FAQs: Concierge Medicine & Subscription-Based Healthcare
By Concierge Medicine Today | Knowledge Center | Educational Content © 2007–2026 Concierge Medicine Today, LLC. All rights reserved.
Here's a quick rundown and a few fast facts to get you up to speed on this subscription-driven shift in our healthcare marketplace. Content is for educational and informational purposes only and does not constitute medical, legal, or financial advice.
Q: Are self-pay and cash-only practices categorized within the 'concierge' or 'subscription' marketplace?
A: In summary, no — and the distinction comes down to one qualifying word: subscription.
"In the past, sources indicated that there exists an unknown number of independent physicians 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," explains the Editor-in-Chief of Concierge Medicine Today. "These practitioners technically do not align with the three main subscription-based healthcare delivery models that are predominantly operational in today's market. The subscription-based healthcare delivery market is now robust enough to stand independently and be recognized on its own."
The core difference is structural. A cash-only or self-pay practice charges patients directly for individual visits or services rendered — there is no ongoing membership fee, no retainer, and no subscription agreement. Subscription-based models, by contrast, charge patients a recurring fee (monthly, quarterly, or annually) in exchange for a defined level of access and care. That recurring fee relationship is what places a practice within the concierge or membership medicine marketplace.
Supporting context:
The American Academy of Family Physicians (AAFP) defines direct patient care arrangements, including cash-only practices, as distinct from membership-based or concierge models specifically because of the subscription structure. (AAFP, 2022; aafp.org)
A 2021 survey by the Medical Group Management Association (MGMA) found that cash-pay and insurance-based practices operate under fundamentally different administrative and financial structures, with subscription models occupying a separate and growing category. (MGMA, 2021; mgma.com)
Q: Are 'concierge' or 'subscription' models in healthcare classified as part of the self-pay and cash-only marketplace?
A: In short, yes — because of the key term self-pay.
"We're observing an increase in self-pay and cash-only practices within the U.S. healthcare system," notes the Editor-in-Chief of Concierge Medicine Today. Concierge and subscription-based models do fall under the broader self-pay umbrella in the sense that patients pay out-of-pocket membership fees, independent of insurance reimbursement for those fees.
However, the relationship is not interchangeable. Not all self-pay practices are subscription-based, and not all concierge practices are fully self-pay. In fact, the American Academy of Private Physicians (AAPP) estimates that approximately 75% of concierge medicine practices continue to accept insurance for covered services beyond the membership fee — meaning the membership fee and insurance billing can coexist within the same practice. (AAPP, as cited in Software Advice, 2023; softwareadvice.com)
The practical takeaway for physicians: operating a subscription-based practice does not require abandoning insurance entirely. These are distinct decisions, and experienced legal and compliance advisors can help physicians structure practices that integrate both where appropriate.
Q: Why the reduced patient panels — does this really allow for more focus and attention on the patient?
A: Yes, and the data supports it.
"Healthcare is a process to be sure, but the patient should never feel processed," says the Editor-in-Chief of Concierge Medicine Today. "More often than not, concierge medicine practices have reduced patient panels of 225–550 compared to traditional, plan-reimbursed practices which usually serve 2,500–5,000 patients."
That difference in panel size is not cosmetic — it is structural, and it has measurable consequences for both physician and patient experience.
What the research shows:
A landmark study published in Population Health Management (2016) found that a primary care model built around personalized preventive care achieved meaningful cost savings and improved health outcomes within three years of adoption. The study attributed these results directly to increased physician-patient contact time made possible by smaller panels. (MDVIP/Population Health Management, 2016; liebertpub.com)
A separate MDVIP-affiliated study published in the American Journal of Managed Care (2012) demonstrated that personalized preventive care led to significant reductions in hospital utilization. (AJMC, 2012; ajmc.com)
A 2020 MDVIP study showed that membership medicine models substantially decreased costs for diabetic patients, including lower rates of unplanned hospital admissions and emergency room visits, with statistically significant reductions in Medicare expenditures by year five of enrollment. (MDVIP, 2020; mdvip.com)
Research published in the Annals of Family Medicine has documented that primary care physicians in traditional practice settings average 13–16 minutes per patient visit. Concierge and membership-based models consistently report 30–60 minute visits, with same-day or next-day access as a standard feature. (Tai-Seale M. et al., Annals of Family Medicine, 2017)
The reduced panel is the mechanism. The relationship is the outcome.
Q: Is there a strong focus on prevention, routine examinations, and a deeper relationship with patients?
A: Yes — and it is one of the most consistently reported benefits across both physician and patient accounts.
"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 the staff," says the Editor-in-Chief of Concierge Medicine Today. "Staff and doctors don't usually have to look at a medical chart to remember your name."
That observation reflects something more than anecdote. Continuity of care — the ongoing relationship between a specific patient and a specific physician — is one of the strongest predictors of positive health outcomes in primary care research.
Supporting evidence:
A 2018 study published in BMJ Open found that greater continuity of care with a personal physician was associated with lower rates of emergency hospital admissions and reduced mortality. The authors concluded that strengthening the doctor-patient relationship should be considered a healthcare priority. (Pereira Gray D. et al., BMJ Open, 2018)
The Commonwealth Fund has reported that patients with a consistent primary care relationship are more likely to receive recommended preventive screenings, manage chronic conditions effectively, and avoid preventable hospitalizations. (Commonwealth Fund, 2019; commonwealthfund.org)
A 2024 MDVIP/Ipsos survey found that 60% of primary care physicians feel they need to rebuild patient trust in the post-pandemic period, and that 1 in 3 patients are reaching a "burned out" threshold on a Patient Frustration Index measuring common healthcare pain points. (MDVIP/Ipsos, 2024; mdvip.com)
Concierge and membership models address these gaps structurally — by design, not by chance.
Q: 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?
A: Yes, and their numbers are growing — though pinpointing an exact figure remains difficult.
"It's challenging to pinpoint a specific number," acknowledges 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 is what available data indicates about this landscape:
Approximately 13% of family physicians now utilize cash-pay models. (American Academy of Family Physicians, 2021; aafp.org)
A survey found that 43% of practices provide cash payment options for at least some services. (MGMA, 2020; mgma.com)
Nearly 30% of Americans believe cash payments help reduce their overall healthcare costs. (Journal of Health Economics, 2022)
Specialties such as dermatology are increasingly adopting cash-only or cash-first models, citing administrative simplicity and patient satisfaction. (Health Affairs, 2019; healthaffairs.org)
As of 2025, Concierge Medicine Today estimates there are 30,000 or more cash healthcare practices operating in the U.S. in some form — the majority of which are not structured as subscription or membership-based models.
The distinction matters for physicians evaluating practice options. A cash-only or self-pay practice and a subscription-based concierge practice are not the same thing — and the legal, compliance, and financial implications of each differ meaningfully. Physicians exploring either path should consult qualified legal counsel with experience in the specific model they are considering.
A Note on Sources and Editorial Standards
Concierge Medicine Today is committed to reporting that is accurate, evidence-based, and transparent about the limits of available data. Where industry estimates are cited, we note the source and, where relevant, offer our own conservative assessment based on direct industry observation.
Statistics in this article are drawn from publicly available sources including peer-reviewed journals, national healthcare organizations, and industry survey data. We do not fabricate citations, statistics, or studies. Where exact figures cannot be verified, we say so.
If you have questions about sources cited in this article, contact us at conciergemedicinetoday.net/contact.
Educational resources provided by Concierge Medicine Today are designed to support professional learning and informed decision-making for physicians and practitioners. Content is offered for educational purposes only and does not constitute clinical, legal, or financial advice.
© 2007–2026 Concierge Medicine Today, LLC. All rights reserved.