More Americans turn to cash-only doctors as health care costs rise [View all]
Source: Scripps News
Posted 10:47 AM, Jan 05, 2026
Affordable Care Act subsidies have officially expired, affecting tens of millions of Americans who get their insurance through the marketplace. With private and employer-sponsored plan costs also rising, more people are turning to a different kind of system — paying cash directly to their doctor. The direct primary care model, where patients pay a monthly fee for visits, is gaining momentum across the country. The American Academy of Family Physicians estimates nearly one in 10 of its members operate a direct primary care practice, a number that has tripled in just a few years.
"Eighty-nine dollars a month, unlimited, and you don't get any other bills for any other care. Totally unrestricted and unlimited," said Jacqueline Robson, vice president of member services at Hy-Vee Health Exemplar Care. Robson spoke to Scripps News during the opening of a new location in Omaha, Nebraska. The organization bills itself as the "Midwest's leading direct primary care provider," with locations in Nebraska, Iowa, Missouri and South Dakota.
The ability to spend more time with patients is what drove Dr. Rahul Iyengar to open his own direct primary care practice in Nashville, Members Health Co. "As a doctor, I want to talk to you for an hour, hour and half and that's what I do here since I'm outside the system. In the system, doctors don't get to make their schedule. You're an employee and insurance is really what dictates their schedule," Iyengar said.
Dr. Rachel Dhani, who owns House of Valor in Tampa, transitioned to direct primary care early in her career after working in a traditional hospital and insurance-based setting. "Freedom is everything. I have joy when I take care of patients and my colleagues who are in insurance-based models, they don't have joy. They are just completely drained from the administrative pressures of these insurance models and patients aren't happy," Dhani said.
Read more: https://www.scrippsnews.com/politics/health-care/more-americans-turn-to-cash-only-doctors-as-health-care-costs-rise
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