Patients pay the practice, not the payer —Membership Medicine
Membership medicine is the umbrella over every model where patients pay a physician a recurring fee for access and care: direct primary care, concierge medicine, hybrid practices, and employer-sponsored arrangements. The clinical promise differs by model. The business mechanics are identical — price a membership, enroll a patient, bill it every month, and keep the member.
- One fee
- Recurring revenue instead of per-visit reimbursement
- 3 models
- DPC, concierge and hybrid — same billing engine
- Employers
- Group enrollment adds members in blocks
The models under the umbrella
Direct primary care
A lower flat monthly fee for primary care, with insurance billing dropped for the covered services. Smaller panels, no claims, revenue that equals fee times members.
Concierge medicine
A higher retainer for enhanced access — extended visits, direct physician contact, coordination — often while continuing to bill insurance for the visits themselves. Fewer members, higher revenue per member.
Hybrid practices
A traditional insurance-based panel alongside a membership tier for patients who want more access. It is the lowest-risk way to test the model, and the most demanding to administer, because two revenue systems run at once.
Employer-sponsored memberships
A local employer buys memberships for its staff on one agreement and one invoice. The fastest path to panel size in most markets, and the reason group billing matters more than practices expect.
What every model needs to run
Tiered pricing, a written membership agreement, enrollment with payment credentials on file, automatic monthly charges, failed-payment recovery, renewals, and reporting on active members and churn. That layer is the same whichever model you choose.
Choosing and launching your model
Pick the model from your panel, not the trend
If you want out of claims entirely and can serve a smaller panel, DPC. If your patients will pay for enhanced access and you want to keep insurance revenue, concierge. If you are not ready to decide, hybrid.
Price against a panel you can actually serve
Membership fee times realistic member count has to clear your overhead with margin. Model it before you publish it — the fee is very hard to raise later.
Get the agreement reviewed where you practice
State rules on membership medicine agreements, and on what may be included, differ meaningfully — several states regulate DPC agreements specifically. This is a question for local counsel, not a template.
Run billing as a system from day one
Autopay at enrollment, retries on decline, anniversary renewals, employer-group invoicing and one dashboard for active members and MRR. Practices that start with spreadsheets rebuild this within a year.
Practices That Got Off The Treadmill.
Select a practice to see how their membership revenue compounded month over month.
“We dropped two of our worst PPO contracts in year one. The membership plan replaced that revenue and then some — and we finally control our own fee schedule.”
- Members
- 612
- MRR
- $38.9K
- ARR
- $467K
- MRR Growth
- +284%
- Write-offs
- -$186K
Membership medicine questions
- What is membership medicine?
- Any practice model where patients pay the physician a recurring fee for care and access rather than the practice depending on per-visit insurance reimbursement. Direct primary care, concierge medicine and hybrid practices are all forms of it.
- Which model makes more money?
- Concierge generally produces more revenue per member and DPC more members per physician. Total revenue depends on the fee you can defend in your market and the panel you can serve well, so model both against your own numbers.
- Can I keep billing insurance?
- In concierge and hybrid models, commonly yes — the membership covers access and services the payer does not. In DPC, practices typically stop billing insurance for the services the membership covers. Medicare participation has its own rules; confirm them before you decide.
- How do employer groups work?
- The employer signs one agreement covering a block of employees and is invoiced as a group, while each employee enrolls as a member. It is the fastest way to reach a viable panel, and it requires billing software that can handle group invoicing.
- What software runs a membership practice?
- An EHR for clinical records and a membership platform for the business side: pricing, enrollment, recurring billing, dunning, employer groups, renewals and revenue reporting. BoomCloud™ is the second, and runs beside any EHR.
One billing engine for whichever model you choose
Price your memberships, enroll patients and employer groups on autopay, and watch recurring revenue instead of receivables.
Own your revenue. Starting this month.
Launch a membership plan, enroll your uninsured patients, and watch recurring revenue land every month — no claims, no write-offs.
Free 30 days · Setup help included · Keep every member you enroll