Membership Medicine is an emerging model in medicine where the practice and the patient have a direct financial relationship. That means we work for you, not the health insurance company. Patients pay a membership fee to join the practice and use insurance for needs outside of primary care (for example, specialists visits or hospitalization.) Depending on the membership plan you choose, patients either pay a small visit fee directly to the practice or no visit fee at all for primary care visits with the practice.

Laurie Birkholz, MD, and Associates offers two membership models:

The Concierge Medicine Model is an all-inclusive primary care model focused on the unique needs of women. Patients pay an annual fee of $2950 (or monthly payments) and all office visits with Dr. Birkholz are included. In addition, patients will be able to reach Dr. Birkholz for emergency issues after office hours by either calling or texting my personal cell phone, or by email with non-urgent questions. Our visits together range from 30 minutes for follow-up appointments to 60 minutes+ for more complex needs or annual wellness physicals. Patients in this practice will benefit from the “one stop shop” experience of a primary care trained physician with additional Women’s Health and Gynecology training.

Benefits of Concierge Membership include the following:

• All-inclusive, women’s health focused, primary care
• Specialty visits to address unique and often complex women’s health issues such as menopause or sexual health
• Longer appointment times, often 30-60 minutes or more
• Wellness and disease prevention strategies
• Annual body composition and metabolic rate analysis
• 24/7 access to Dr. Birkholz
• Guaranteed same-day or next day urgent visits with a provider
• Comprehensive health care coordination for referrals outside of our office
• Healthcare advocacy if hospitalized or for complex referrals (i.e. oncology, surgical)
• A complimentary 30 minute visit with one of our wellness experts (i.e. nutrition, skin care & aesthetics, pelvic floor therapy)
• Access to deeply discounted in-office labs, prescription medications and other office services
• A state-of-the-art patient portal
• Access to member-only events such as fitness classes, nutrition and lifestyle workshops and other wellness gatherings

The Direct Primary Care (DPC) model is a more affordable way to become a member of the practice. Patients pay a monthly or annual fee based on their age and modest fees for visits. Patients can expect an exceptional standard of care with access to same-day or next-business-day appointments for urgent matters, longer appointment times, little-to-no-wait times, convenient technology and membership in a practice dedicated specifically to the complex health needs of women. DPC patients will also benefit from discounted pricing for consult appointments with Dr. Birkholz to address more complicated Women’s Health concerns and/or procedures. DPC patients will see Physician’s Assistant, Angela Burch.

DPC Pricing
• Age 10-25 – $25 per month
• Ages 26-44 – $45 per month
• Ages 45-64 – $65 per month
• Age 65 and older – $85 per month

DPC Visit Costs
• 60-minute visit – $85
• 30-minute follow-up or acute visit $45

Yes. For women who wish to continue their relationship with their current primary care provider but want to see Dr. Birkholz for menopause/perimenopause, sexual health, breast health, annual gynecologic exams or other specific Women’s Health/gynecologic concerns, I offer consults. Patients do not need to become a member of the practice to schedule consults.

Similar to the Concierge and DPC practices, we will not bill insurance but work directly with you for payment.

Learn more about Women’s Health Specialty Consultations here.
Learn more about Gynecology services here.

Yes. If you and your spouse (or domestic partner) wish to both join my concierge practice, I will discount the second membership to $2,700 annually ($5,650 annually for both).

By starting my own membership-based practice, I have a much greater impact on my patients’ lives than I could in a traditional primary care practice. By using the membership model, I can opt out of traditional health insurance. Now, we are no longer beholden to insurance barriers that dictate your care and require physicians to see an unreasonable number of patients in a day. Rather than carrying a panel of nearly 3,000 patients, I will welcome just 300 members into my practice. This allows us to spend more time together to focus on prevention, overall wellness, and the issues that matter most to you – not just treatment when you are sick. That’s the way I think medicine should be.

Health insurance is important, and I absolutely recommend that patients have health insurance to help cover medical expenses, especially for specialty care and hospitalization.

But the truth is, the out-of-pocket costs for patients are increasing every year. Many patients (especially those with high deductible plans) never reach their deductible in a given year and essentially pay completely out-of-pocket for their care. However, these patients are still being cared for in an outdated and under-equipped model of traditional primary care.

Today’s traditional, insurance-based, medical model works against patients. Doctors are expected to see 26-28 patients in a day, resulting in minimal time with each patient – the average visit? Just 10-15 minutes with their doctor. That’s barely enough time to address immediate health needs let alone focus on prevention and overall wellness. In fact, doctors are actually financially penalized when they do spend time providing preventive health care because more time with individual patients means seeing fewer patients per day.

No. Because Ms.Medicine practices opt out of traditional health insurance, annual membership fees are not covered or reimbursable by insurance. However, insurance might still cover other areas, such as office visits or annual wellness exam, specialists’ visits, hospitalizations, diagnostic testing, etc. In addition, some patients who have Health Savings Accounts (HSAs) are able to receive reimbursement for some costs. Check with your third-party administrator. Our office will be happy to provide you with documentation for you to submit to your carrier.

Patients commit to an initial 6-month membership contract, and after that, you may choose to pay monthly, semi-annually or annually.

I understand. I’d encourage you to consider the amount of money you’ll spend out-of-pocket in an average year for your healthcare needs. Also consider if you’re getting the kind of access, timeliness and care you want from your provider.

Do you have chronic illness, a family history of illness or concerns about your health that you have not had time to discuss with your primary care provider?

Do you feel like you’re getting expert advice about preventative measures you should take to reduce your risk of illness?

Does your doctor address issues such as sexual health, menopause, bone health, and cancer risk with you?

Sometimes, the money you spend to prevent illness results in money saved should you become sick down the road and require extensive or long-term treatment. In fact, academic studies have shown that patients who belonged to a membership medicine practice had fewer emergency department visits and fewer in-patient admissions than those who did not. Unfortunately, good insurance coverage doesn’t always translate to excellent care.

I have always had a special interest in women’s health which is why I decided to pursue additional fellowship training and have dedicated my past 14 years of practice to the care of women. Ms.Medicine is the first national concierge primary care model designed to address the complex medical needs of women. Like me, Ms.Medicine physicians have received additional specialty training in women’s health, and our practices provide an exceptional level of care that addresses women’s unique needs, especially in areas such as menopause, bone health, breast cancer risk assessment, cancer survivorship and sexual health. Ms.Medicine embodies my belief that knowledge is power and by educating women about their bodies and health we empower them to live their best lives.

Sadly, HMO insurance policies are often quite restrictive about services we as providers can render without “prior authorization” or simply put, their approval. This could directly impact, or delay, your ability to receive services at various healthcare institutions and potentially impact your freedom in selecting a healthcare provider that best suits your needs. We value your freedom in selection and quality of care, that’s why we started Laurie Birkholz MD and Associates. We encourage you to contact your insurance carrier to inquire as to whether our providers can be ordering and referring providers for your insurance.

To learn more about how to become a member, sign up, or schedule an appointment please reach out to our office at 616-345-5263 or email info@lauriebirkholzmd.com.

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