The hidden costs of traditional primary care and how to avoid them
Health care costs are continuing to get more expensive. Premiums keep climbing, and for employers and employees alike, the true costs go far beyond the price tag.
That’s because the way we buy and use health insurance is layered with complexity, by design. It's difficult to navigate, easy to misunderstand, and hard to trust. And when it comes to primary care, the most essential part of healthcare, the consequences show up in unexpected ways: longer waits, surprise bills, and the people they’re meant to serve aren’t getting the care they need.
These are the hidden costs of traditional primary care, and they add up.
Hidden Cost #1: Unpredictable and unnecessary charges
The rising cost of care is hard enough, but it’s the unexpected and preventable charges that feel the most frustrating.
As reimbursement for primary care services has fallen behind inflation, many traditional PCPs have started billing for multiple issues in a single visit that historically were covered under a single charge, a practice called ‘unbundling of services’. The American Medical Association confirms that it's allowed: doctors can bill separately for both preventive and problem-related services during the same appointment.
This means when a patient comes in for an annual checkup and briefly brings up a new concern, they could be charged for two visits instead of one. And in many cases, they don’t find out until the bill arrives. Vox reports even something as simple as asking how a patient is doing emotionally can change the billing code and increase the cost.
Surprise charges aren’t the only problem. Fragmented care can also lead to unnecessary costs, like paying twice for the same test. When patients see multiple providers or switch between systems, their records don’t always follow. That can lead to duplicate lab work, imaging, or procedures - all of which drive up costs. One analysis found that duplicates make up 22% of all patient records, adding nearly $100 in extra costs each time.
How we’re different
One monthly membership fee
All concerns addressed in the same visit
Coordinated care that prevents unnecessary repeat testing
Hidden Cost #2: Time lost in the system
It takes time to get in and even more time to be seen. In 15 of the largest U.S. metro areas, the average wait to schedule a physician appointment is now 31 days - up nearly 50% since 2004. For specialists, it’s even worse: 291 days for dermatology in Portland, and 231 days for OB/GYN in Boston.
When patients finally do get in, visits often feel rushed. Traditional primary care physicians often manage about 5,000 patients and see more than 40 per day, limiting the time they can spend with each person.
How we’re different
Smaller patient panels
Quick appointment availability
Unrushed and timely visits
Hidden Cost #3: Uncertainty
Health insurance no longer feels like peace of mind. Commercial insurers are instituting rate hikes averaging over 20% in 2026— one of the highest increases in years. And as prices rise, so does anxiety: 74% of adults say they’re worried about being able to afford an unexpected medical bill. More employers are passing costs to employees through higher monthly paycheck deductions, higher copays and coinsurance, and through the use of high deductible health plans.
How we’re different
Transparent monthly pricing
No unexpected bills
Predictability that builds confidence in your care
HSA (Health Savings Account) funds can be used for membership fees
Hidden Cost #4: Avoidance that leads to bigger problems
When people avoid care because of the cost, they often end up facing consequences down the line. According to Vox, one in four adults skipped or delayed care in the past year due to cost.
These delays don’t just impact individuals, they strain the entire system. A MedPAC review found that fewer primary care visits have been accompanied by a rise in emergency department use, which is both more costly and more disruptive.
How we’re different
Unlimited visits with no additional cost
Encouragement to raise concerns early
Relationships that feel more like a health coach: supportive and proactive.
Hidden Cost #5: Erosion of trust
Even when people do get care, the experience often feels transactional. Patients often wonder whether their doctor is focused on them, or focused on documenting the visit for insurance.
And trust in insurers isn’t faring much better. The Wall Street Journal reports that UnitedHealth is under criminal investigation for alleged Medicare Advantage fraud.
Removing insurance from primary care can reduce paperwork, ease administrative complexity, and help rebuild trust in the doctor patient relationship. This shift helps providers focus more on care and less on documentation.
How we’re different
Physicians work directly for patients
No insurer interference
Transparency and continuity rebuild trust
Hidden Cost #6: Productivity and retention
For employers, it’s a concern when employees struggle to access or trust their care, because it doesn't just affect their health - it shows up in the workplace as stress, absenteeism, and turnover. Health benefits should help people thrive, not add to the burden.
According to the Primary Care Collaborative, “Higher investment in primary care is associated with lower costs, higher patient satisfaction, fewer hospitalizations and emergency department visits, and lower mortality.” And SHRM’s 2025 survey found that 88% of employers consider health-related benefits a top priority for recruitment and retention.
How we’re different
Predictable costs
Fewer absences thanks to quick appointments and house calls
Early care that prevents problems from getting worse
A healthier team that shows up ready to work
How to avoid the hidden costs
Together Health’s direct primary care model eliminates the hidden costs that frustrate patients and employers alike. With one monthly fee, unlimited access, extended hours, and unrushed visits, Together Health delivers a primary care experience that is easy to access, easy to understand, and easy to trust.
We provide a relationship that feels like having a health coach in your corner. Instead of gatekeeping care, Together Health helps patients stay healthy, supported, and confident in every step of their journey.
If you’re ready for care that’s easy to access, easy to understand, and easy to trust, we’re here.
