Employers are among the most influential players in the US healthcare system, covering over 60% of people under 65 through employer-sponsored health insurance (KFF). With rising costs and dissatisfaction with traditional healthcare options, many employers are exploring innovative solutions to support their workforce. This shift presents a significant opportunity for cash-pay practices to partner with employers, offering direct access to quality care and personalized services that address gaps in the current system.

In this post, we’ll explore the growing trends and opportunities for cash-pay providers looking to tap into the employer market to accelerate their practice growth.

The current state of employer-sponsored healthcare

Employer-sponsored healthcare is getting more expensive yet less valuable every year. Over the past five years, family coverage premiums have surged by 22%, outpacing inflation and reaching nearly $24,000 in 2023 (KFF). Despite these rising costs, 60% of insured employees experienced issues with their coverage in the last year, with common problems including unexpected payment shortfalls and difficulty accessing in-network providers(KFF).

Frustrated with high costs and inadequate care, many employers are now turning to alternative solutions, such as point solutions (e.g., Sword Health for MSK, Livongo for diabetes, Lyra for mental health) and care navigation (e.g., Accolade, Garner Health).

Increasingly, they’re also exploring direct partnerships with independent providers—creating a promising opportunity for cash-pay practices to offer more accessible, high-quality care to employees.

Employer interest in cash-pay practices

Employer interest in cash-pay practices has been growing steadily, with three areas showing the most promise:

Interest in direct primary care

Direct primary care is a rapidly expanding model where patients pay a monthly membership (typically $75-$150) for unlimited access to a trusted primary care provider. Employers are increasingly recognizing the value of this model, with DPC employer sponsorships increasing by 800% from 2017 to 2022, and 45% of all DPC memberships in 2022 being employer-sponsored (Hint Employer Trends in DPC 2023).

This trend signals a significant opportunity for DPC providers to incorporate an employer-focused strategy into their growth plans.

Interest in GLP-1s

As obesity rates continue to rise, weight management has become a priority for employers. With 74% of adults in the US classified s overweight or obese (CDC) and 44% of employees willing to switch jobs for obesity treatment coverage (Obesity Action Coalition), employers are increasingly considering GLP-1 medications. Notably, 43% of employers plan to cover GLP-1s in 2024, up from 25% in 2023 (Noom).

However, the traditional healthcare system struggles to address the obesity epidemic effectively. This creates a window for cash-pay providers to offer affordable weight management solutions through compounding pharmacies, helping employers tackle a major healthcare concern.

Interest in women’s health

Employers are increasingly investing in women's health, with 46% now offering at least one specialized benefit, a notable rise from 37% in 2023 (UHC). This heightened interest also extends to menopause support, where the share of large organizations providing or planning to provide menopause benefits jumped from 4% in 2022 to 15% in 2023 (Mercer).

Cash-pay practices have an excellent chance to partner with employers by providing personalized care in areas like menopause management, reproductive health, and hormone therapy.

These trends highlight a growing willingness among employers to explore direct partnerships with cash-pay providers, making now an ideal time for practices to engage with this market.

Ways to partner with employers

For cash-pay providers specializing in direct primary care, weight management, or hormone therapy, partnering with employers can be a powerful way to grow your practice. Here are a couple effective partnership models:

1. Subsidized memberships: Offer a discounted membership where the employer covers a portion (10%-100%) of the monthly fee for enrolled employees. This option works well for employers who don't offer traditional health insurance but still want to provide access to quality care. Consider offering an additional 5-15% discount on your usual membership fees as an added incentive.

2. Group discounts: Negotiate a group rate once five or more employees enroll. This approach suits employers who aren’t ready to contribute financially but see value in your services. They act as a distribution partner, informing employees about your practice while providing an agreed-upon discount (up to 15%) once the enrollment threshold is met.

By tailoring your approach to meet employer needs, you can create mutually beneficial partnerships that drive growth and make your services more accessible to a wider audience.

Potential employer partners

Focusing on the right employers can be crucial for building partnerships with wellness-focused, cash-pay practices. Here's a refined approach:

1. Small (<50 employees): These companies aren't legally required to offer health insurance but often want to provide some level of health benefits. They’re easier to approach since you can manage most interested employees, making it an attractive, straightforward solution for them.

2. Local: These employers are more likely to want to support other local businesses.

3. Specific industries: While many industries are interested in membership-based preventive care, some are overrepresented, such as supply chain, hospitality, construction, healthcare, education, food service, and manufacturing. Prioritizing these sectors can lead to more success.

It’s worth noting that large employers are often interested in these types of collaborations as well. Large employers are more likely to be self-insured, meaning they pay for their employees’ healthcare themselves. As such, any cost savings from working with higher-quality, more affordable providers accrue directly to them. However, they’re often too big for one provider to serve effectively, and their workforce is often spread out geographically. Start with smaller, local employers for more manageable and impactful partnerships.

Good luck!

Partnering with employers offers a tremendous opportunity for cash-pay practices to expand their reach, enhance patient access, and create a sustainable revenue stream. By understanding the trends and needs of today’s employers, you can position your practice as a valuable solution to rising healthcare costs and gaps in care quality. Whether you’re focusing on direct primary care, weight management, or women’s health, now is the time to tap into the employer market and accelerate your growth.

If you’re ready to explore how employer partnerships can benefit your practice, let’s talk! We can help you take your practice to the next level.