Why modern healthcare is switching from fee-for-service to membership-style care — and how to market it
For decades, “going to the doctor” has meant a transactional, fee-for-service experience: book an appointment, show up, pay (or bill insurance), leave, repeat. That model works for acute issues, but it often breaks down for what most patients actually need: proactive prevention, consistent follow-up, behavior change support, chronic-condition management, and a care team that has the time to connect the dots.
Membership-style care flips the incentives. Instead of charging per visit, practices charge a predictable monthly or annual fee in exchange for ongoing access to a defined set of services. Direct Primary Care (DPC) is one well-known version of this model. The American Academy of Family Physicians describes DPC as typically charging a flat monthly or annual fee that covers many primary care services, reducing financial barriers to routine, preventive, and chronic care. The AMA similarly describes retainer-based models (concierge/DPC) as a membership fee that covers a defined range of services.
In plain terms: when care is structured like a membership, the practice can be built around outcomes and relationships—not billing codes.
Why memberships are winning (and why patients are saying yes)
1) Predictable cost + lower friction = more care actually happens
Membership care removes the “Should I book this appointment?” hesitation that happens when every interaction has a separate cost—especially for prevention and early intervention. In DPC arrangements, the membership fee commonly covers many routine primary care services.
2) Time-rich care teams create better experiences
Membership practices can design longer visits, more frequent touchpoints, asynchronous messaging, health coaching, and proactive follow-ups—because revenue isn’t tied to squeezing in more billable visits.
3) Ongoing support fits modern health problems
Most expensive health issues are lifestyle- and behavior-linked and require continuity (metabolic health, autoimmune issues, mental health overlap, long-term symptom workups). The membership model is structurally better suited to this.
Real-world examples of membership healthcare in the U.S.
Membership-based care isn’t theoretical—it’s already mainstreaming across multiple categories:
Parsley Health: functional medicine + membership continuity
Parsley promotes a membership care model (including “Complete Care”) designed for ongoing, whole-body care—available virtually nationwide and in-person in select cities. Parsley has publicly stated outcome claims such as a high percentage of members reducing symptoms in their first year (as reported on their site).
Marketing lesson: they sell an ongoing care relationship, not a single appointment. Their messaging emphasizes “root-cause,” long-term support, and structured programs rather than isolated visits.
One Medical (Amazon One Medical): subscription layer on top of primary care
One Medical positions itself explicitly as “membership-based primary care,” with an annual membership price publicly listed on its membership page, and a consumer-grade digital experience. Amazon also markets discounted One Medical membership pricing for Prime members, reinforcing the “membership” behavior consumers already understand.
Marketing lesson: operational convenience is a product feature. App-based access, 24/7 virtual care, and easy scheduling aren’t “nice-to-haves”—they’re conversion drivers.
Galileo: telehealth membership positioning
Galileo markets a membership where care delivered within the app is covered by a monthly or annual fee (with plan details published via their materials).
Marketing lesson: clarity wins. When your offer is recurring, patients need crisp definitions of what’s included, what’s not, and what “access” actually means.
The wider DPC movement: growing employer adoption
Industry data providers tracking DPC report significant scale (e.g., Hint has published trend reporting citing thousands of clinicians and hundreds of thousands of members in its dataset). More recent employer-focused reporting from the same source describes growing employer sponsorship and retention.
Marketing lesson: membership care isn’t only B2C. Employers increasingly want predictable costs and better primary care access—opening a B2B channel many clinics ignore.
A cautionary example: tech alone doesn’t carry the model
Forward (a subscription primary care startup) shut down in 2024, with reporting emphasizing missteps in execution and overinvestment in tech versus patient care.
Marketing lesson: you can’t out-market a weak care experience. Memberships magnify both excellence and operational flaws because retention becomes the business.
Fee-for-service vs membership care: what changes for the business?
A membership model forces (and enables) better business fundamentals:
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Revenue predictability: recurring revenue stabilizes staffing and growth planning.
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Higher LTV potential: retention + referrals matter more than one-time visits.
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More measurable outcomes: you can track adherence, engagement, and longitudinal improvement—key for differentiation.
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Different growth math: your marketing model shifts from “cost per appointment” to CAC vs LTV and churn management.
Best marketing practices for membership-based healthcare
Membership healthcare marketing isn’t “more ads.” It’s building a conversion and retention engine that supports recurring relationships.
1) Sell the transformation, not the transactions
Patients don’t want “unlimited messaging” as a feature. They want:
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fewer flare-ups
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better labs
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fewer urgent care trips
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feeling heard
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a plan they can follow
Your homepage and ads should lead with the outcome story, then support it with what’s included.
Practical tactic: create a single “Membership Explained” page with:
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who it’s for / who it’s not for
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what’s included (bullets)
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what isn’t included (bullets)
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pricing (transparent or at least a clear range)
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comparison table: fee-for-service vs membership (time, access, follow-up, coaching, ongoing plan)
2) Build your acquisition around intent, not demographics
Membership care is a higher-consideration decision. Your best leads tend to come from high-intent searches like:
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“direct primary care near me”
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“functional medicine membership”
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“concierge doctor cost”
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“doctor who actually listens”
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“chronic fatigue help” / “gut health clinic” (condition-driven)
Channel priorities that usually win:
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Search + Local SEO: capture intent and convert with clarity (Google Business Profile, reviews, local landing pages, structured service pages).
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Content that answers pricing and model questions: “Is DPC worth it?”, “Can I keep insurance?”, “What happens if I need a specialist?” (AAFP/AMA framing helps you explain the model credibly).
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Retargeting: membership decisions often take multiple visits—use retargeting to bring prospects back to the explainer page, pricing page, and “meet the provider” pages.
3) Make “trust” the primary conversion metric
In fee-for-service, the conversion is an appointment. In membership care, the conversion is commitment.
That means your marketing must prove:
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clinical credibility
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operational accessibility
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continuity of care
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patient experience quality
Trust assets to prioritize:
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clinician bios that read like humans, not résumés
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patient stories (HIPAA-compliant, de-identified)
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transparent boundaries (what you do / don’t do)
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clear “how it works” flow (especially for insurance/hybrid models)
4) Design your onboarding like a product company
Churn often isn’t about clinical dissatisfaction—it’s about unclear expectations and weak early engagement.
Best-in-class membership onboarding includes:
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a “first 30 days” roadmap (what happens when)
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immediate “quick win” touchpoint (baseline labs, intake review, care plan kickoff)
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scheduled follow-up cadence in advance
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proactive nudges for app setup, messaging, booking
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a simple member portal/experience that matches the promise
(Healthcare organizations broadly emphasize that onboarding and experience alignment matter for retention; this is a common theme in patient/member retention literature and experience management. )
5) Track the right numbers (membership metrics, not campaign vanity metrics)
Minimum dashboard for membership care marketing:
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CAC (cost per member acquired)
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activation rate (did they complete onboarding milestones?)
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churn at 30/90/180 days
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LTV (or at least LTV proxy: average months retained × monthly margin)
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referral rate (members → members)
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speed-to-lead + speed-to-enrollment (sales operational KPI)
Big unlock: tie ad platforms to CRM + membership enrollment events. Most clinics track “leads,” but recurring-revenue businesses must track “members.”
The positioning that works best right now
If you’re building (or converting into) a membership model, the strongest positioning tends to land in one of these lanes:
- Access + convenience: “care that’s actually reachable” (One Medical-style)
- Root-cause + longitudinal outcomes: “a program, not a visit” (Parsley-style)
- Cost predictability + transparency: “simple, flat fee care” (classic DPC framing)
- Employer-sponsored primary care: “better access for employees, simpler utilization” (employer channel)
Pick one primary lane, then support it with secondary proof points.
Closing: membership care is a business model—and a promise
Membership healthcare is expanding because it matches what patients want (clarity, access, continuity) and what clinicians need (time, autonomy, predictable revenue). But it’s also less forgiving: if the experience doesn’t match the promise, churn will expose it quickly.
The clinics that win won’t be the ones who say they’re modern. They’ll be the ones who operationalize modern care—then market it with clarity, credibility, and a retention-first growth engine.
