Alternatives to insurance-based healthcare you should know about
Who else out there recently sat down with their pen, paper, calculator, computer and began crunching health insurance numbers?
Maybe you’re part of an organization that did it earlier in the year as you made selections for your team’s benefits.
This post may come a little late for folks who already set their healthcare plans for 2026, but the information will still be helpful for the next time you’re evaluating healthcare options.
Traditional health insurance continues to become more expensive and doesn’t deliver better outcomes associated with the higher cost. Whether you're navigating healthcare for yourself or selecting benefits for a workforce, the frustrations are similar: rising premiums, high out-of-pocket costs, narrow networks, and unpredictable bills.
Most adults (92%) have health insurance (think Medicare, Medicaid, and private insurance) and yet about one-third (36%) of adults say that in the past 12 months they have skipped or postponed getting health care they needed because of the cost.
Healthcare can’t be effective when it’s not used…in fact it’s most effective when it is used, and used proactively, because it helps prevent small issues from getting bigger.
The insurance-based system is so widely adopted and viewed as the only avenue for accessing healthcare, that most people don’t realize alternative options exist. While traditional insurance is still the right fit for a lot of people, we’ll explore two common alternatives today called Direct Primary Care (DPC) and Healthcare Sharing Programs that can be utilized by both individuals and organizations.
Direct Primary Care (DPC)
Direct Primary Care replaces insurance-driven medicine with a simple membership model. For a flat monthly fee, individuals (or employees through an employer plan) receive direct, ongoing access to their primary care provider.
How DPC Works
Most DPC memberships include:
Unlimited visits without a copay
Long, unrushed visits
Direct provider communication
Preventive and wellness services
Discounted labs and procedures
Some medications
DPC removes the traditional barriers that prevent people from getting care early—before a problem grows into a costly crisis. DPC providers can see fewer patients so they have more time to consult with you, research treatment options, and focus on preventive health and education. For example, a common caseload for a full time DPC provider is closer to 500 patients versus approximately 2000-2500 for an insurance-based provider.
Why Individuals Choose DPC
Individuals appreciate DPC because it offers:
Transparent costs (commonly $55-$125/month)
Highly accessible care
Personalized attention
Strong prevention and early intervention focus
It aligns perfectly with people who want to be more proactive, not reactive, with their health. Check out Northern Michigan DPC provider Table Health and their blog post about why and how DPC saves money.
Why Employers Are Moving Toward DPC
Across the country, employers—from small businesses to mid-sized companies—are switching their benefits toward DPC for several reasons:
Lower overall healthcare spending
Reduced use of ER and urgent care
Better employee health outcomes
Stronger engagement with primary care
Improved retention and satisfaction
Predictable budgeting
If you want to learn more about how companies have successfully implemented DPC and alternative healthcare models in their the organizations, check out the book by Matt Ohrt called Don't Feed the Beast: The Employer Healthcare Success Formula.
Healthcare Sharing Programs
Healthcare sharing programs offer another alternative by pooling member contributions to share major medical expenses. While not insurance, they serve as a financial safety net for surgeries, hospitalizations, and serious illness and often have some built in preventive care as well.
Members often experience:
Lower monthly costs
Freedom to see any provider
Emphasis on health responsibility
Encouragement of wellness and prevention
Many of these programs often have services like, DPC, virtual urgent care, virtual mental healthcare and more built in because access to decision support and preventive care helps reduce overall costs. However, in most cases, members pay for their own lower-cost healthcare needs.
It is common for health share programs to be faith-based but others are not. Check out groups like Crowd Health and Sedera as you begin your search.
These services also often have built in solutions to help their members shop around for providers with both good prices and good outcomes as well as will negotiate high ticket bills.
It’s good to note that many health share programs do not cover costs associated with pre-existing conditions for set periods, so they are not necessarily a best option for some folks.
If you consider a program like this, it is important to research the program stipulations and ensure it’s a good fit. These organizations will often have folks to help you understand the facets of their program to help you decide.
Why Individuals Choose Healthcare Sharing
Individuals often choose cost-sharing because it offers:
Lower costs compared to insurance
Flexibility and autonomy
Protection against large, unexpected expenses
Easy pairing with DPC
A wellness-first culture
Why Employers Incorporate Healthcare Sharing
Organizations may adopt cost-sharing strategies to:
Reduce total healthcare spending
Offer affordable coverage options
Pair with DPC for comprehensive care
Provide high-value benefits with lower administrative burden
Many employers use DPC + cost-sharing to create a complete, sustainable healthcare model for their workforce. Anecdotally, I heard of one Northern Michigan employer who was facing a 35% increase in their insurance, switched to a DPC plus a cost sharing service, and actually saved 38% compared to the prior year.
Where Northbound Physical Therapy and Wellness Fits In
Northbound Physical Therapy and Wellness integrates seamlessly into the direct-pay, DPC, and cost-sharing ecosystem as a specialized provider focused on prevention, early intervention, and long-term musculoskeletal health.
Because Northbound is fully out-of-network from insurance, the practice is able to offer:
Transparent, upfront pricing
One-on-one, dedicated treatment sessions
No visit limits, referral requirements, or insurance restrictions
Holistic and proactive care rather than reactive treatments
Flexible program design tailored to individuals and organizations
How Northbound Supports Individuals in the Direct-Pay Ecosystem
Individuals using DPC or cost-sharing programs often look for specialty providers who also operate outside traditional insurance constraints. Northbound fills that gap by offering:
Preventive Musculoskeletal Care
Movement screenings, strength, and mobility assessments
Guidance on ergonomics, posture, and daily mechanics
Personalized exercise programs
Early Intervention
Access to care when a musculoskeletal issue first appears
Hands-on treatment to prevent chronic problems
Education to reduce recurrence
This empowers individuals to stay healthier, more active, and less reliant on costly medical interventions.
How Northbound Supports Employers Using DPC + Cost Sharing
Employers committed to improving employee health and lowering long-term costs increasingly recognize musculoskeletal issues as one of their highest-cost categories both in private insurance and worker’s compensation claims.
Northbound offers organizations:
Preventive Onsite or Virtual Programs
Injury-prevention consulting and workshops
Ergonomic assessments for office, caregiving and labor-focused workforces
Education on safe lifting/body mechanics, preventive health education mobility, and daily warm-ups
Screening and OSHA First Aid interventions for MSK issues
Organizations using DPC + cost-sharing often turn to specialty partners like Northbound to complete the preventive-care ecosystem Ohrt describes in his book by “investing early in employee health to avoid feeding the healthcare system’s cost-driving mechanisms”.
the Healthcare Landscape— people, Prevention, Access, and Value
Another good reminder of the strain of the insurance-based system is how it contributes to burnout among healthcare workers and the exacerbation of healthcare provider shortages like primary care providers, physical therapists, nurses, and mental health providers.
I personally experienced burnout after only 5 years in my career in part due to the large demands the insurance-based system places on providers through time squeezes and administrativia (death by paperwork).
Non-insurance payment models are actually often preferred by healthcare providers because they don’t have to navigate the complexities of billing and obtaining payment, get locked into reimbursement rates that can be dropped at any time, or plan for the possibility of their payments being denied or rescinded.
Communities benefit from the presence of healthcare providers who are skilled, passionate and focused on taking care of people, not on micromanaging their day around the second hand of the clock, billing codes, and meticulously-managed productivity units.
It’s often said that the healthcare system is broken, but I appreciate this framing of it from author Matt Ohrt who once said
“The healthcare system isn’t broken, it’s functioning exactly the way it’s designed to”
It’s a great reminder that if we desire a different outcome from our healthcare system, we have to do something different.
As consumers in a free-market economy, we can and should shop around to find the best product to meet our needs even if that’s different from what we’ve always done.
As both individuals and employers evaluate their healthcare options, the DPC + cost-sharing model will likely continue to grow.
There are many different DPC and Healthcare Sharing organizations out there.
If you already use DPC and/or a cost sharing service, I’d love to hear what your experience has been like! Tell me about it: here.