Reimagining Healthcare: Why More Providers Are Choosing Cash-Based and Concierge Models
There’s a quiet but important shift happening in healthcare. More and more providers—including physical therapists, primary care physicians, and even surgeons—are stepping away from traditional, insurance-based models in favor of more flexible, personalized approaches to care.
In my own practice as a physical therapist, this has meant adopting a concierge care model. I travel to clients’ homes, work independently of insurance, and offer a blend of rehab, injury prevention, strength training, and Pilates based on each person’s unique needs. This approach—sometimes called cash-based physical therapy—has allowed me to spend more time with each client and focus on long-term wellness, not just short-term symptom relief.
Why Providers Are Leaving the Insurance Model
Much of this change is being driven by shared frustrations. For providers, insurance-based care often means juggling multiple patients per hour, wrestling with restrictive billing codes, and feeling unable to give each patient the attention they deserve. For patients, that typically translates to short, rushed appointments and inconsistent follow-up.
In contrast, cash-based healthcare models allow for more time, better continuity, and care that’s genuinely tailored to the individual—not just their diagnosis code or insurance coverage. We’re seeing these models emerge across the board, from concierge physical therapy and mobile IV drips to boutique surgical centers and private wellness practices.
The Value of Personalized, Proactive Care
These alternative healthcare models are more than just a workaround—they’re filling an important gap. Traditional systems often don’t have the time or capacity to offer proactive, preventative care. That’s where concierge and private-pay providers can make a real difference.
In my work, that means helping clients avoid surgery, recover fully from injury, or reduce the risk of chronic issues before they start. It’s about keeping people moving well and living well—before they ever reach a crisis point.
By addressing health concerns early, these models also reduce strain on the broader system. When fewer people need emergency or specialist care, it creates more space and resources for those who do.
The Accessibility Challenge
It’s important to acknowledge a limitation here: these models aren’t accessible to everyone. Right now, the most personalized, flexible care often comes at a cost—and not everyone can afford to pay out of pocket. As cash-based practices grow, we need to keep having conversations about equity and accessibility.
Still, expanding the diversity of care options has value. By offering alternative healthcare services, we’re creating new ways for people to get help—and new ways to support an overburdened system.
Supporting the System by Working Alongside It
Ultimately, I see my practice not as separate from the healthcare system, but as a support to it. I want to help people stay well so they don’t need to enter the system unnecessarily. And when they do, hopefully they enter it stronger, more informed, and more empowered.
As we face growing health challenges as a society, we need creative, patient-centered solutions. It’s not about replacing the system—it’s about creating thoughtful alternatives that give people more ways to stay healthy, supported, and seen.
