Could subscription model be the answer to US health care cost woes?

Although improving health care is a never-ending topic of discussion, the real issue often is not so much the quality of care but how to access and pay for it. Subscription care, an all-encompassing term for membership-style primary care services such as direct primary care (DPC), changes the incentives of the doctors and health care providers to be more proactive in managing the patient’s health. The model is designed to be a bridge between modern medicine and a more traditional, less complex health care model.

“DPC has improved access to quality care by building stronger relationships between patients and their primary care physicians by eliminating the inefficiency of paying for primary care services through an insurance company,” according to a new report from Accresa. “By eliminating the unnecessary expenses created by inefficiency, physicians are able to spend more time focused on their patient’s wellbeing, and patients will feel more trust and access to their doctor.”

Employers and individuals are showing interest in innovative, tailored subscription care plans as a way to control health care costs and obtain better access to care, according to the Accresa Subscription Care Benchmark Report 2022. According to the survey of more than 280 employers and 6,000 individuals:

• Health care costs are going up for most employers. Eight in 10 said they have experienced an increase in premiums year over year.
• Employers are interested in subscription care. Sixty percent said they would contribute money to a monthly subscription care membership and add it to their health plan.
• Individuals likely will contribute to a subscription care membership if given the opportunity. Employers indicated that more than half of their employees likely would sign up for a subscription care membership.
• Inconvenience is a barrier for patients getting the care they need. More than half of the individuals who responded said they have put off going to the doctor because of cost or inconvenience.

The survey results are good news for health systems and hospitals that are on the fence about subscription care, according to the report. Many employers are willing to incorporate subscription care into their health plans, while individuals want strong relationships with their doctors and more dedicated, direct access to their services without surprise billings.

“Subscription care is here to stay, and it’s only going to grow in popularity as barriers to entry and price become more competitive,” the report concluded. “The payment efficiencies created by subscription care further increase the viability of these programs. The reduction in payment acquisition expense and reduction in administrative overhead when compared to the traditional fee-for-service claim process is substantial and driving the development of subscription-based care products nationally.”