Should your direct care practice charge a registration fee?

One of the major attractions of a direct care practice for patients is the simplicity of the model. Patients pay a monthly membership fee for which they receive basic primary care services. The benefits include more time with their physician, including time outside the office visit, and no need to stress over insurance coverage for their primary care visits. Monthly membership fees can range from $50 to $150, depending on age and provider.

Some direct care providers also charge a registration fee, typically between $50 and $99, payable before the first patient visit. The registration fee is seen by some as a reasonable fee for setting up a billing account. Other direct care physicians see the registration fee as a sort of security against patients who may take advantage of the low monthly fee to access their healthcare services for the first month only and then drop out of the practice.

Many direct care practices do not require patients to commit to a long-term contract. In these cases, the patient could pay the first monthly fee, go to their appointment, receive their full direct care health services, and then not pay any additional fees. Some physicians see this possibility as the patient taking advantage of a “quick and cheap” visit.

On the other hand, some direct care physicians see the registration fee as unnecessary and possibly even a deterrent. The point of the direct care model is to provide quality healthcare at lower costs, so adding a registration fee may be seen as a negative, a potential barrier to new patients.

Alternative solutions include having the patient agree to a minimum participation term. In other words, the patient may contract for three or six – or even twelve – months of direct care membership fees before they are allowed to cancel.

Given the benefits of the direct care practice, including higher quality care, more focused provider attention, and fewer overall costs, direct care physicians believe that patients will stay with their practice without a formal long-term commitment and without a registration fee.