Alternatives to insurance-based healthcare you should know about
Who else has recently sat down with their pen, paper, calculator, and laptop to crunch health insurance numbers?
Maybe you did it as an individual, or maybe you’re part of an organization that did it earlier in the year while selecting employee benefits.
Even if your plan choices for 2026 are already locked in, this information will be invaluable the next time you evaluate your options.
Whether you’re navigating healthcare for yourself or for a team, the frustrations are familiar: higher premiums, high out-of-pocket costs, narrow networks, and unpredictable bills.
Even having insurance doesn’t mean you’ll use it. Ninety-two percent of adults in the US have health insurance, yet on average 36% of people skip or delay needed care due to cost.
This begs questions like:
“Why do we pay for a product we hesitate to use?”
“Can a product be effective if it’s not used?”
Healthcare is most effective when it is used, and used proactively—preventing small issues from escalating into expensive problems.
Most people don’t realize there are alternatives. In this post, we’ll explore two increasingly popular models used by both individuals and employers: Direct Primary Care (DPC) and Healthcare Sharing Programs.
Direct Primary Care (DPC): A Prevention-Centered, Relationship-Based Model
Direct Primary Care replaces insurance-driven medicine with a simple membership model. For a flat monthly fee, members—individuals or employees—receive direct, ongoing access to their primary care provider.
How DPC Works
Most DPC memberships include:
Unlimited visits with no copay
Long, unrushed appointments
Direct provider messaging or phone access
Discounted labs and in-office procedures
Some medications
Because full-time DPC clinicians typically care for around 500 patients (compared to 2,000–2,500 in insurance-based practices), they have more time to spend with patients to understand issues, provide education, and strategize interventions before sending patients patients out for testing or to the specialist.
Why Individuals Choose DPC
Transparent, predictable costs (typically $55–$125/month)
Convenient access
Personalized, relationship-based care
A strong focus on prevention and early intervention
For Northern Michigan residents, there are several local DPC options and even more online. Check out this blog post from my friends at Table Health on why DPC saves money for individuals and employers.
Why Employers Are Moving Toward DPC
In Northern Michigan and across the country, employers—from small businesses to multi-location organizations—are redesigning their benefits around DPC because the improved access and care commonly results in:
Lowers total healthcare spending
Reduced ER and urgent care use
Better chronic disease management
Greater employee satisfaction and retention
Predictable budgeting and fewer renewal surprises
If you want to dive deeper into how companies have successfully implemented DPC and other nontraditional healthcare models, check out Matt Ohrt’s book, Don’t Feed the Beast: The Employer Healthcare Success Formula, is a must-read.
Healthcare Sharing Programs: A Community-Based Approach
Healthcare sharing programs pool member contributions to cover major medical expenses. Although not insurance, they function as a financial safety net for hospitalizations, surgeries, accidents, and major illness and commonly include preventive services.
What Members Experience
Lower monthly contributions
Freedom to choose any provider
An emphasis on personal responsibility
Encouragement of prevention and wellness
Many programs also include built-in services like:
Telemedicine
DPC memberships
Virtual mental health care
Negotiation for large bills
Price shopping tools for labs, imaging, and procedures
Some health share programs are faith-based, while others—like CrowdHealth and Sedera—are not. They vary considerably, so it’s important to research whether the program fits your needs. Check out this blog post for more cost sharing programs.
A key note: Many sharing programs limit coverage for pre-existing conditions for a period of time, so they may not be the right fit for everyone. One benefit of health insurance is that insurance providers cannot charge more or deny you coverage if you have a pre-existing condition as it is mandated by the Affordable Care Act.
Why Individuals Choose Cost Sharing
Lower costs compared to insurance
Flexibility and autonomy
Protection against major medical events
Easy integration with DPC
A wellness-first approach
Why Employers Adopt Cost Sharing
Employers may integrate cost sharing to:
Reduce total healthcare spending
Offer more affordable, flexible coverage
Pair with DPC for a comprehensive model
Lower administrative burden
Some Northern Michigan employers have adopted this model and have already seen significant results. One shared anecdotally that after facing a 35% insurance increase in the year ahead, switching to DPC + cost sharing resulted in a 38% overall savings compared to the prior year.
Where Northbound Physical Therapy and Wellness Fits In
Northbound Physical Therapy and Wellness naturally integrates into the direct-pay, DPC, and cost-sharing ecosystem by focusing on prevention, early intervention, and long-term musculoskeletal health—an area that represents a significant portion of healthcare spending.
Northbound is fully out-of-network, we offer:
Transparent, predictable pricing
One-on-one dedicated treatment sessions
No visit limits, referrals, or insurance restrictions
Flexible, holistic care tailored to the individual
Programs designed for both individuals and organizations
This structure aligns perfectly with models that prioritize early action and keeping people well.
How Northbound Supports Individuals
Individuals using DPC or cost-sharing often seek specialty providers who operate outside traditional insurance constraints. Northbound fills this gap with:
Preventive Musculoskeletal Care
Movement, strength, and mobility screenings
Posture, ergonomics, and daily mechanics guidance
Personalized exercise and wellness programs
Early Intervention
Quick access to care when symptoms start
Strategies to reduces recurrence
How Northbound Supports Employers
Musculoskeletal issues are one of the highest-cost categories for employers in both private insurance and workers’ compensation systems.
Northbound helps organizations reduce risk and costs through:
Preventive Programs
Injury-prevention consulting and workshops
Ergonomic assessments for office, caregiving, and labor workforces
Education on safe lifting and movement mechanics
Mobility warm-up programming
Screening and OSHA First Aid–level MSK interventions
Organizations using DPC + cost-sharing often partner with specialty providers like Northbound to round out the preventive-care ecosystem that Matt Ohrt describes—investing early to avoid feeding the cost-driving mechanisms of the traditional system.
The Healthcare Landscape Ahead: People, Prevention, Access, & Value
The insurance-based system doesn’t just affect patients—it contributes to burnout and workforce shortages among providers, including primary care clinicians, physical therapists, nurses, and mental health professionals.
I began to feel burnout within the first five years of my career, largely due to the administrative burden and ultra-high efficiency pressures built into the insurance system.
Many healthcare businesses actually prefer non-insurance payers because they allow focus on patient care—not coding, paperwork, and obtaining payment.
Communities thrive when healthcare providers can spend their energy caring for people and learning how to do their jobs better, not micromanaging every single facet of their work and skipping lunch or bathroom breaks.
As Matt Ohrt notes, “The healthcare system isn’t broken; it’s functioning exactly the way it’s designed to.”
If we want different outcomes from health, we need different systems.
Whether you’re an individual or an employer, exploring models like DPC and cost sharing can open the door to care that is:
More accessible
More affordable
More preventive
More human!
There are many DPC and health-sharing options available, if you already use one, I’d love to hear about your experience. Tell me about it here.