Why More Patients May Seek Out Insurance-Free Practices

Internist Michael Freedman recently opened Evolve Medical Clinics in Annapolis, Md. His practice, which provides patients with access to perks such as secure virtual visits, e-mail, and text communication in exchange for a $35 monthly fee, is also a direct-pay practice. That means patients pay $25 per visit, as well as additional fees for services, out of pocket, rather than relying on insurance.

Just a few months after opening his practice in July 2014, Freedman is predicting large growth. In fact, he hopes to replicate his model across the country. One reason for that positive outlook is the current state of the insurance market. As more insurance plans include higher deductibles (as do many plans purchased through the health insurance exchanges) more patients will likely be attracted to the cost transparency and low rates that direct-pay practices offer. "What's happening is with all these high deductible [plans], and we're seeing a lot of them in this area go up to $5,000, $6,000 [for an annual deductible] ... is that people are going to primary care and they're getting a bill for what the insurance would have paid, and everything is their responsibility, so they're paying all this money anyway," says Freedman. "My goal is to carve insurance out of the entire industry period so that healthcare insurance will not be part of primary care or urgent care. I think we're at this amazing time right now where primary care can get free of the insurance hassles that have haunted it for the last [several years]."