
National Stats and Other Subscription and Membership-Based Healthcare Delivery Industry Insights
BASICS OF SUBSCRIPTION HEALTHCARE TODAY
This page provides valuable insights from both physicians and C-suite experts, including industry trends, polls, statistics, news releases, and journal articles from Concierge Medicine Today. Media representatives are invited to explore this page prior to submitting any general contact inquiries.© 2007-2025 All rights reserved. Concierge Medicine Today, LLC.
“Once upon a time, the ‘NOW accepting new patients’ sign was the standard signal for patients that their doctor was ‘in the box’ and ‘open for business.’ It was a marathon most doctors would HUMBLY endure in the service of patients and ultimately one day call a career. Though as the years went by more doctors saw that entering the practice felt more like a penalty box than an altruistic calling. And today's healthcare marketplace isn’t giving doctors much choice anymore FOR a long career. HEALTHCARE TODAY is riddled with bureaucracy, ambiguous prices, visits that feel like speed-dating, and unwelcoming environments where both patients and doctors are running on empty. Enter cash-pay, membership, executive, preventative, routine and subscription healthcare (and all of its current iterations, labels and price points). For a few thousand doctors today in the U.S. and abroad, these cash-pay, subscription-based healthcare delivery business/practice models have become one of the few prescriptions and solutions available to both doctors and patients to treat patient and physician burnout in our chaotic, cold, unfriendly and overcomplicated healthcare marketplace. And let’s be honest, healthcare today is more like a maze than a place of refuge or healing. Doctors in these practice models have rediscovered their passion for healthcare – and patients, well, they’re sitting on the other side of these Doctors and rekindling that personal bond with their physician that they honestly thought had gone extinct!”
Editor-in-Chief, Concierge Medicine Today, LLC., industry trade publication, est. 2007.
FROM OUR VANTAGE POINT, HOW WE SEE THINGS —
FAQs
Here’s a quick rundown and a few fast facts and FAQs to get you up to speed on this subscription-driven disruptive shift in our healthcare marketplace.
— Are self-pay and cash-only practices categorized within the ‘concierge’ or ‘subscription’ marketplace?
“In summary, the answer is no. This is primarily due to the qualifying term ‘subscription,’” explains the Editor-in-Chief of Concierge Medicine Today. “In the past, sources indicated that there exists an unknown number of independent physicians (or practitioners) working across the U.S. who practice some variation of cash-only or self-pay healthcare, yet are not associated with any marketing label, organization, consulting agency, or brand as we understand them today. While this is likely accurate when examining other facets of the self-pay and cash-pay healthcare landscape, these practitioners technically do not align with the three main subscription-based healthcare delivery models that are predominantly operational in today’s market. Therefore, previous figures estimating these programs in the tens of thousands likely included those self-pay and cash-only practitioners — however, we now observe that the subscription-based healthcare delivery market is robust enough to stand independently and be recognized on its own.”
Are 'concierge' or 'subscription' models in healthcare classified as part of the self-pay and cash-only marketplace?
"In short, yes! However, this is primarily due to the key term 'self-pay,'" remarked the Editor-in-Chief of Concierge Medicine Today. "We're observing an increase in self-pay and cash-only practices within the U.S. healthcare system."
Why the reduced Patient Panels, does this really allow for more focus and attention on the patient?
"Healthcare is a process to be sure, but the patient should never feel processed. More often than not, concierge medicine practices have reduced patient panels of 225-550 to that compared to the traditional, plan reimbursed practices which usually boast 2,500-5,000." ~Editor-in-Chief, Concierge Medicine Today
Is there a strong focus on prevention, routine examinations and a deeper relationship with patients:
"Concierge Medicine practices and programs today are typically known for their focus on prevention and have often curated strong relationships between Patients and the Physician and Patient and the staff. So in essence, staff and Doctors don’t usually have to look at a medical chart to remember your name." ~Editor-in-Chief, Concierge Medicine Today
Are there many self-pay and cash-only healthcare practices in the U.S. today that do not include subscriptions or memberships in their services?
"It's also challenging to pinpoint a specific number," stated the Editor-in-Chief of Concierge Medicine Today. "However, we have observed an increase in the number of self-pay and cash-only healthcare practices across the country. Here's what we've learned over the years about this landscape, which differs from the subscription-based healthcare model: Approximately 13% of family physicians now utilize cash-pay models (American Academy of Family Physicians; 2021); a survey indicates that 43% of practices provide cash payment options (MGMA; 2020); nearly 30% of Americans believe cash payments help reduce costs (Journal of Health Economics; 2022); and specialties like dermatology are increasingly adopting cash-only models due to their simplicity (Health Affairs; 2019)."
first generation
SUBSCRIPTION-BASED HEALTHCARE
According to industry sources from within the bespoke, luxury and ultra-high net worth concierge medicine space, Concierge Medicine Today reports that it is estimated that there are approximately 200-400 doctors across the U.S. and maybe 300-400 abroad.
Bespoke Concierge Medicine Practices (Original Version)
Background: “This is original version of concierge medicine,” says the Editor-in-Chief of the industry’s trade publication, Concierge Medicine Today. “Started by some pioneering and visionary physicians in the 1990’s it’s believed by sources in the industry that while these upscale programs get most of the criticism and commentary, these premium-priced programs present less than 10-15% of the 4,000 subscription-based or membership medicine models operating today. While potentially small in number nationally they do have a nice service offering. While this original and still quite unique form of concierge-style healthcare continues to serve an important purpose and innovate beyond it’s origin story, it is estimated by some close the bespoke subscription practice models that these practices primarily cater to the global citizen, traveler and ultra-high net worth individual and family. It’s estimated that these bespoke concierge medicine models typically charge between $10,000 to $40,000 annually and generally do not market or advertise their services. While media representations of these costly practices often mischaracterize Physicians ambitions for practicing in a business model like this, these stories can often be quite misleading when we all look at how modest and humble most of these doctors are today. I've dedicated my career to illustrating over the past 20 years, that market forces and differing price points exist in healthcare just like in any other marketplace. But it’s important to recognize that luxury service niches exist in every industry, including healthcare, whether your medical school professors like it or not! I’m also of the persuasion that price points for different services and offerings in our economy are perfectly fine. If there’s a market for an ultra-high-end pool table for your basement, go for it. To each there own I say!”
Most Common Myth: Less expensive and more common cash-pay, subscription and membership models with different patient demographics and service offerings often get associated with this high-end version by critics — but more often than not, the criticism is rendered mute given the fact that just like in business, models evolve.
Target Audience: High-Income Earners or individuals with significant disposable income; Executives or busy professionals seeking convenient healthcare access; Wealthy Families or parents looking for comprehensive care for their family; and, Travelers, Global Citizens or people desiring consistent, quality medical care while abroad. (Davis, S., 2019; Health Affairs; "The Rise of Concierge Medicine"; and Lichtenstein, A., 2020; Concierge Medicine Today; "Market Trends in Concierge Healthcare.")
History: For more about the history of bespoke concierge medicine, click here.
SECOND generation
SUBSCRIPTION-BASED HEALTHCARE
Not to be confused with the bespoke version of concierge medicine, this more modern-version appears to be the most common version of today’s subscription-based, self-pay membership medicine offering.
Personalized Care Models (PCMs) or Today’s More Contemporary Version of Concierge Medicine
PCMs (as we’ll refer to them here for simplicity) have taken a decidedly middle-class and upper middle class practice model (est. 2,000+/- doctors): Today’s most common iteration of modern-day subscription or membership-based healthcare is business model — and like some executive health programs, it remains quietly unconcerned about bespoke or low-cost cash only (i.e. DPC-style) options. These practice models do very little advertising and have patient panels between 200-600 patients and range between $1,500-$2,800 per year. Think of it as the sweet spot in the marketplace. It is also believed that there are around 2,000+/- practices aligned with national enterprises and organizational consultancies that assist Physicians in moving into compliant concierge-style practice models. Today, there are likely 30,000 or more cash healthcare practices in the US.
Business Models Used By Physicians In PCM-style models: Segmented; Hybrid; Full Conversion (SignatureMD; 2025) and click here to learn more and get connected with industry experts and leaders to get started.
Background (More Middle-Class Patients Than Ever): “Although Concierge Medicine started out as a concept for the affluent nearly 20 years ago, over time, the PCM models in the subscription-based and membership medicine space have taken a decidedly middle-class turn and a lot of people don’t recognize that” says the Editor of Concierge Medicine Today, the industry’s healthcare trade publication. “Today, we can see impressions of old-fashioned medical care where a doctor carries a medical bag into your home or visits you when you’re in the hospital because it’s simply the right thing to do. In the past several years, we’ve observed that there are countless people (i.e. prospective patients) searching for these types of doctors every day because their current plan reimbursed, traditional doctor’s office isn’t providing the level of time, attentiveness and relationship they desire from their doctor. The average consumer today no longer equates concierge medicine with only the affluent. From the mid 1990’s to present day, Concierge Medicine has matured into countless less expensive and affordable subscription-based healthcare delivery service variations within our local communities. Annual fees today in most concierge medicine practice environments simply reflect the level of personal attention and service that a doctor provides and noticeably, patients are deciding to make a personal investment in their own healthcare. It’s no longer about being the best Doctor in world, it’s about being the best Doctor FOR the world, FOR your patients and FOR your local community.”
Most Common Myth: “If you were to ask me how most headlines about concierge medicine should accurately read, I would say this: ‘The existence of a wealthy clientele in urban areas prompts a few healthcare practices to develop and promote luxury health services – but there’s also less expensive and very affordable programs and practices out there too!’“ says the Editor of Concierge Medicine Today, the industry’s healthcare trade publication.
Target Audience or Demographics of "Personalized Care Models: Middle and Upper Middle-Class Patients or individuals seeking high-quality, individualized attention; Chronic Disease Patients or those needing tailored management of health conditions; Health-Conscious Individuals or proactive patients looking for customized care; and, Aging Populations and older adults needing specialized care for multiple conditions. (Ralston, R.; 2021; Journal of Personalized Medicine; "Personalized Medicine: A Paradigm Shift in Healthcare."; Zhai, P., & Harris, J.; 2020; American Journal of Managed Care; "The Future of Personalized Healthcare.")
Disruptively Innovative: “No matter how one perceives or understands concierge medicine, along with its subscription and membership options today, most people's first reaction to these novel healthcare delivery concepts is typically curiosity. However, it can also be met with preconceived opinions and criticism,” stated the Editor-in-Chief of Concierge Medicine Today to a gathering of physicians in Atlanta last October. “It's no surprise that much of the criticism directed at these business models comes from a small group of entrenched healthcare professionals who overlook a well-known and essential business principle: ‘disruptive innovation.’ This concept, introduced by Clayton Christensen in the 1990s, explains how smaller companies with limited resources can challenge established businesses by creating new markets or transforming existing ones with simpler, more affordable alternatives. These innovations typically emerge in neglected market segments and gradually ascend, displacing established competitors. Examples include Top Golf revolutionizing the driving range and entertainment sector, Netflix disrupting video rental services, and Uber reshaping the taxi industry — all underscoring the importance of adaptability and innovation for maintaining a competitive edge (Christensen, C. M.; 1997; Christensen, C. M., Horn, M. B., & Johnson, C. W.; 2008; Schindler, R. M., & Pelsmacker, P. De.; 2017; Koller, T., & Wutz, A.; 2018; and Teece, D. J.; 2010). A mentor of mine years ago once shared a thought that has remained with me: ‘Someone is already creating a uniquely better approach, product, environment, or model. There’s someone out there redefining the rules of the current model of whatever it is you do. The aim [he said] isn't necessarily to be the first to create something uniquely better, but rather to be positioned both organizationally and personally to recognize ‘unique’ it when it comes along.’ While I appreciate the altruistic mission of the healthcare field, I observe that much of the criticism aimed at concierge medicine — whether it be the bespoke versions or the more contemporary iterations — originates from within the healthcare system itself. Patients, like myself, generally embrace and appreciate these models. The next generation of patients will require healthcare to innovate as well. While some may dissent ideologically on these models, my experience shows that when the term ‘concierge medicine’ is mentioned, curiosity usually outweighs criticism by both Patients and Physicians. Looking at the bigger picture, I believe we are discouraging more doctors who bring innovative ideas and inadvertently pushing them away when we should be inviting them to the table and expressing interest in their fresh ideas for unique healthcare delivery alternatives. The concept of fairness has not proven effective in healthcare. We must move beyond fairness and actively engage with those waiting on the other side of the exam room or service window today. Ignoring what capable doctors envision for their patient communities benefits no one. The overly complex healthcare marketplace we have today is not truly healthcare; it’s ‘sick care’ and it’s complicated. This ‘sick care’ environment presents numerous reasons for doctors to feel disheartened and potentially leave the medical profession altogether. Concierge medicine (in all of its iterations) has revitalized the careers of many physicians, and to those who argue that it worsens the physician shortage, I would emphasize that five words from my doctor carry immense weight — they are likely one of the most influential voices in my life, second only to my wife and children. It costs little to support a physician's entrepreneurial ideas. When we critique, discourage and fold our arms and stand at the back of the room new ideas in healthcare based solely on fairness regarding shortages, it can come off as simply out of touch and intransigent— so by not listening and failing to encourage innovation in healthcare, we risk losing more physicians to burnout (or worse). Let’s not be in a position where we may overlook the next disruptive innovation, whatever it’s called.”
Growth Expectations
In an article by HealthTech written by Brian Eastwood in December of 2022, Grand View Research estimates that the concierge medicine market will grow more than 10 percent annually each year until 2030. The consultancy cites several factors, including a continued increase in patient volume that started during the pandemic, greater financial stability due to limited reliance on insurance reimbursement, and improved quality of life for physicians. (Eastwood; 2022)
However, the industry’s trade publication, Concierge Medicine Today, has a slightly more conservative estimate of 6-7% growth rate year over year, based on industry observations, physician interviews and experts’ outlook.
Future Forecasts & Trends
According to Precedence Research, a worldwide market research and consulting organization in December of 2023 in a press release (click here) published on Globe Newswire, the U.S. concierge medicine market size accounted for USD 6,633.91 billion in 2023 and grew to USD 6,958.51 million in 2024, expanding at a CAGR of 5.70% between 2023 and 2032. The press release by Precedence Research also said the global concierge medicine market size is projected to surpass USD 34.27 billion by 2032, increasing from USD 19.12 billion in 2023 and is expanding at a CAGR of 6.7% from 2023 to 2032 (Precedence Research; 2023).
STUDIES and DATA SUPPORTING THE PCM or today’s more contemporary concierge medicine and membership MODEL(s)
With the trust gap widening between patients and physicians, it was recently found that 60% of primary care physicians feel they need to earn trust back with patients post-pandemic (MDVIP; 2025) and 1 in 3 reaching “burned out” status – on the Patient Frustration Index, which measures common healthcare pain points across major population groups (MDVIP; 2024). What’s even more remarkable is that around half of these practitioners mentioned have been actively learning from currently successful practices, affiliated organizations and pioneering physicians in the field and experimenting with various subscription and membership pricing models of their own. What’s even more encouraging is that data and studies from the industry reveal some surprising findings:
One study from MDVIP shows personalized primary care reduces ER visits, hospitalizations and outpatient expenditures for diabetic population. The study found that the MDVIP model substantially decreases costs in the diabetic population by year five of enrollment in the preventive care program. After the first post-enrollment year, the mean costs continue to rise for the comparison population, while flattening for MDVIP beneficiaries. The study found decreased unplanned hospital admissions, emergency room visits and outpatient expenditures. At year five, MDVIP patients have statistically significant lower Medicare expenditures. These patients also showed increases in primary care office visits, as their physicians spend more time coaching and monitoring their progress (MDVIP; 2020).
Another study notes that personalized preventive care yields decreased costs and better health management. A study in Population Health Management from MDVIP (MD-Value In Prevention) highlights how a primary care model based on personalized preventive care achieves definitive cost savings and improved health management within three years of adoption. The study, appearing in the February 2016 edition of the peer-reviewed journal, reinforces earlier research published in 2012 in the American Journal of Managed Care (AJMC) proving the efficacy of the MDVIP model(MDVIP; 2016).
And finally, another study proves dramatic reduction in hospitalizations and $300 million savings for MDVIP's Personalized Healthcare Model. MDVIP-affiliated physicians have the time to focus on acute, chronic and preventive health issues, and this increased physician contact time results in improved outcomes for patients and ultimately lowers healthcare costs (MDVIP; 2012, 2013).
How would you some experts define today’s more contemporary version of concierge medicine (present day)? For one last industry perspective, a CEO of one of the conversion companies had this to say to Medical Economics when asked ‘How would you define concierge medicine?’ The CEO said “I would define it simply by saying that physicians elect to reduce their patient panels to much more manageable sizes so they can provide the care their patients deserve. Patients who join the practice pay a membership fee either annually, semiannually or quarterly. In exchange for that membership fee, the patients maintain (or gain) that deep, intimate relationship with their doctor, receive the ability to schedule same-day or next-day appointments and have longer, more comprehensive office visits and annual exams. The practice size typically is reduced from 2,000 to 3,000 patients to 300 to 500. The practice becomes more manageable at that size, and as our affiliated doctors tell us, they have the time to think, plan, dig deeper with their patients and really focus on health, wellness and disease management, not just the symptom of the day. I would [also] say, it’s not for every physician. We receive dozens of inquiries every week from doctors all over the U.S. and engage with between 5% to 8% of them. The ideal candidate is a doctor who’s in internal medicine, family practice or another specialty where there is an ongoing physician-patient relationship. Being located in a market where they’ve been practicing for at least five years is also key. Once they have a following of patients and longer-term relationships, they develop a depth of intimacy with their patients. Also important is that the market where they practice has a median household income above a certain level — and let me add that this is not just for wealthy people. A median household income above $75,000 and median household net worth of $250,000 has proven to be sufficient for patients to make this valuable investment in their health. I don’t want anyone thinking this is only for people in Beverly Hills or New York City. So if it’s the right doctor, in the right market, with the right specialty, today physicians must also have high patient ratings on Google and Healthgrades. Due diligence by both the doctor and the concierge medicine management company must be completed and if everything meets expectations; a detailed plan must be constructed. It takes between 90 and 120 days from the signing of the agreement to the time the concierge practice opens. There are many steps before launch including … ongoing patient communication and engagement, developing a customized website, creating a crystal clear message, confirming a vision for the practice, and training the staff.” (Mazzolini; 2023)
The Industry’s C-Suite Experts Weigh-In Over the Years: For more about the history of personalized care models, click here.
More In-Depth History: For more about the history of personalized care models, click here.
THIRD generation
SUBSCRIPTION-BASED HEALTHCARE
The low-cost version subscription-based healthcare delivery — (not to be confused with Bespoke Concierge Medicine and more contemporary PCM models)
Direct Primary Care (DPC) Models
Often called direct primary care (or DPC): The air space around the DPC model which typically touts it’s no insurance, no Medicare policy is considered to be a low-cost, cash-only healthcare delivery model with a thousand-ish (depending on your sources) around the country. Comprised of a small number of practices but with evangelistic enthusiasm, these Physicians don't want to necessarily have the label 'cheaper' associated with their model but instead prefer the term 'affordable.' While it appears that there are roughly 1,000-1,500+/- cash-only, no insurance, no Medicare, direct primary care (DPC) practices, their fees range in price between $600-$1,200 per year on average, some higher, some lower.
Background, DPC is A DISTANT RELATIVE, BUT NOT CONCIERGE CARE: In the tail end of the 2000s, a spirited group of altruistic doctors (often self-labeling themselves as the “rebels” of healthcare) unveiled something they now call "direct primary care" (DPC). It was once called ‘fee for care’ but that didn’t really stick. It’s been known by a few other names over the years but DPC seems to have stuck; albeit the insider jargon might be a bit clunky from a marketing and advertising perspective it’s a no hassle model (think micro-practice of years ago) attracting new patients and physicians already frustrated with healthcare’s bureaucracy.
Background: Simply put, DPC is a modern-day, cash-only, no insurance, no Medicare, self-pay, reboot or budget-friendly subscription spin on the original 90’s luxury or bespoke concierge medicine subscription model that catered primarily to the affluent clientele years ago. DPC has often been compared and contrasted in the media (and by critics) to its higher priced yet distant relative, bespoke-luxury concierge care and even the PCM models. Conversely, DPC docs often urge their curious colleagues to ditch Medicare and kick insurance headaches to the curb and offer a more affordable fee. They champion a cash-only subscription model for primary care or family health services and those fees can range (typically, but not always) between $55-85/month.
Branding Conundrum: “In contrast, DPC arose as a response to insurance limitations for lower-income populations, focusing on lobbying for legal changes instead of adapting to existing regulations, often leading to violations. Steer clear of marketing and branding, that, while quite prevalent in the marketplace, is frustrating your patient fees achieving qualified medical expense status. For example, you may dearly love the DPC or concierge [as terms or] brands, but, the IRS is convinced that neither brand’s patient fees are qualified medical expenses. Why debate the IRS? Neither brand is likely to fully explain YOUR medical or healthcare philosophy, and neither brand assists with qualified medical expense status so both brands frustrate HSA/FSA/HRA/MSA funding absent changes in tax laws and IRS regulations.” (Eischen; 2025)
Most Common Myth: So while DPC shares some distant genetic traits to other subscription healthcare delivery ancestors, DPC is essentially just a third primary care (or family medicine) subscription healthcare delivery option trying to build its own sand castle on the beach with the some of other subscription options in the healthcare marketplace. Think of DPC as that distant cousin who only pops up at a family reunion every now and then with an interesting take on cash-only, self-pay patients.
Target Audience or Demographics of DPC: Families and Young Adults or individuals seeking transparent and accessible healthcare; Small Business Owners or entrepreneurs wanting straightforward healthcare for employees; Health-Conscious Individuals or patients valuing preventive care; and, Disillusioned Patients or those frustrated with traditional healthcare models. (Tew, J.; 2020; Journal of Health Economics; "Understanding the Demographics of Direct Primary Care."; Peterson, J.; 2021; American Family Physician; "Direct Primary Care: A Review of the Evidence.")