Month: July 2025

Hari Prasad
July 21, 2025

Emerging from the pandemic, virtual care has shown healthcare practices that telehealth is here to stay. But simply enabling video visits is just the beginning. To capitalize on virtual care’s benefits while avoiding common pitfalls, practices must thoughtfully address operational, clinical, and patient-experience challenges when evaluating additional virtual care options.

Here are five key considerations to help guide your virtual care strategy.

1. Seamless Integration with Existing Systems

Virtual visits should complement, not complicate, your current workflows. Practices often juggle the management of multiple platforms, including scheduling software, electronic health records (EHRs), billing systems, and patient portals. A fragmented approach creates data silos and increases administrative burden. 

That’s why it’s important to look for telehealth solutions that offer bi-directional EHR integration, so that appointment details, encounter notes, and billing codes flow automatically into the patient’s record. Practices that achieve seamless integration report fewer documentation errors and faster revenue cycle turnaround. Mapping out the patient journey, from online scheduling through virtual check-in to post-visit billing, will ensure that every team member understands their role and can deliver a consistent experience.

2. Regulatory Compliance and Reimbursement Models

Telehealth regulations and payer policies continue to evolve. During the COVID-19 public health emergency, federal waivers and state “parity” laws expanded coverage for telehealth, but many of those flexibilities are now fading away. Practices must stay current onstate licensure requirements, controlled-substance prescribing rules, and Medicare/Medicaid reimbursement policies. Make sure your documentation meets Centers for Medicare & Medicaid Services (CMS) guidelines such as capturing visit start/end times, the modality used (video or audio), and the provider’s location. Likewise, confirm with commercial payers that virtual visits will be reimbursed at rates comparable to in-person encounters. Proactive monitoring of regulatory updates, from resources like the Center for Connected Health Policy, will protect your bottom line and prevent unwelcome reimbursement surprises.

3. Prioritize Cybersecurity and Patient Privacy

As virtual care expands, practices become responsible for securing sensitive health information across new digital channels. Telehealth platforms and patient portals must be fully HIPAA‑compliant, with end‑to‑end encryption to protect video streams and stored data. Practices should conduct regular risk assessments, apply multi‑factor authentication for both staff and patients, and ensure software patches are installed promptly. Staff training is also critical; any team member handling patient data needs clear protocols for secure password management, recognizing phishing attempts, and reporting breaches. By making cybersecurity a foundational element of your virtual care strategy, you safeguard patient trust, avoid costly data breaches, and ensure regulatory compliance as telehealth becomes a core practice modality.

4. Staff Training and Change Management

Rolling out virtual care isn’t simply a tech deployment; it’s an organizational transformation. Administrative and clinical staff need to understand not only how to use telehealth platforms, but also when to triage patients to virtual versus in-person visits. Establish clear protocols detailing which conditions or visit types, such as medication refills, mental health check-ins, or follow-up consultations, are appropriate for telehealth. Provide hands-on training sessions, quick-reference guides, and ongoing tech support so your team feels confident troubleshooting connectivity issues or guiding patients through the process. When staff feel empowered, they can focus on patient care rather than technical problems, boosting both efficiency and satisfaction on both sides of the screen.

5. Maximizing Patient Engagement and Experience

Virtual care can be convenient, but it risks feeling impersonal if not executed thoughtfully. Patients value transparency around costs and care expectations. Integrate online scheduling that displays real-time availability, automated appointment reminders via text or email, and secure portals where patients can complete intake forms and view estimated copays ahead of their visit. Clear communication about audio-only versus video visit requirements, how to log in, and what to expect during the virtual encounter reduces “no-shows”; practices that implement robust pre-visit engagement see attendance rates climb by up to 25%. After each visit, solicit feedback through brief surveys to surface usability issues or workflow improvements. Satisfied patients will be more likely to return and to recommend your practice to family and friends, extending the benefits of virtual care well beyond a single appointment.

Looking Ahead

Integrating virtual care into your practice is not a one-time project but an ongoing evolution. By focusing on integration, compliance, digital equity, staff readiness, and patient engagement, you can build a robust hybrid care model that expands access, streamlines operations, and enhances outcomes. As technology advances, from remote monitoring devices to AI-driven virtual assistants, practices that establish a strong foundation today will be best positioned to adapt and thrive in the healthcare landscape of tomorrow.

Hari Prasad

CEO at Yosi Health

Hari Prasad is the CEO of Yosi Health, a digital front-office automation platform that helps healthcare practices streamline patient intake, virtual visits, and payment workflows. With more than a decade of experience in health-tech innovation, he guides practices in implementing patient-centric solutions that drive engagement and efficiency.

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At West Point Optical Group, delivering a seamless and efficient patient experience is a top priority. Founded in 2014, the group has grown from 10 locations to over 87 across 14 states, managing around 200,000 patient exams annually. But with rapid growth came mounting operational challenges—especially related to manual patient intake processes and integrating paperwork into their electronic health records (EHR).

The Challenge: Manual Intake Bottlenecks

Before implementing Yosi Health, West Point Optical’s staff spent significant time managing paperwork. Patients would arrive, fill out forms by hand, and staff would manually enter this data into the EHR. This process was not only repetitive but also took away valuable time from patient care, leading to longer wait times and potential inefficiencies in appointment flow.

The Solution: Yosi Health’s Automated Intake

Seeking a solution, West Point Optical discovered Yosi Health through their EHR provider, RevolutionEHR, which offers a white-labeled, fully integrated intake platform called Rev Intake. With Yosi Health, patients receive a link to complete their intake paperwork conveniently from their own device days before their appointment. The process is user-friendly and appreciated by both patients and staff.

Key Benefits Realized:

• Reduced Wait Times: Paperwork is done ahead of visits, so patients can check in and see their doctor more quickly.
• Streamlined Operations: Automated data entry has eliminated redundant tasks and saved hours for both staff and patients.
• Seamless EMR Integration: All forms are uploaded directly into the EHR, ensuring data accuracy and speeding up the check-in process.
• Enhanced Patient Satisfaction: Patients enjoy a smoother, faster experience from arrival to exam to checkout.

Jared Noble, West Point Optical’s Director of Operations, calls Yosi Health “one of the most impactful initiatives” they’ve launched, emphasizing that the platform saves significant time and lets staff focus more on direct patient care rather than paperwork.

Why Yosi Health?

Beyond intake paperwork, Yosi Health offers tools including online scheduling and support for marketing initiatives—making it a comprehensive platform for modern healthcare practices looking to boost efficiency, reduce costs, and deliver superior patient experiences.

“If you want to save time, allow your employees to focus on patient-facing behaviors, and make your patients happy by streamlining workflows, then Yosi is the place for you,” says West Point Optical.

Interested in transforming your practice? Learn more at yosi.health and discover how Yosi Health can help optimize your operations and delight your patients.

This blog post is inspired by the testimonial video from West Point Optical—watch the full story to see the impact in action!

By Hari Prasad, founder and CEO, Yosi Health.

Over the past decade, the US healthcare landscape has witnessed the emergence of alternative payment models designed to realign incentives, improve patient access, and stabilize practice finances. Chief among these innovative models are concierge medicine, Direct Primary Care (DPC), and the pay-first approach.

Although each model operates differently, they share a common goal: reducing administrative burden, enhancing patient engagement, and ensuring predictable revenue streams. Understanding their nuances, benefits, and implementation challenges can help practices decide which path best fits their mission and patient population.

Concierge Medicine, sometimes called “boutique” or “retainer” medicine, typically involves patients paying an annual fee, often several thousand dollars, in exchange for enhanced access to their physician. This can include same-day or next-day appointments, longer visit times, 24/7 phone or text access, and comprehensive annual physicals. For physicians, the concierge model offers a reliable source of revenue detached from traditional insurance reimbursement.

This steady income can reduce reliance on high patient volumes, allowing doctors to maintain smaller patient panels and dedicate more time to individualized care. Patients, in turn, enjoy a white-glove experience: fewer waits, more personal attention, and simplified navigation of preventive care.

Despite its advantages, concierge medicine remains accessible primarily to higher-income patients who can afford the retainer fee. Practices evaluating this model must consider patient demographics and local competition. Physicians must be transparent about which services the retainer covers and which remain subject to traditional insurance billing.

Clear contract terms help prevent confusion when patients seek specialists or hospital care outside the concierge arrangement. Additionally, regulatory and legal frameworks governing retainer practices vary by state, so clinics should seek guidance to ensure compliance with fee-splitting and insurance regulations.

Direct Primary Care (DPC) represents a middle ground between concierge medicine and traditional fee-for-service. In DPC, patients pay a flat monthly or annual subscription—typically ranging from $50 to $100 per person—that covers an agreed-upon suite of primary care services. These may include preventive exams, chronic disease management, basic labs, and unlimited office visits. By removing insurance billing for primary care services, DPC practices eliminate much of the administrative overhead associated with coding, claims submission, and payer denials. The model enables physicians to focus on delivering comprehensive care, often with same-day appointments and enhanced access through telehealth or direct messaging.

Unlike concierge medicine, Direct Primary Care is designed to be affordable for a broader patient base, including those with high-deductible insurance plans or no coverage at all. Patients appreciate the predictability of subscription fees, which can replace unpredictable copays and coinsurance charges. For physicians, DPC creates predictable revenue streams while maintaining the flexibility to bill insurance for services outside the primary care scope, such as specialist referrals, imaging, or hospitalizations. Practices considering DPC should carefully size their patient panels to balance access with financial sustainability, as too many subscribers can strain provider capacity and erode the very benefits that make the model attractive.

The Pay-First Model addresses financial sustainability through a different mechanism: point-of-service collections. At its core, pay-first asks patients to pay their copays, deductibles, or estimated out-of-pocket responsibility when they check in, or even in advance via secure online portals. After insurance adjudication, any remaining balance is automatically charged to a credit card on file. By collecting anticipated patient dues upfront, practices can drastically reduce accounts receivable and bad debt write-offs. Staff spend less time on billing follow up and more on patient engagement, while revenue cycles accelerate and cash flow becomes more predictable.

From the patient perspective, pay-first delivers transparency and convenience. When patients understand their financial responsibility before the visit, surprise bills become a thing of the past. Many practices augment this clarity with automated estimates generated from integrated eligibility and benefits platforms, which check coverage in real time. To succeed with pay-first, practices must communicate clearly across multiple channels—phone, text, email, and web—and offer flexible payment options, including online portals, health savings account payments, or payment plans. Training staff to navigate conversations about costs empathetically is crucial to maintaining trust and minimizing friction.

Although these models each offer compelling advantages, practices must carefully align choice of model with their patient population, specialty, and operational capacity. Smaller primary care clinics in underserved areas may find DPC especially well-suited to populations with high-deductible insurance, as the predictable subscription fee encourages regular preventive visits. Specialty practices with stable, affluent patient bases might lean toward concierge medicine, offering a differentiated, service-rich experience. Multi-specialty groups or larger health systems can pilot pay-first for routine outpatient visits, leveraging their administrative infrastructure and digital engagement tools to reduce billing complexity and improve patient satisfaction.

Regardless of model, technology plays a pivotal role in ensuring success. Practices should invest in integrated EHR platforms that streamline scheduling, billing, and documentation for virtual and in-person visits alike. Automated patient portals and mobile apps facilitate pre-visit questionnaires, consent forms, and payment processing. Telehealth capabilities extend reach beyond the conference room, offering virtual check ins and chronic disease monitoring that complement subscription- or retainer-based care. Data analytics tools can track key performance indicators such as patient acquisition costs, no-show rates, revenue per visit, and patient satisfaction, which enables continuous optimization.

Looking ahead, the adoption of concierge medicine, Direct Primary Care, and pay-first models reflects a broader shift toward value-based, patient-centric care. These approaches challenge the status quo of volume-driven reimbursements, incentivizing proactive, relationship-driven engagement over transactional encounters. As policymakers and payers increasingly recognize the importance of preventive care and population health, hybrid models may emerge, blending subscription fees with performance-based incentives for quality metrics. Practices that remain agile, invest in digital infrastructure, and prioritize transparent communication will be best positioned to thrive in this evolving landscape.

Ultimately, the future of U.S. healthcare depends on aligning financial incentives with patient outcomes and experience. Emerging payment models, whether through concierge retainers, DPC subscriptions, or pay-first collections, offer practical pathways to reduce administrative overhead, improve access, and build sustainable practices. By thoughtfully selecting and tailoring these models to fit their unique context, healthcare providers can create resilient, patient-focused practices that stand the test of time.

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In an interview with Managed Healthcare Executive, Yosi Health CEO Hari Prasad praised insurers’ new voluntary pledge to simplify prior authorization, calling it a key step toward faster care and reduced administrative burdens for providers and patients.

Major health insurers recently pledged to simplify and reduce prior authorization across commercial plans, Medicare Advantage and Medicaid managed care. Hari Prasad, CEO of Yosi Health, sees the move as a significant step forward for both patients and healthcare providers.

“This is a really welcome move by the health insurance plans, especially because this comes (as) voluntary,” Prasad said, adding that prior authorization delays have caused 74% of patients to abandon care in the past.

He added that streamlining the process could lead to faster treatment and better outcomes for patients, while also reducing stress on clinicians.

Founded in 2015, Yosi Health has focused on reducing administrative burdens in healthcare from the start. The company’s mission aligns closely with the insurers’ pledge, which also includes efforts to digitize the prior authorization process and enable real-time approvals.

Prasad shared that the current process often involves manual, paper-based or phone-based steps, causing delays and inefficiencies. By switching to digital systems, providers can avoid redundant paperwork, speed up care decisions, and track outcomes more effectively.

He also pointed to broader financial implications: with U.S. healthcare spending projected to reach $7.7 trillion by 2033, eliminating unnecessary administrative costs is becoming increasingly important.

The voluntary nature of the insurers’ pledge adds to its impact, as it shows a willingness across the industry to address a known pain point in care delivery, he shared.

Prasad hopes this is the beginning of more industry-wide efforts that put patients and outcomes at the center of care processes.

Click to Read the full article here.

Virtual visits have demonstrated solid potential to expand access, reduce in‑office congestion, and support continuity of care, but implementing these tools successfully relies on careful planning and strategy.

As virtual care becomes a new staple of modern healthcare delivery, practices find themselves navigating operational and engagement challenges that traditional office systems were never designed to address. It’s true; virtual visits have demonstrated solid potential to expand access, reduce in‑office congestion, and support continuity of care, but implementing these tools successfully relies on careful planning and strategy. 

If your practice is looking to scale up its virtual care offerings, here are five factors to consider.

First and foremost, seamless integration with existing workflows and electronic health records (EHRs) is critical. Many practices already juggle multiple platforms such as scheduling tools, billing systems, patient portals, and the EHR itself. Introducing telehealth without integrating into those systems can create data silos and inefficiencies. 

Many organizations have observed that bi-directional integration can lead to fewer documentation errors and reduced administrative overhead. To avoid duplicative data entry and ensure a smooth patient experience, invest in a telehealth platform that exchanges visit notes, billing codes, and patient histories in real time. Before launch, map out the entire patient journey – from appointment scheduling, through virtual check‑in and the video consultation itself, to follow‑up and billing – so every team member understands which steps occur virtually and which require in‑person interaction.

Second and equally important is staying ahead of the ever‑evolving compliance and reimbursement landscape. Federal waivers enacted during the Covid-19 pandemic have opened doors for virtual care, but many are scheduled to expire or be modified (Opens in a new window). Practices need to remain agile to ensure they capture appropriate reimbursement without risking compliance.

At the state level, licensure rules, prescribing regulations, and originating site requirements vary, so regularly consulting resources such as the Center for Connected Health Policy is essential. Practices must also verify payer policies to ensure that virtual services qualify for reimbursement at parity with in‑person visits. Finally, meticulous documentation, capturing visit start and end times, the virtual modality used, and the clinician’s location, is indispensable for passing audits and maximizing revenue.

While integration and compliance are foundational, none of it matters if staff aren’t fully prepared to support virtual care. Front‑desk and clinical teams play a pivotal role in guiding patients through new technologies, troubleshooting connection issues, and managing virtual‑visit workflows. A simple, intuitive platform makes onboarding easier, but it’s only half the battle. Practices should provide hands‑on training, clear step‑by‑step guides, and ongoing technical support to ensure staff can confidently assist patients with everything from logging in to handling insurance eligibility checks remotely. When staff feel empowered, they can deliver a smoother, more consistent virtual experience that builds patient trust and satisfaction.

Beyond administrative readiness, preserving clinical quality and continuity of care is paramount. Virtual visits should be integrated into a broader, hybrid model rather than acting as isolated encounters. Telehealth is highly effective for routine medication refills, mental health check‑ins, and postoperative wound inspections, but certain conditions, such as acute chest pain or complex physical exams, necessitate in‑person assessment.

 Developing clear clinical guidelines and decision pathways allows providers to match each patient’s needs with the appropriate care setting. After every virtual encounter, automated reminders can prompt patients to complete lab work or follow up with secure messaging, seamlessly incorporating remote monitoring data into the EHR.  A Mayo Clinic study found that synchronized virtual and in-person approaches improve hypertension control by 20% (Opens in a new window)compared to in-person only care. 

Finally, optimizing patient engagement and experience ensures that virtual care delivers value for both sides of the appointment. Though digital visits offer convenience, they can feel impersonal unless thoughtfully executed. Practices should simplify virtual check‑in by offering online scheduling and pre‑visit intake forms, allowing patients to complete paperwork at their own pace. Transparent communication about out‑of‑pocket costs, through clear estimates during scheduling and flexible payment options like credit‑card‑on‑file, prevents surprise bills that erode trust. 

Collecting feedback after each virtual visit via brief satisfaction surveys helps identify technical glitches or communication gaps, enabling continuous improvement. A recent Surescripts study noted that 50% of patients feel more engaged (Opens in a new window)when care teams proactively share test results or care plans via a portal. This clearly highlights the importance of providing ongoing virtual touchpoints beyond the video call.

Expanding virtual care presents an opportunity to enhance access, streamline operations, and deliver more patient‑centered services. Yet success hinges on thoughtful implementation: integrating telehealth into existing systems, maintaining compliance, investing in staff training and support, preserving clinical quality, and prioritizing engagement. 

By addressing these considerations head‑on, practices can build a robust hybrid care model that meets the evolving needs of patients and providers alike, offering the convenience of virtual visits alongside the trusted relationships and hands‑on care that define modern medicine.

Photo: elenabs, Getty Images

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Hari Prasad(Opens in a new window)

Hari Prasad (Opens in a new window)is Founder and CEO of Yosi Health (Opens in a new window), a leading provider of digital front-door automation solutions, He brings over a decade of experience in transforming practice workflows to improve access and patient engagement.

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Orthopaedic Industry Peers Validate Yosi’s Digital Front‑door Automation for Boosting Practice Efficiency, Productivity, and Patient Experience

NEW YORK, April 29, 2025 /PRNewswire/ — Yosi Health, a provider of digital patient scheduling, registration, payment, and communication cloud-based software solutions, today announced it has earned Peer Reviewed™ recognition from the American Alliance of Orthopaedic Executives’ (AAOE) Peer Review Program. This distinction underscores Yosi Health’s commitment to advancing front‑office efficiency and enhancing the patient experience in orthopaedic and musculoskeletal practices.

After undergoing AAOE’s rigorous 11-step evaluation, Yosi Health’s Digital Front Door Automation Platform received exceptionally positive feedback from peer administrators:

• 92% of reviewers said they would recommend the platform to colleagues
• 100% agreed the platform enhanced individual and organizational productivity

“Our mission has always been to streamline administrative workflows so practices can focus on patient care,” said Hari Prasad, Founder and CEO of Yosi Health. “This peer‑driven validation confirms that our emphasis on intuitive design, seamless EMR integration, and measurable time savings is truly resonating with orthopaedic teams nationwide.”

Yosi Health’s platform automates key front‑office tasks—including self‑scheduling, digital patient intake, insurance eligibility verification, and pre‑visit payments—helping clinics reduce no‑shows, eliminate manual data entry, and reclaim valuable staff time. Practices leveraging Yosi routinely report:

• Up to 45% reduction in no‑shows
• 70% fewer phone calls for appointments and intake inquiries
• A 10–15x return on investment through operational efficiencies

“Peer Reviewed™ status from AAOE provides a trusted benchmark for orthopaedic administrators seeking solutions proven to deliver real value,” added Prasad. “We’re proud to join a special group of vetted vendors recognized by the professionals who use our platform every day.”

For more information about the Yosi Health Patient Management platform visit: https://www.yosi.health.

ABOUT AAOE

The American Alliance of Orthopaedic Executives was founded in 1969 and is the only nonprofit orthopaedic-management specific organization developed to serve the musculoskeletal industry. Membership includes more than 1,200 orthopaedic practice executives, administrators, physicians, and their staff. AAOE provides education, community, and resources to set the standard of professional knowledge and industry insight. Orthopedic industry professionals can read more about the program in the informational toolkit, and begin the application here. For questions about AAOE or the Peer Review Program™, contact Addy Kujawa, CEO, akujawa@aaoe.net.

About Yosi Health

Yosi Health is the leading patient engagement and workflow automation platform for busy clinics and care centers. Pioneering remote patient engagement since 2015, Yosi Health has been successfully reducing the cost of care for healthcare providers while improving patient outcomes.

Our award-winning, customizable, and cloud-based solutions are powering medical practices across all 50 States and is bi-directionally integrated with leading Electronic Medical Record (EMR) vendors in the US.

Yosi Health meets the highest patient privacy standards including HIPAA by being certified as SOC 2 Type 2 Security and PCI compliant in addition to being singled out as an ISV Advanced Technology Partner for Amazon Web Services (AWS); a highly selective program with stringent security requirements for induction.

Yosi Health has been recognized by its clients as Best in KLAS® 2024 Patient Intake Management vendor.

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Author(s): Hari Prasad|
Fact checked by: Austin Littrell, Afton Woodward

Key Takeaways

• Physicians face financial challenges due to rising costs and tightening insurance margins, prompting interest in new payment models.
• The pay-first model improves cash flow by collecting patient payments upfront, reducing manual collections and bad-debt write-offs.

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Innovative payment models — like pay-first and direct primary care — enhance financial stability and patient engagement for independent practices.

Hari Prasad, founder and CEO of Yosi Health

More than half of physicians (56%) report concern about their organization’s financial health, according to the 2024 Medscape Physician Compensation Report. As operating costs continue to rise while insurance margins tighten, many practices, especially independent and smaller groups, struggle with myriad challenges, including cash flow uncertainties, staff turnover and mounting administrative burdens.

Enter into this climate two emerging payment approaches that are gaining traction: the pay‑first model, which collects copays, deductibles and any postvisit balances up front, and the direct primary care (DPC) model, which replaces fee‑for‑service billing with a flat subscription fee for primary care services. Each offers distinct advantages, yet both share the goal of improving practice stability and streamlining workflows.

The pay-first model

Under the pay‑first model, practices prompt patients to settle their financial responsibilities such as copays and estimated deductibles before or at check‑in via a secure interface that is compliant with payment card security standards. Once the insurer processes the claim, any remaining patient responsibility is automatically charged to the credit card on file, drastically reducing manual collections and bad‑debt write‑offs. Outstanding balances from previous visits can also be settled proactively, preventing them from slipping into long‑term receivables.

From a provider’s perspective, this shift to point‑of‑service collections leads to a more predictable cash flow and lower accounts receivable days. Front desk and billing teams spend significantly less time chasing unpaid bills and more on patient engagement, and many of these practices report no-show reductions ranging from 25% to 45%.

“Collecting copays and deductibles before appointments means our billing team spends far less time on follow‑up, and we’ve been able to reinvest resources into patient retention initiatives,” reports Shine John, DPM, of Shine Foot and Ankle Center in Austin, Texas. For patients, up-front payment offers enhanced cost transparency, which means no more surprises when they receive a statement and the convenience of settling balances on a mobile portal days before their visit. This allows them to focus on in-person, face‑to‑face time on their health concerns rather than paperwork.

Direct primary care model

While pay‑first optimizes the traditional fee‑for‑service framework, the DPC model reimagines primary care financing entirely. Under DPC, patients pay a flat monthly or annual subscription, often between $50 and $100 per person, that covers most in‑office services, from preventive exams and chronic disease management to same‑day appointments, basic labs and administrative support.

This subscription revenue provides practices with stable, recurring cash flow that is not subject to insurance processing delays or denials. Without the need to submit claims for routine visits, administrative teams can redirect their efforts toward care coordination, patient outreach and practice growth rather than coding and appeals.

Patients, in turn, benefit from eliminated copays and coinsurance for covered primary care services, predictable budgeting and more accessible care: Many DPC practices guarantee same‑day or next‑day appointments, 24/7 messaging and extended visits that foster deeper physician‑patient relationships.

Those patients typically maintain traditional insurance for services outside the primary care scope, such as hospitalizations and specialist procedures, making DPC an attractive complement to high‑deductible plans or for those without coverage.

Which model is right for your practice?

Deciding which model to adopt depends on a practice’s patient demographics and strategic priorities. Pay‑first is well suited for practices that wish to retain insurance partnerships while reducing billing lag and minimizing outstanding patient balances.

It represents a gradual shift toward patient‑centered payment without abandoning fee‑for‑service entirely. DPC, by contrast, appeals to practices aiming to offer a white‑glove, relationship‑driven experience: Smaller patient panels enable more time per visit, and subscription revenue frees physicians to innovate in care delivery.

Regardless of the path chosen, clear communication is essential. Practices must articulate which services are covered, when payments are due and any remaining out‑of‑pocket costs. Implementing either model also requires robust digital tools — such as integrated patient portals, automated reminders and secure payment interfaces — to ensure seamless eligibility checks, billing coordination and patient record continuity.

Continuous measurement of key metrics, such as revenue stability, no‑show rates, patient satisfaction and administrative time saved, enables practices to refine pricing tiers, panel sizes and workflows. Furthermore, understanding legal and regulatory considerations is critical: DPC practices must navigate state direct‑contracting laws, while pay‑first models must comply with federal and commercial payer requirements for telehealth and billing.

The health care industry is moving toward payment models that prioritize transparency, predictability and patient engagement. The pay‑first approach offers a pragmatic enhancement to existing fee‑for‑service practices, while DPC delivers a more fundamental transformation of the primary care experience. By selecting the model that aligns with their patients’ needs and investing in clear communication, integrated technology and ongoing evaluation, practices can achieve both financial sustainability and a superior patient experience — ultimately strengthening the delivery of care in today’s ever‑evolving landscape.

Hari Prasad is the founder and CEO of Yosi Health, a digital front‑office automation platform that enables health care practices to streamline patient engagement, simplify billing workflows and optimize revenue cycle management.

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