Trend Watch: How Subscription Medicine Is Transforming Preventative Care
COVID-19 challenged the American healthcare system in an unprecedented way, but there were massive problems long before the pandemic began. In 2019, nearly a third of people under age 65 were uninsured, with nearly 75% blaming the high cost of coverage. Now, in 2021, more than one-third of insured adults and half of uninsured adults say they have problems paying their medical bills. But cost isn’t the only hurdle—in fact, it’s a symptom of a deeper issue.
The real problem is that Americans aren’t seeing their primary care physicians for preventative care, often simply because it’s a hassle. On average, a patient in a large metropolitan area waits 24 days for an appointment, and can spend up to 2 hours waiting at a medical office.
As a result, primary care accounts for just 5 to 7% of total health spending. Yet studies show a strong correlation between preventative check-ups and lower spending on hospital visits, surgeries and other expensive procedures—and yes, potentially lower insurance premiums down the road.
Still, with all the hurdles that exist, it’s no surprise that people are reluctant to see their primary care physicians. But what if there was a way to make care more accessible? Alternatives to traditional care are emerging and have the potential to do just that, with the most promising options built around subscription models.
Making Sense of the Models
Direct Primary Care Providers (DPCs)
One of the fastest growing alternatives to traditional primary care is subscription-based direct primary care (DPC)—a healthcare model that prioritizes access, affordability and relationship-building. For a monthly subscription, patients can have unlimited office visits as well as 24/7 access to telehealth and other digital services, like renewing a prescription via a simple app.
This digital component is a key differentiator for subscription-based DPCs—it not only cuts down on the need for in-office visits, but also maintains a continuous record of patient health and data. This way, while patients often have the option of seeing the same doctor time after time, if they do see a new provider, that provider still has full visibility into their record of care and a relationship can develop. This relationship-building is essential for an effective healthcare model because it enables doctors to gain full visibility into patients’ health to accurately diagnose them, and builds trust.
One Medical is one of many emerging direct primary care providers, and it’s growing fast. Today, it serves 22 metropolitan areas around the United States and has over 600,000 members, a 31% increase from last year. For $199 a year, patients can book same-day, no-wait appointments at one of their 100+ offices, see a provider virtually at any time, receive on-site lab work—and even get live support for navigating their site and setting up a profile. And many DPCs, including One Medical, accept insurance.
Though DPCs differ, these providers are succeeding at reducing the cost of care, while improving quality, thanks to subscriptions. In the case of One Medical, the reliable revenue and working capital that memberships bring in enables the company to pay doctors a regular salary rather than paying them per patient. That means there’s no pressure to rush visits, no massive copays, and no delays. As for tackling the larger issue of high healthcare and insurance costs, DPCs aim to curb that by focusing on preventative, primary care, which in turn reduces massive downstream healthcare costs, such as specialty visits, radiology appointments, and hospital stays.
Concierge medicine is similar to direct primary care, but consists of a more one-on-one relationship between a single doctor and patient, rather than a group of doctors. And while some doctors do use a digital platform as part of their care, it’s not necessarily standard practice for concierge providers. Concierge subscriptions charge users a flat monthly fee in exchange for unlimited office and (in some cases) telehealth visits without copays—no insurance required. Patients can also call doctors directly with medical questions, which takes the traditional patient-doctor relationship to a much deeper level.
This type of care isn’t exactly cheap. Because doctors operating under this model don’t accept insurance and patients pay them directly, the upfront costs can seem relatively high. And fees differ: depending on the type of care offered. But for patients that want an even more personal relationship with a doctor than DPC can offer, concierge medicine is appealing. Though insurance is not accepted for primary care visits, it is accepted for prescriptions, lab work, specialist referrals, and hospital visits so patients won’t need to pay out of pocket for those services.
Specialized Medical Subscriptions
Preventative care can come in the form of other, more niche subscription healthcare services, too. Calm, for example, offers affordable subscription-based mental health care through meditation support, sleep tips, and anxiety reducing practices. Tia, meanwhile, is a subscription offering that specializes exclusively in women’s health, giving members access not only to appointments with expert physicians and digital care, but also a personal assistant that can help booking, health planning, billing, and everything in between.
The advantage of these services is direct, convenient speciality care—no searching for in-network providers, getting referrals, or other hassles. And, like DPCs, these providers are building their businesses on digital platforms, which means patients leave a continuous trail of data that enables the companies to continually improve the service.
Can Subscriptions Transform Healthcare?
U.S. healthcare is a $260 billion market, and for the time being, subscriptions control just a tiny fraction of this space. But the tide is changing quickly. Though the U.S. had long been known for delivering some of the best quality of care in the world, the pandemic was eye-opening and left consumers questioning whether that was, in fact, true. Costs are higher than ever, delays are prevalent, doctors are frustrated, and as a result, patients aren’t proactively seeking primary, preventative care that could save them money, and more importantly, protect them.
Health is the ultimate investment—patients can’t afford to gamble by skipping annual physicals or hesitating to get something checked out because they don’t want to sit in a waiting room for hours or because they’re uninsured. As new subscription-based healthcare solutions continue to emerge, options are expanding and are slowly closing the gaps between the need for care and access to it.