Direct Primary Care works because it puts the doctor-patient relationship at the center again. When you remove insurance requirements and coding pressures, you get time, access, and the ability to actually care for the whole person.
As the year comes to an end and with no extension of the enhanced insurance subsidies in sight, more Americans are turning toward membership-based health sharing organizations as alternatives to traditional health insurance. To understand why this is happening, it helps to look at the pressures shaping today’s healthcare climate.
Several factors are driving the shift, from rising premium costs due to the expiring subsidies, and limited provider options, to a desire for greater autonomy, community values, and affordability. Naturally, this has opened the door for another approach to healthcare.
Amid this change, healthshare memberships are intriguing to individuals because they are not insurance but rather non-profit organizations in which communities of like-minded individuals come together to share in each other’s medical expenses. This community-based structure changes how people view financial responsibility in healthcare.
Instead of paying premiums to a corporation, the contributions are used to help pay for eligible needs when members experience an unexpected medical event. This shift away from corporate premiums gives members more control.
One of the biggest perks of healthshares not being traditional insurance is that members are able to take control of their healthcare as it is best for themselves and their family. This freedom is especially valuable when choosing where to receive care.
They have the flexibility to decide which providers they would like to see and not be restricted to a pre-selected network, request self-pay discounts, and decide when to involve their healthshare for those medical expenses. As a result, members start to look beyond traditional clinics.
With the ability to choose their own providers, many members turn to private doctors for their preventive care. These doctors, known as Direct Primary Care physicians, are becoming increasingly popular as they do not work with insurance companies and rather establish a monthly fee for their patients in exchange for unlimited access to their services.
Maryal Concepcion, a DPC provider and creator of MyDPC Story, states: “Direct Primary Care works because it puts the doctor-patient relationship at the center again. When you remove insurance requirements and coding pressures, you get time, access, and the ability to actually care for the whole person.”
This could lead to a larger impact on the healthcare industry as it may result in facilities having to re-evaluate pricing for their business once patients begin to choose their own providers instead of blindly following an “in-network” list. This sentiment is echoed by policymakers as well.
Warren Hamilton, senator of Oklahoma, stated that “Prices are high because government is involved…Imagine if everyone was part of a healthcare sharing ministry where doctors, hospitals, pharmacists and surgery centers had to compete for quality of care and price to earn our business.”
When asked what patients should look for when choosing a healthshare, Maryal further explained that there are 6 important things she recommends that they should consider.
- Choose a healthshare that understands how Direct Primary Care works. There are healthshares that encourage or require DPC membership because they know it improves care and reduces unnecessary medical spending.
- Look for clear, transparent guidelines. There should be no surprises around what the details are of the healthshare, how pre-existing conditions are handled, or what to expect with maternity or hospital bills.
- Find a healthshare that processes submissions quickly and communicates well. Digital-friendly platforms, straightforward instructions, and reasonable processing times are important.
- The monthly contribution should be a good fit for a patient so it is within the patient’s budget and does not fluctuate without explanation.
- Talk with other patients about their experience with the healthshare one is looking at; a friend who has similar medical needs can help clarify the value and utility of a healthshare.
- Make sure the support team is responsive, kind, and easy to reach. A cost-sharing community should feel like a community.
Healthshares can be a great fit for many people if they are generally healthy and are looking for something to provide help when there is an unexpected medical event that they incur, however, cost alone isn’t why people are joining.
For many, it’s not just about saving money, it’s about regaining control, reducing corporate gatekeeping in healthcare, and reinforcing community support during medical crises. This shift represents a broader cultural change in healthcare preferences.
Healthshares are emerging as an alternative to employer-based insurance for freelancers, self-employed individuals, and those seeking options beyond the traditional system. This movement signals a broader shift away from traditional insurance models toward healthcare rooted in community, shared responsibility, and personal values.
* Zion HealthShare does not endorse or recommend the direct primary care (DPC) providers that are listed on its website. DPC providers are listed merely as a reference to assist members and not as a guarantee of sharing. Additionally, any and all treatment received from a DPC is still subject to the Member Guidelines. Members should read and understand the Member Guidelines concerning what is considered eligible and ineligible for sharing with the community.
* Zion HealthShare is not an insurance company. Neither this publication nor membership in Zion HealthShare are offered by an insurance company. Visit ZionHealthShare.org to view your state-specific notice.