St. Louis Primary Care: New Fee Structures and Employer Benefits

St. Louis patients now have more options to see a primary care physician quickly, but access often comes with a new annual fee. As a national shortage of primary care doctors continues, some physicians are leaving large groups to care for fewer patients. In exchange for an annual membership, these doctors offer longer visits and direct communication. Meanwhile, local employers are preparing to cover the cost of a new health benefit for their staff, removing the price tag for eligible employees.

Dr. Hilary Bensinger recently opened an independent concierge practice in Town and Country. She is a board-certified internist who left a large practice because she felt pressure to see too many patients daily. "I’m very thorough, and I spend a lot of time with my patients," she said. "I want to know everything about them and form individualized treatment plans for them, and it was becoming more and more difficult to do so." Her practice charges $2,500 per patient per year and does not accept insurance. Patients receive 24/7 access to her, longer appointments, and preventive screenings.

Other local practices use different models. BJC HealthCare operates BJC Concierge Care on North Mason Road with four physicians. They accept insurance and charge a $1,980 annual membership fee. Benefits include same-day or next-day appointments and 24/7 physician access. MDVIP, a national company, supports physicians in O’Fallon, St. Louis, Town and Country, and Creve Coeur. These doctors set their own annual fees within a regional range and may or may not accept insurance. SSM Health offers Express Virtual Care for minor issues like colds or allergies. E-visits cost up to $41, and video visits cost up to $61, with no insurance required.

A new employer-sponsored model is also entering the market. The Gateway Business Health Coalition is preparing to offer member companies access to Rezilient Health. This St. Louis-founded provider combines telehealth with in-person visits at its CloudClinics. Rezilient was founded by two former Washington University physicians. Under this model, employers pay for the benefit, so employees do not face out-of-pocket charges. At a CloudClinic, an assistant uses connected medical equipment to transmit exam data to a remote physician. The service also offers messaging and same-day consultations in 70 specialties.

"This is a new kind of employee benefit that marries the best of telehealth and in-person care," said Dr. Danish Nagda, Rezilient’s founder and CEO. "It’s virtual, so you can get your doctor virtually via messaging, via telehealth, and in person. The doctors are actually on the screen, and all the tools in a doctor’s office are connected and live streaming to the doctor. So now your doctor can examine you no matter which clinic you go to." Nagda stated the company is working to solve access challenges for employers.

Laurel Pickering, president and CEO of the Gateway Business Health Coalition, said employers are expanding access to care as part of benefits packages. "Employers are starting to offer this for their employees because they see the value in it," she said. Pickering noted that employees using Rezilient are not required to leave their existing primary care physicians. The benefit is intended to provide an additional option.

Membership fees for concierge practices in the area range from $1,980 to $2,500 annually. Patients must decide if the added cost is worth the direct access and longer visits. For those with employer-sponsored options like Rezilient, the service is available without direct cost. Pickering emphasized that maintaining an ongoing relationship with a primary care physician remains the key to better health and lower costs.