MDVIP and Concierge Medicine Networks: How Franchise Models Compare to Independent Practices

Concierge medicine is a care model where patients pay a recurring membership fee directly to a primary care doctor in exchange for enhanced access and services. That fee might cover same-day appointments, longer visits, direct phone or text access to the physician, and a smaller patient panel so the doctor has more time for each person. The American Academy of Family Physicians recognizes concierge medicine as one of several direct-pay practice models that operate outside the traditional fee-for-service insurance billing system.

It is important to understand that a concierge membership is not health insurance. It does not cover hospitalizations, specialist visits, surgeries, or prescription drugs. Patients who enroll in a concierge practice typically still carry a separate health insurance plan or a cost-sharing arrangement for those larger expenses. The membership covers primary care access and the services the practice explicitly lists in its agreement with you.

Concierge practices vary widely in what they include and what they charge. Some practices bill insurance for covered services on top of the membership fee, while others operate on a fully cash-pay basis. Before enrolling anywhere, ask the practice for a written list of exactly what the membership covers and what will be billed separately.

MDVIP is one of the largest and best-known branded concierge medicine networks in the United States. It operates on a franchise-like model: individual physicians affiliate with MDVIP, pay a portion of their membership revenue to the network, and in return receive administrative support, marketing, technology platforms, and a standardized wellness program. The physician still practices medicine independently, but the business structure and patient-facing brand are shaped by the network's requirements.

Because MDVIP sets program standards, patients at any MDVIP-affiliated practice can expect a broadly similar experience in terms of the wellness visit format, the patient portal, and the types of services offered. Annual membership fees at MDVIP-affiliated practices are set by the individual physician within ranges the network guides, so fees can vary by location and physician. MDVIP has publicly stated that its affiliated physicians typically limit their panels to around 600 patients, compared to the 2,000 or more patients a typical primary care doctor sees in a conventional practice. Always ask the specific practice for its current fee before enrolling.

Other branded concierge networks exist alongside MDVIP, including Privia Health, SignatureMD, and others. Each has its own physician agreement terms, fee-sharing structure, and program standards. What they share is that the physician is operating under a corporate umbrella that provides infrastructure in exchange for a financial relationship. That arrangement can benefit patients through consistency and resources, but it also means the physician's practice decisions are partly shaped by network policies.

An independent concierge practice is owned and operated by the physician without affiliation to a branded network. The doctor sets the membership fee, decides what services are included, chooses the patient panel size, and designs the practice around their own clinical philosophy. There is no revenue-sharing with a corporate parent, which some physicians say allows them to keep fees lower or invest more directly in patient care.

Because there is no standardized program, independent concierge practices vary enormously. One physician might offer a bare-bones membership focused on access and annual physicals, while another might include advanced preventive testing, nutrition counseling, or care coordination. This flexibility is a strength for patients whose needs are specific, but it also means you have to do more homework. Ask for a detailed membership agreement in writing and compare it line by line with other practices you are considering.

Independent practices also carry different business risks. A solo physician practice has no network safety net if the doctor retires, relocates, or closes the practice. Ask any independent concierge physician what happens to your membership fee if the practice closes mid-year and whether there is a transition plan or refund policy.

Both network-affiliated and independent concierge practices typically charge an annual or monthly membership fee. Some practices also bill your health insurance for covered services like lab work or procedures on top of that fee. Others are fully cash-pay and do not bill insurance at all. The IRS has issued guidance indicating that direct primary care and concierge-style membership fees are generally not considered qualified medical expenses for Health Savings Account (HSA) purposes, though this can depend on how the practice structures its fees. Consult a tax professional and review IRS Publication 502 for current rules before assuming your membership fee is HSA-eligible.

Medicare beneficiaries face additional considerations. CMS has stated that physicians who accept Medicare cannot charge Medicare patients a concierge membership fee for services that Medicare would otherwise cover. Some concierge physicians opt out of Medicare entirely, which means Medicare will not reimburse any of their services. Others have structured their membership to include only services not covered by Medicare. If you are on Medicare or approaching Medicare eligibility, ask any concierge practice directly whether the physician participates in, has opted out of, or has withdrawn from Medicare, and what that means for your out-of-pocket costs. CMS provides information on physician Medicare participation status at its official website.

For patients without insurance, a concierge membership can sometimes provide a predictable primary care cost, but it does not replace coverage for hospitalizations or specialist care. The CFPB and HHS both recommend that consumers understand the full scope of any healthcare agreement before signing, including what is and is not covered and what the cancellation and refund terms are.

Whether you are considering a network-affiliated practice like MDVIP or an independent concierge physician, the same core questions apply. First, get the membership agreement in writing and read it carefully. Confirm exactly which services are included in the fee and which will be billed separately to you or your insurance. Ask about the patient panel size and how the physician handles after-hours calls, urgent needs, and situations when the doctor is unavailable.

Ask about the physician's Medicare status if that is relevant to you. Ask what happens to your prepaid membership fee if the practice closes or the physician leaves the network. For network-affiliated practices, ask whether the physician could leave the network and what would happen to your care relationship if they did. For independent practices, ask about the physician's long-term plans and whether there is a coverage arrangement with another physician.

Finally, ask about the practice's approach to referrals and care coordination. A concierge membership covers primary care, not specialist visits. Understanding how the physician helps coordinate your broader care, including how they communicate with specialists and hospitals, is an important part of evaluating the value of any membership.

Patients in network-affiliated concierge practices often report that the standardized wellness program and technology platform make the experience feel polished and consistent. The network's administrative support can mean the physician spends less time on billing and paperwork and more time on patient care. On the other hand, some patients feel that the network's program structure leaves less room for the physician to customize care to individual preferences.

Patients in independent concierge practices often describe a more personalized relationship, since the physician has designed the practice entirely around their own approach to medicine. The tradeoff is that quality and comprehensiveness vary more widely, and the patient bears more responsibility for evaluating what they are getting. Reading the membership agreement carefully and asking detailed questions matters even more in this setting.

Neither model is universally better. The right fit depends on what you value most: the consistency and infrastructure of a branded network, or the flexibility and direct physician ownership of an independent practice. Both models represent a meaningful shift away from the volume-driven, insurance-billed primary care that many patients find frustrating.

DirectMedicine is a directory of direct-pay, cash-pay, and direct primary care physicians across the United States. When you search for a provider, you can see whether a practice is affiliated with a network or operates independently, along with the membership and fee information the practice has chosen to share publicly. This makes it easier to compare your options side by side without having to call multiple offices just to get basic information.

Because DirectMedicine focuses on price transparency and direct-pay care, the providers listed have opted into a model where patients are treated as informed consumers rather than passive insurance claimants. You can use the directory to identify both network-affiliated concierge practices and independent concierge physicians in your area, then use the questions outlined in this article to evaluate each one before making a decision.

DirectMedicine does not endorse any specific practice or network, and nothing on the site constitutes medical advice. The goal is to give you the clearest possible picture of your direct-pay primary care options so you can have a confident, informed conversation with any physician you are considering.