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Is Subscription Medicine the Wave of The Future?

June 1, 2018

Subscription memberships are all the rage. We pay member fees for television programs, meal delivery services, and, increasingly, for access to medical care. Subscription-based medicine can take many forms, from high-end concierge practices that charge steep annual fees on top of insurance, to direct primary or specialty care models that accept a more modest subscription fee and do not accept insurance. Is subscription medicine the wave of the future?

It is certainly a current, providing healthcare providers and patients viable alternative models to the traditional fee-for-service practice. These models are promising, especially in addressing specific pain points in the healthcare ecosystem, but as with any change to an ecosystem, the disruptions caused by the introduction of a new model means some aspects of the environment will need extra monitoring.

Promises

Meeting the demands of consumerism

Consumerism in healthcare is rising, and subscription-based models of healthcare delivery cater to demands that many patients have. For patients, subscription-based models offer increased physician access and reliability, with many models offering consumer-friendly benefits such as same-day appointments, shorter wait times, longer appointments, and increased after-hours access to the physician.
Alleviating private practice headaches

Many of the private practices that have turned to a subscription-based model are doing so in order to remain independent. Subscription medicine can reduce many administrative headaches and expenses, especially with models that do not accept health insurance. Providers may also enjoy a reduced number of patients and the security that comes from a steady revenue stream from annual fees.

Opportunities with telemedicine

Subscription medicine and telemedicine both fulfill demands from healthcare consumerism. As telemedicine continues to grow, healthcare providers will continue to get creative in ways to market and utilize their skills outside the exam room, and as this becomes normalized, patients with expect it. A subscription model paired with telemedicine could be a lifesaver for patients with limited mobility or who live in very rural areas.

Concerns

Primary care provider shortage

Primary care providers are already in short supply. If more of these providers drop their patient load by moving to a subscription model, where would the patients who have been left behind then turn?

Unregulated insurance

Practices moving to a subscription model must tread carefully with state laws. Many potential models of subscription medicine could effectively meet the definition of health insurance, and need to be regulated as such.

Tiered system of access

If more practices in a given economy turn to subscription medicine, the effects on the community as a whole should be considered as patients are forced to make consumer choices to deal with the provider displacement. Of particular concern, of course, would be vulnerable patients who cannot afford or who are unwilling to commit to a subscription-based practice. Will these patients still have access to care? How will the larger local healthcare community be impacted if these patients are displaced?

Subscription medicine is growing in popularity as an option for private practices to remain independent. While its slice of the provider-model pie is getting larger, it is unlikely to represent the entire pie anytime soon. Patients and providers should be aware of this trend, and tailor their choices to best balance the positives and negatives for their own needs with appreciation for the impact on the larger community.