For over 16 years, we've helped healthcare professionals break free from insurance constraints to create thriving direct care practices. Our unique routine exam model ensures full Medicare/Medicaid compliance, qualifies for employer and tax-advantaged funding, and allows you to deliver exceptional world class exceptional care to patients who value your expertise.
Personal Story: When Jim Eischen sought treatment for ADHD, I encountered the broken healthcare system firsthand. My insurance required prior authorization for the safer medication, which would have cost $400 monthly out-of-pocket. I opted for Adderall at $30 instead, despite its higher addiction risk. Then came a surprise $400 bill for the assessment itself.
Total unexpected costs: $600 within two months—on top of my $3,000 monthly premium.
The US healthcare system is already a cash driven system Medicare covers only 80%, Medicaid provides limited care, and private plans shift costs to consumers through deductibles, co-pays, coinsurance and denied claims. Americans face unpredictable out-of-pocket expenses regardless of insurance status.
Our system rewards reactive care over proactive health management. Primary care and comprehensive wellness medicine receives far lower reimbursements than specialized interventions and surgeries. Healthcare professionals aren't compensated for comprehensive patient care and are only rewarded for treating disease.
Non-transparent costs force people to delay seeking care until conditions become serious, leading to worse outcomes and higher expenses. This particularly impacts those without wealth, creating a healthcare system where financial status directly correlates with lifespan.
While executive health and bespoke medicine programs have provided comprehensive preventive care to corporate leaders for decades, most Americans lack access to this model. The result is a two-tiered system that reserves the best comprehensive care for those with the most resources.
Most practice models promise freedom or better patient care, but very few deliver both without risking Medicare violations, losing HSA eligibility, or capping your revenue potential. Our approach relies on decades of Medicare/OIG guidance and three (3) federal statutes to assemble Medicare compliant and tax-advantaged direct care practice models.
| Style of Practice | Medicare Compliant | HSA/FSA Eligible | Insurance-Free Option | Preventive/Wellness Focus | Specialized Services | Sustainable Business Model |
| Executive Health Path | ✅ | ✅ | ✅ | ✅ | ✅ | ✅ |
| Direct Primary Care Path |  |
|
❌ | ✅ | ❌ | ❌ |
| Concierge Medicine Path | |
|
|
|
❌ | ❌ |
| Functional Medicine Path | |
|
✅ | ✅ | ✅ | |
| Integrative Health Path | |
|
✅ | ✅ | ✅ | |
| Specialty Care Path | |
|
✅ | ✅ | ✅ | |
| Lifestyle & Longevity Path | |
❌ | ✅ | ✅ | ✅ | |
| Obesity & Nutrition Path | |
❌ | ✅ | ✅ | ✅ | |
While Executive Health offers a premium experience, the EISCHEIN Direct Practice Path goes further, delivering:
More services. More subspecialties. More revenue.
All fully compliant and fully fundable.
No other model offers this combination.
This is the path that works.
Our model is built on decades of Medicare and OIG guidance and grounded in three key federal statutes, delivering a fully Medicare-compliant and tax-advantaged direct care practice structure.
This means that virtually any healthcare specialty can offer routine exam services on a cash basis without Medicare compliance concerns, provided they are properly structured and not billed to plans as medically necessary services.
A service is "routine" when it is pre-sold as an available annual or follow-up exam, not in reaction to or because of any specific condition or medical necessity.
None of the three federal statutes that exclude routine exams from Medicare coverage ever defined "routine" - this flexibility is both a strength and a source of confusion.
Healthcare professionals themselves determine if a service is "covered" by a plan (and therefore not part of "routine" exams) simply by following all plan requirements, coding properly, and submitting to the plan for reimbursement. If they don't do this = it's not covered.
This distinction is deceptively simple but confusing to healthcare professionals trained only in fee-for-service healthcare.
“The following services are excluded from coverage: (a) Routine physical checkups such as: Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury…” – 42 U.S.C. § 1395y(a), Social Security Act
Our Approach | Traditional Direct Care/DPC | Corporate Platforms | |
|---|---|---|---|
| Practice Ownership | You own 100% | You own your practice | Corporate ownership or control |
| Medicare Compliance | Full compliance without opting out | Often requires Medicare opt-out | Variable compliance strategies |
| Employer Funding | Qualified for HSA/FSA/HRA | Generally doesn’t qualify | Limited funding options |
| Practice Design | Custom-built bespoke medicine | Template approach | Cookie-cutter model |
| Revenue Potential | Up to 300 patients paying $5k-$50k/year=$1.5-$15 million gross revenue per year. | $400K-$750K annually | Revenue sharing with platform |
| Setup Cost | $10K flat fee | Variable | Significant percentage-based fees |
| Health Coaching Integration | Comprehensive approach | Limited offerings | Typically outsourced |
After 15 years of traditional practice, I was ready to quit medicine altogether. Jim showed me how to create a practice that aligns with my values while maintaining full compliance. Two years later, I'm working fewer hours, earning more, and providing better care.
Dr. Michael ChenYour patients are waiting for a healthcare experience that prioritizes their needs without the constraints of traditional insurance models. We can help you build a practice that delivers exceptional care while maintaining full compliance and financial viability.
Stop struggling with declining reimbursements, administrative burdens, and compliance concerns. Create the practice you’ve always wanted one that aligns with your vision while providing the stability and profitability you deserve.
Jim Eischen
Eischen DPSC LLC
2323 Locust Street
San Diego, CA 92106
619-919-5395
jim@eischenlawoffice.com
When I hired Jim Eischen last summer, I remember thinking to myself that $10k was the most I had ever spent on a lawyer or consultant at the time. I made myself feel better by thinking that 10 years from now, when I look in retrospect, I will think that concierge ophthalmology was the best thing I ever did with my business, and the $10k on Jim Eischen was the best $10k investment I ever made!
Dr. Sarah Johnson Family Medicine