The Insurance Middleman Was Never Your Friend

I’ve spent years running a rehab clinic. In that time, I’ve watched prior authorizations delay care for weeks. I’ve watched patients discharge early because they hit their insurance cap — not because they were done getting better. I’ve watched clinicians spend more time on documentation and billing compliance than on actual clinical thinking.

I’ve also spent years on the other side of that equation — consulting and advising health tech companies building the tools that enable direct-to-patient care. Telehealth platforms, remote monitoring companies, digital health startups trying to route around the traditional system. I’ve seen what those companies get right and where the pitch diverges from the reality.

The free version of this piece covered the landscape: what DTP is, what it gets right, and where it overstates its case. If you haven’t read that yet, start there.

This version goes deeper. It’s for clinic owners trying to figure out whether and how to integrate DTP into their business. It’s for healthcare executives evaluating DTP platforms as partners or competitors. And it’s for health tech founders who need to understand how the operators they’re selling to actually think about this decision.

*This post is for paid subscribers. What follows is a framework for evaluating your DTP readiness, a breakdown of the four models worth considering, and the questions I ask every clinic owner before they make a move in this direction.