Cash-pay primary care is growing. Concierge medicine, direct primary care, executive health programs, and preventive care memberships all collect payment directly from patients. These practices need an EMR built for direct payment — not an insurance billing workflow dressed up as a primary care platform. Brooke is $99 a month flat with no per-provider fees.
Cash-pay primary care encompasses several models that share one characteristic: the patient pays the physician directly without routing payment through an insurer. These practices typically offer what insurance-billed primary care does not — longer appointments, same-day access, comprehensive preventive care, and a deeper patient-physician relationship.
Concierge physicians charge an annual or monthly retainer for a limited panel of patients with premium access — same-day appointments, direct physician communication, longer visits, and comprehensive care coordination. The billing model is a retainer, not a per-visit claim. The software needs to handle that model directly.
Executive health practices offer comprehensive annual assessments, preventive screenings, and ongoing wellness management to a high-income patient base. The visit is typically sold as an annual package — a full-day or half-day comprehensive evaluation — billed as a single direct payment at booking.
Cash-pay primary care practices focused on preventive medicine, longevity optimization, and proactive health management charge directly for comprehensive assessments, advanced lab panels, and ongoing health coaching. These are panel-based relationships billed through membership or package models.
DPC internists and primary care physicians charge a flat monthly membership for unlimited primary care access. The simplicity of the model — no claims, no coding, no denials — is the product. The software should be equally simple: direct billing, direct documentation, direct checkout.
Each of these cash-pay primary care models collects payment directly from patients and operates the same Brooke workflow: intake, documentation, billing, and checkout without an insurance layer.
Annual or monthly retainer with a limited patient panel and premium access. Recurring billing on card on file, comprehensive intake, and detailed visit documentation for long-term patient relationships.
Annual executive health packages priced as a single direct payment. Comprehensive assessment documentation, package billing at enrollment, and follow-up care scheduling through one platform.
Cash-pay practices focused on biological age assessment, advanced diagnostics, and longevity optimization. Membership billing, detailed clinical documentation, and in-office infusion or supplement tracking.
Cash-pay internists who address chronic conditions through root-cause approaches — nutrition, hormones, gut health, and lifestyle. Longer visits, recurring care relationships, and direct-pay billing for each session.
DPC internists and primary care physicians with monthly membership panels. Recurring card-on-file billing, unlimited visit scheduling, and direct checkout for additional services beyond the membership.
Cash-pay primary care that combines conventional and integrative approaches — nutrition, IV therapy, supplementation, and hormone optimization alongside general primary care on a direct-payment model.
Concierge and DPC practices bill the same patient the same amount on the same cycle every month or year. The software needs to store a card on file and run that charge automatically
without a manual step. Brooke's card-on-file recurring billing handles this without a separate billing platform or a manual invoice process.
A concierge or executive health patient intake covers medical history, family history, lifestyle, current medications, and health goals in depth. This intake should be completed digitally before the first appointment so the physician spends the appointment on assessment and relationship, not data collection. Brooke sends intake forms automatically when a patient is booked.
A concierge primary care patient is seen multiple times per year over multiple years. The treatment record for each visit needs to sit alongside the full visit history in one chart, accessible at the next appointment without searching through a separate archive. Brooke's patient profiles store the complete visit history in one place from the first appointment forward.
An executive health annual assessment is sold as a package — billed once at enrollment, not coded and claimed per service rendered. Brooke's package billing handles the annual program fee, the additional service checkout, and recurring follow-up billing through the same system without a separate billing workflow for each billing type.
Cash-pay primary care practices that perform in-office infusions, dispense supplements, or administer medications in-office need inventory tracking and lot number capture for every product used. Brooke tracks in-office product inventory automatically, with low-stock alerts before the practice runs out of a high-use item.
Card-on-file recurring charges for monthly and annual memberships. Package billing for executive health programs and wellness assessments. Per-visit checkout for additional services. All in one platform without a separate billing system.
Detailed patient intake forms covering medical and family history, current medications, lifestyle factors, and health goals — sent automatically before the first appointment and available in the chart from every subsequent visit.
Provider-specific calendars, online booking, and automated reminders for a recurring patient panel. Same-day access scheduling and advance appointment booking through one calendar system that handles both.
Visit-by-visit treatment records stored in the patient's chart alongside the complete visit history. A concierge physician who sees a patient four times per year has every prior visit in one chart view at the next appointment.
Medications, supplements, and IV supplies dispensed or administered in-office tracked automatically with lot number capture. Low-stock alerts before the practice runs out of high-use products.
Revenue per provider, rebooking and retention rate, average spend per visit, and revenue per service type — updated live. The numbers a cash-pay primary care practice owner uses to manage panel size and service expansion decisions.
A cash-pay primary care practice tracks its health through different numbers than an insurance-billed practice. Panel retention, average revenue per member, and service utilization tell the practice whether the model is working and where to focus growth effort.
What percentage of concierge or DPC members renew their membership each cycle. For a cash-pay primary care practice, panel retention is the primary revenue stability metric. A high-quality patient relationship should translate directly into high renewal rates. Tracking this number tells the practice whether it is delivering on that relationship.
Which physicians in the practice are generating the most revenue from their panels and additional services. For a multi-physician concierge group, this informs panel size allocation and capacity planning for adding a new physician to the group.
How much the average patient spends per appointment beyond their membership or retainer fee. For a cash-pay primary care practice that offers additional services — in-office infusions, supplements, procedures, or wellness add-ons — average spend per visit tracks whether those services are being used.
Which service categories generate the most revenue. A concierge practice considering expanding into IV therapy, longevity testing, or an in-office procedure category uses this report to understand what the existing patient panel values and what new services are most likely to generate uptake.
A cash-pay primary care practice that charges monthly or annual membership fees depends on patient retention in a way that per-visit billing practices do not. A member who does not schedule regular visits is a member at risk of not renewing. Brooke's automated reminders and rebooking tools help keep the panel active without a manual outreach process.
Brooke sends automated reminders before each scheduled appointment and can send follow-up messages to patients who have not scheduled a visit within a defined period. For a concierge practice that wants its members to use the access they are paying for, automated outreach keeps the panel engaged without a staff member manually tracking inactive patients.
Brooke tracks rebooking rate automatically — the percentage of patients who schedule a follow-up visit. For a membership-based primary care practice, this number tells the physician whether panel members are staying engaged with care. A rebooking rate below target is an early indicator that member retention may be at risk before renewals fail to renew.
A solo concierge physician and a four-provider DPC group practice pay the same $99 per location. No per-physician fees, no appointment caps, no insurance billing overhead.
Per location
Concierge, DPC, executive health, and preventive medicine practices that collect payment directly from patients do not need a claims workflow. Brooke is built for direct payment, and that is all it does.
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