A little-noticed provision in the recently passed HR 1 Bill (you may have heard it called it the “Big Beautiful Bill”) could change everything for independent practitioners.
Most of the headlines focused on the very public Trump/Musk jockeying over the bill, or on Medicaid and insurance coverage. However, the bill is poised to have a significant impact on direct primary care (DPC), cash-pay medicine, and membership-based models.
This bill sets the stage for a dramatic shift in how care is delivered, paid for, and valued. If you’ve been sitting on the sidelines wondering whether to move away from fee-for-service, this could be the catalyst you’ve been waiting for.
We don’t need to tell you that striking out on your own for a DPC or cash-pay model required a leap of faith. You needed to leave the security of a full-time position and the same amount of money reliably showing up in your bank account every month for the unpredictability and volatility of entrepreneurship.
Next, when you opened your doors, you had to educate patients, challenge the insurance status quo, and take on the risks of an unfamiliar model.
HR 1 changes everything. What was once the road less travelled could become a super highway. Membership-based care isn’t just an option anymore. It could become the norm in modern medicine.
HR 1 explicitly makes direct primary care memberships eligible for pre-tax spending. That means patients can now use health savings accounts (HSAs), flexible spending accounts (FSAs), and employer contributions for DPC memberships.
The bill:
The financial implications are huge. For patients, it could reduce the cost of DPC by 30–40%. For employers, it clears away the legal gray area that prevented them from offering DPC as a benefit. For practitioners, it means demand is about to skyrocket.
Fee-for-service has been the default in American healthcare for years, but it’s fundamentally broken. Patients pay for visits, procedures, and tests. Doctors chase volume, patients feel rushed, and nobody wins.
Membership models solve this problem. With recurring monthly revenue, practitioners gain predictability, stability, and freedom to focus on relationships and outcomes. Patients get ongoing access, continuity, and trust. HR 1 validates this model at a national level and makes it more affordable for both sides.
If you’re still relying on fee-for-service, you should see HR 1 as a warning shot. If you’re running a DPC, concierge, or membership practice, you should see it as a turning point.
Some specialties are particularly well-suited to the membership model:
Even hybrid models can work. Some patients need intensive upfront programs, while others benefit more from long-term, lower-touch membership care. The key is aligning the model with the patient’s journey.
This all takes effect January 1, 2026. Are you ready?
If you’re already running a fee-for-service practice, HR 1 gives you the perfect opportunity to make the shift. Here’s how:
Send a letter or e-blast to existing patients. Consider holding an event explaining the new law and how it benefits patients. Frame it as amazing news, because it is.
Consider $150/month for full care and a lower-cost $90/month tier with group visits, webinars, or limited direct access.
Many patients don’t realize how much pre-tax money they already have available.
Share real patient outcomes to show the value of membership. These can be video testimonials or printed case studies.
You also need to ensure that your current systems and procedures are scalable—meaning, if you double your patient load, will you break half of your systems?
Start looking at things right now. Take a look at how your practice is structured today. Create a hiring plan based on milestones so you can stay ahead of the influx and avoid panic-based hires.
We provide a do-it-all EHR, practice management, and patient portal solution that helps you slash the time spent on administrative tasks, streamlining all workflows and allowing you to scale with ease.
“While it takes a while to customize Cerbo to fit your practice, it is well worth the investment and ultimately saves time and money. The best part is that this translates into successful patient outcomes while minimizing the burden of charting, educating, and day-to-day administrative tasks on the practice team.”
— Dr. Kristann Heinz, MD, RD, Red Hill Medical + Wellness, Pennsylvania.
