more about outcomes than any satisfaction score.
High satisfaction, thin independent data
Patient satisfaction is the outcome concierge practices cite most, and it is the one with the least independent data behind it.
MDVIP describes a study in The Open Public Health Journal of its 2011 and 2012 member surveys (16,271 members in 2012): 97% were satisfied with their physician relationship, compared with 58% in a conventional-care group, and 90% intended to renew.15 Industry Research A 2015 survey by Concierge Choice, a company serving concierge practices, reported that 97% of roughly 18,000 surveyed members would recommend membership to a friend.16 Industry Research
Both surveys asked current members. People unhappy with a membership tend to leave it, so surveys of those who stay overstate satisfaction for everyone who ever joined. Neither source CMT opened reports a response rate. The comparison group in the MDVIP study is not described in the material CMT could see. CMT searched for an independent, peer-reviewed survey of concierge patient satisfaction and did not find one.
To patients
“Membership buys time and access: longer visits and a physician who knows you. Studies funded by the largest network found fewer hospital stays among members. An independent study found no difference in survival. I can promise the access. I cannot promise you will live longer.”
The AMA asks retainer physicians to “take care not to imply that more or better medical services will be provided” under the contract.17
To journalists
Name the Journal of Health Economics study before they do, and describe it accurately. Then name the MDVIP-funded studies with their funder in the same sentence. Offer your own practice data, such as member tenure and ED visits per 1,000 members, with the method stated. Reporters notice when a source volunteers the inconvenient study.
To employers
Employers ask about cost. The honest summary: two MDVIP-linked studies using insurer data reported fewer ED visits, one with savings that did not reach clear significance, and the most rigorous MDVIP-funded study found no significant change in total Medicare spending over five years.7,
Lines to retire
- “Concierge patients live longer.” No study shows it.
- “Studies prove concierge care saves money.” The independent study found the opposite for Medicare.
- Any hospitalization percentage quoted without its funder and year.
- Continuity statistics presented as if they were concierge results.
“Concierge medicine didn’t create the primary care shortage. It made it visible. The fair question, and one this field has to answer with data rather than slogans, is what happens to patients who don’t join. We publish the critics’ research alongside our own for that reason.”
Michael Tetreault, Editor-in-Chief, Concierge Medicine Today. Commentary from the CMT Media Desk, labeled as CMT’s view, not a research finding.18 CMT original
How to read an outcomes claim
Use this on any outcomes claim about concierge care, favorable or critical: a vendor deck, a press release, a news story, a study a patient forwards. Each item you can check off makes the claim more trustworthy. It is a reading aid, not a scoring system.
Before I repeat this claim, do I know...
Read the funders
Before citing any outcomes figure, find the funding and disclosure lines. Put the funder in the same sentence as the number.
Measure your own
Track member tenure, the share of visits with the member’s own physician, ED visits and admissions per 1,000 members. Publish the method with the numbers.
Promise access, not longevity
Describe what the membership delivers today. Let the evidence, not the brochure, decide what you claim about health.
How this brief was built
CMT searched for published studies and company-reported data on outcomes in concierge or retainer-based primary care, and separately for systematic reviews and large registry studies of continuity of care. CMT started from its own Brief No. 26 and the reference library behind it, then opened every source again in October 2026, including each article’s funding and disclosure statements. The Journal of Health Economics study is behind a paywall; CMT relied on its published abstract, an earlier conference abstract, the Penn LDI summary and one published commentary, and says so in the references. The Open Public Health Journal satisfaction study is cited only through MDVIP’s description of it, because CMT could not locate the article itself.
Every study is labeled by its design, not its funder, so peer-reviewed industry-funded studies carry the Population Data label, with the funder named in the text and the reference list. Company websites and company-run surveys are labeled Industry Research. Continuity studies are labeled as continuity research, not concierge research, wherever they appear. The 2018 continuity review is labeled Clinical Trial Evidence because it is a systematic review, although every study it included was observational. No direct primary care outcomes data are included, because none of the studies here examined DPC.
How to read the evidence types
Every key finding is labeled by evidence type. Labels describe the type of evidence, not its value. Each type answers different questions. Funding is disclosed on every source.
Randomized trials and systematic reviews.Best for cause and effect.
Large observational studies and government data.Best for trends at scale.
Surveys, smaller studies and expert consensus.Best for real-world experience.
Company-sponsored or company-reported data that is not peer-reviewed.Best for early signals and operating data.
Statutes, regulation and official guidance.Best for what is required.
What we don't know
- Whether concierge membership raises measured continuity of care. Practices assert it; no study CMT found measured it with a standard index.
- Outcomes outside the hospital: function, quality of life, time to diagnosis, and how patients die. None of the concierge studies measured them.
- What happens to the health of patients who do not join when their physician converts. The Journal of Health Economics study tracked them for spending and mortality only.
- Whether results from one national network apply to independent practices, hospital-owned programs or higher-fee practices.
- Independent satisfaction data for concierge members, collected with a published response rate.
How to cite this brief
External review: this brief has not yet been reviewed by an outside expert. When review is complete, the reviewer is credited by name above with any conflicts of interest, and the version number is updated. Reviewers check accuracy and fairness; CMT is responsible for the final content.
Corrections policy: when an error is identified, CMT corrects it in the open and updates the version number above. Send corrections to the editor through conciergemedicinetoday.net.
Related CMT Research Briefs
References
- Leive A, David G, Candon M. On resource allocation in health care: the case of concierge medicine. Journal of Health Economics. 2023;90:102776. doi:10.1016/j.jhealeco.2023.102776. ideas.repec.orgFunding: not stated
- Leive A, Candon M, David G. The economics of retainer-based medicine. Conference abstract, 7th Annual Conference of the American Society of Health Economists (ASHEcon), Atlanta, June 11, 2018. Earlier version of the Journal of Health Economics study. ashecon.confex.comFunding: not stated (conference abstract)
- Hinckley J. Concierge medicine drives higher health costs without extending lives. Penn Leonard Davis Institute of Health Economics. September 18, 2023. ldi.upenn.eduFunding: not stated (research summary by Penn LDI)
- Dinerstein C. Concierge medicine: worth the price? American Council on Science and Health. June 17, 2024. Commentary on the Journal of Health Economics study. www.acsh.orgFunding: not stated (commentary published by the American Council on Science and Health)
- MDVIP. Proven primary care health outcomes for patients (company website). Accessed October 2026. www.mdvip.comFunding: industry (MDVIP company website)
- Morefield B, Tomai L, Slanchev V, et al. Payer effects of personalized preventive care for patients with diabetes. American Journal of Managed Care. 2020;26(3). Study commissioned by MDVIP; one author is MDVIP's chief medical officer. www.ajmc.comFunding: industry (MDVIP; authors were commissioned by MDVIP to evaluate)
- Musich S, Klemes A, Kubica MA, Wang S, Hawkins K. Personalized preventive care reduces healthcare expenditures among Medicare Advantage beneficiaries. American Journal of Managed Care. 2014;20(8):613-620. www.ajmc.comFunding: industry (MDVIP; the article states the study was funded by MDVIP); one author is an MDVIP officer
- Musich S, Wang S, Hawkins K, Klemes A. The impact of personalized preventive care on health care quality, utilization, and expenditures. Population Health Management. 2016;19(6):389-397. doi:10.1089/pop.2015.0171. Repository record via University of Michigan Deep Blue. deepblue.lib.umich.eduFunding: not stated on the record CMT opened; co-author Andrea Klemes was MDVIP's chief medical officer
- Vora P. Personalized preventive care positively impacts cost savings, health management. AJMC news report on the 2016 Population Health Management study. March 6, 2016. ajmc.comFunding: not stated (news report)
- Klemes A, Seligmann RE, Allen L, et al. Personalized preventive care leads to significant reductions in hospital utilization. American Journal of Managed Care. 2012;18(12):e453-e460. Authors from MDVIP or MDVIP-affiliated physicians, plus one consultant. www.ajmc.comFunding: none reported (the article states there were no external funding sources); four authors were employed by or affiliated with MDVIP, and one reports payment for preparing the manuscript, payer not stated
- Hargrave E, Mahmud A, Quirk K, Summer L, Hoadley J (NORC at the University of Chicago and Georgetown University). Retainer-Based Physicians: Characteristics, Impact, and Policy Considerations. Report to the Medicare Payment Advisory Commission, No. 10-9. October 2010. MedPAC states it does not endorse the views expressed. www.medpac.govFunding: federal (prepared under contract for the Medicare Payment Advisory Commission)
- Pereira Gray DJ, Sidaway-Lee K, White E, Thorne A, Evans PH. Continuity of care with doctors: a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open. 2018;8(6):e021161. bmjopen.bmj.comFunding: none reported (the authors state the research received no specific grant)
- Sandvik H, Hetlevik O, Blinkenberg J, Hunskaar S. Continuity in general practice as predictor of mortality, acute hospitalisation, and use of out-of-hours care: a registry-based observational study in Norway. British Journal of General Practice. 2022;72(715):e84-e90. doi:10.3399/BJGP.2021.0340. bjgp.orgFunding: research institute (National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre AS); data from the Norwegian Patient Register
- Bazemore A, Petterson S, Peterson LE, Bruno R, Chung Y, Phillips RL Jr. Higher primary care physician continuity is associated with lower costs and hospitalizations. Annals of Family Medicine. 2018;16(6):492-497. doi:10.1370/afm.2308. www.annfammed.orgFunding: foundation (American Board of Family Medicine Foundation, through a research contract with the Robert Graham Center)
- MDVIP. 97% satisfaction rate reported by The Open Public Health Journal for patients of MDVIP-affiliated practices (company blog post describing a study of 2011 and 2012 member surveys). Undated. www.mdvip.comFunding: industry (MDVIP company blog)
- Lipton W. What patient surveys say about concierge medicine. Physicians Practice. November 19, 2015. Reports a 2015 member survey conducted by Concierge Choice. www.physicianspractice.comFunding: industry (survey conducted by Concierge Choice, a company serving concierge practices; published as a Physicians Practice article)
- American Medical Association. Code of Medical Ethics Opinion 11.2.5: Retainer Practices. code-medical-ethics.ama-assn.orgFunding: not stated (American Medical Association ethics policy)
- Concierge Medicine Today. Media Desk: quotes from the Editor-in-Chief, FAQs and data. Accessed October 2026. conciergemedicinetoday.netFunding: Concierge Medicine Today (self-published; no outside funder) CMT original
Educational and informational only. This CMT Research Brief does not constitute medical, legal, tax, financial, accounting or other professional advice, and it does not create a professional relationship of any kind. Statements about laws, regulations, tax rules and payer policies are general, may not reflect the rules in your state, and can change after publication. Consult a qualified attorney, accountant, tax adviser, compliance professional or licensed clinician before acting on anything here.
Independence. Concierge Medicine Today is an independent publication. It does not accept payment for favorable coverage, and it does not favor one practice model over another. Company names and products are mentioned for context only and are not endorsements. Funding is disclosed for every source in the reference list.
Accuracy. CMT verifies figures against their original or best available sources at the time of publication. Where a figure is an estimate, an inference or a company-reported number, the brief says so. This content is not without possible error or omission.
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