What IS Membership Medicine?

Membership medicine is a broad category of care models that includes any primary care practice in which patients contribute a recurring fee beyond traditional fee-for-service insurance billing. In that sense, it defines everything outside of purely insurance-funded FFS medicine.

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These models exist on a spectrum of patient subsidy and choice. Some ask for a modest membership fee to support longer visits, improved access, and care coordination while still billing insurance. Others rely primarily or entirely on membership fees, offering maximal access and personalization with little or no insurance involvement.

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What unites these approaches is that patients are choosing to directly support aspects of their care that insurance alone does not reliably fund. Membership medicine reframes primary care not as a single alternative to FFS, but as a continuum of models that balance access, time, personalization, and sustainability.

How is this different from concierge medicine?

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Concierge medicine is one specific expression within the broader category of membership medicine. It typically sits at the high-subsidy end of the spectrum, where patients pay higher membership fees to fully underwrite smaller panels, maximal access, and highly personalized service.

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Membership medicine, by contrast, is a framework rather than a single model. It includes a range of designs that vary by degree of patient subsidy, use of insurance, panel size, and access intensity. Many middle-ground membership models ask patients to modestly subsidize the time and access that insurance does not reliably cover, while insurance remains responsible only for standard covered services.

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The distinction is not philosophical but structural. Concierge medicine concentrates benefits through high individual subsidies, while other membership models distribute those same benefits more broadly by calibrating price, panel size, and care design. This allows membership medicine to function not only in boutique practices, but also within health systems and community-based settings.How does this help health systems?

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Membership medicine gives health systems a practical way to add margin to primary care without abandoning insurance-based care. Because patients contribute directly to support time, access, and staffing, these practices can be consistently profitable even in environments where traditional primary care struggles to break even.

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That profitability matters at the system level. The recurring revenue generated by membership practices can be retained locally to strengthen primary care infrastructure, or it can be used more broadly to subsidize underfunded programs such as safety-net clinics, academic missions, care for complex populations, or other strategic initiatives that lack reliable reimbursement.

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In addition to financial performance, membership models deepen patient loyalty, reduce leakage, and improve continuity across the system. They also create more sustainable physician roles, improving recruitment and retention in a workforce environment where burnout and turnover are costly.

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Taken together, membership medicine allows health systems to diversify their ambulatory portfolio with models that are financially viable on their own while also helping support the broader institutional mission.