Firm arranges VIP access to top docs, manages member care

Firm arranges VIP access to top docs, manages member care

Baltimore-based Pinnacle Care International (PCI) has a rarefied role even in the world of concierge or boutique medicine: It is not a medical practice at all, but a company that provides access, analysis and advocacy for the health care needs of its members.

PCI, which is 18 months old, is based on the priority or “trustee-level” or “Very Important Person (VIP)” service levels that many large teaching hospitals offer to attract key supporters of the institutions and full-paying domestic and international patients, Chief Operating Officer Bill Amos, M.D., explains. Its managing partner, John Hutchins, founded and directed VIP programs at the Cleveland Clinic and Johns Hopkins Hospital.

For its members’ health problems requiring specialty care, PCI contacts a member of its medical advisory board, which consists of about 30 physicians well-known in their specialties and tied to top-rated medical schools, Amos says. The advisory board member reviews the patient’s medical records and suggests what care is needed and who would be the best doctors in any institution to provide that care. The firm has on staff five patient advocates, some of whom are RNs who have served as patient advocates in large institutions, in Baltimore, Chicago and Rochester, Minn. The advocates pursue the consultation and placement for the members, letting the patient’s family focus on providing emotional support, Amos adds.

The advisory board members serve the firm without compensation in part to bring full-paying patients to their institutions to support the research and charitable missions, says Amos, an ob/gyn who practiced in Georgia and was medical director of AFLAC Insurance for 12 years. Other reasons for members to serve are for prestige and to participate in care focused solely on the patient’s well-being.

PCI members–the firm now has about 200 “lives,” which includes members’ nuclear families–agree to pay the “usual and customary” or gross charge rate for care arranged by the company, says Marketing Director Debbie Schwartz. They may bill their insurance for whatever it will pay.

There are three levels of membership: silver, gold and platinum. The fee for silver membership is $5,000 per year per member, and for platinum it is $25,000 per year. Silver requires a $10,000 initial fee, and platinum requires a $30,000 initial fee. A key difference between the membership levels, she explains, is the number of patient-advocate hours that may be devoted to the member’s concerns. Platinum members have unlimited hours.

When a member–20% of members come from abroad–joins, PCI gathers all medical records of the person and his or her family. The company arranges annual executive physical exams for all family members at one of the firm’s “primary centers of excellence,” which generally are the teaching institutions from which its advisory board members come. Schwartz says the company has contractual relationships with Johns Hopkins, Harvard, Emory in Atlanta, Cedars-Sinai in Los Angeles, the University of Chicago Hospital and Cleveland Clinic. It has informal relationships with the Mayo Clinic in Rochester, Minn., M.D. Anderson Cancer Center in Houston, Columbia Presbyterian Hospital in New York, and National Institutes of Health, especially the National Cancer Institute, in Bethesda, Md., she adds.

The company has sold memberships through corporations for their executives, and through wealth advisors for their clients, Schwartz says. Some members have boutique doctors for primary care.

She declines to disclose the company’s annual revenues.

Contact Amos at (410) 752-1712 or www.pinnaclecareinternational.com.

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