Concierge Medicine

Subscription-based practices sometimes don't accept insurance and they also require annual membership fees which can add up to thousands of dollars per year. In return, patients are promised more personalized care and round-the-clock access to medical providers. As doctors transition to concierge care, this retainer-based medicine model is forcing people to choose between searching for new primary care providers or paying hefty fees.

These concierge medicine practices tend to have a high proportion of people ages 50 and older and are particularly concentrated in states with older populations, especially California and Florida.

Concierge medicine practices offer more opportunities for same-day visits and longer meeting times with doctors in exchange for annual membership fees on top of typical insurance payments, copays, and deductibles.

That's the rough estimate from Zirui Song, a Harvard Medical School professor who focuses on health care policy and studies the growth of concierge medicine. He and other researchers found that between 2018 and 2023 the number of concierge and direct primary care practices (concierge care without accepting insurance) grew by 83% and the number of clinicians in those practices increased by 78%.

A clinician describes how he's "one call away" from his patients in the concierge medicine system. His patients pay about $150 per month to be members in his practice on top of normal care visit costs. Doctors like him may only have hundreds of patients in their practice—instead of thousands.

Parents are interested in concierge and direct primary care services for their kids, including offerings with dorm visits, guaranteed same-day appointments, and medication access, so new practices have sprung up catering to college settings. (Some users may encounter a paywall.)

FSAs, used by roughly half of Americans, can only cover qualified medical services—so actual care—and cannot be used to cover membership fees for a concierge medicine practice. These fees must be paid out of pocket by clients.

Data Horizons Research put the value of this global market at $18.9B in 2021, but anticipates massive growth by 2032, with North America comprising the majority of the market. Chronic health conditions, their analysis suggests, will be a contributing factor to this growth as medically complex individuals seek more personalized care.

Some research suggests that the average wait time for a primary care visit in major US cities can be 21 days. Subscription-based medical practices offer faster in-person and virtual appointment options, but the price barrier to this type of service may worsen inequity in healthcare access. (Some users may experience a paywall.)

Research published in December 2025 in the journal Health Affairs indicates that these retainer-fee care models are expanding across the country. Concierge medicine charges monthly or annual fees, as does direct primary care (which doesn't take insurance).