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: I was billed out-of-pocket nearly $1,500 for three low-complexity primary care visits. No procedures. No advanced diagnostics. Just routine care. The charges were non-transparent, unpredictable, and completely disconnected from value. I did not simply pay them, I challenged them, but the experience confirmed what I already knew.
Fee-for-service medicine kills Americans.
Fee-for-service creates a system of hidden prices, surprise bills, administrative friction, and financial anxiety that causes people to delay care. When patients finally enter the system, they are sicker, their conditions are more advanced, and treatment is more expensive. The outcome is devastating: the United States has the most expensive healthcare system in the world and some of the worst public health outcomes of any developed nation. This is not a failure of clinicians. It is a failure of the payment model.
Healthcare has never been abstract to me. I grew up inside it. My father served as a U.S. Navy dentist and later built a private orthodontics practice in Southern California. My mother became a licensed pharmacist, worked in both independent and hospital settings, and eventually ran our family practice. Doctors, dentists, pharmacists, and their families filled my childhood. Healthcare was personal, human, and deeply familiar.
Over the next 16 years, I expected to follow the same path. Sports injuries redirected my college focus away from competitive athletics and toward pre-med and biology studies. As I reassessed my interests, my focus shifted to the liberal arts (English) major, music, and the creative arts. That path ultimately led me to law, where I became a corporate, real estate, and land-use attorney with significant trial and transactional experience focused on business planning, complex disputes, and commercial strategy, far removed, it seemed, from clinical medicine.
Healthcare pulled me back anyway.
I entered healthcare law nearly by accident 16 years ago, helping a physician leave a large, system-based concierge practice to launch an independent model. That work pushed me directly into Medicare compliance, cash-based care, concierge medicine, and retainer practices. What I encountered was not clarity, but fear, misinformation, and poorly grounded assumptions. In fact, I found pervasive confusion regarding nearly all aspects of U.S. healthcare. I concluded that if no one understands the why of U.S. healthcare, there is little chance anyone truly comprehends the how.
Over the next 16 years ago, I immersed myself in nearly every variation of U.S. cash healthcare: concierge medicine, direct primary care (DPC), executive and corporate health, functional and integrative medicine, longevity and lifestyle care, and low-fee public health education models. I watched some practices collapse financially while others generated extraordinary profits. I watched physicians burn out under one model and thrive under another. The question became unavoidable: why?
After years of research, regulatory analysis, historical study, and real-world observation, my team and I reached conclusions that remain largely absent from public discourse. The answers were not ideological. They were rooted in U.S. history, tax policy, Medicare statutes, federal guidance, economics, marketing theory, and human behavior. We identified a subscription care model tax-advantaged in the 1940s and rendered statutorily Medicare compliant with the creation of Medicare in 1965 (reinforced by federal statutes in 1996 and 2006). This model originated as a more personalized and higher-connection way to more effectively deliver life-extending healthcare that was then quietly privileged/protected as a model to enhance health for the powerful and wealthy. Today, any US healthcare model to compliantly provide any style or theory of healthcare with no need to opt out of Medicare, with plan integration flexibility, and with a full range of employer/tax advantaged funding options.
Today, my work is focused on empowering healthcare professionals to practice medicine the way they want to practice, using a proven care and compliance model that offers maximum regulatory protection, patient funding flexibility, pricing control, and insurance integration options. I work to combine a healthcare professional’s vision with proven compliance structures and business efficacy solutions.
Fee-for-service broke American healthcare.
I am committed to fixing it, one practice, one professional, and one patient relationship at a time.
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. This health care system was never designed to keep all residents in America alive, and it doesn't.
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, combined with inconveniences, force people to delay care.
While executive health and bespoke medicine programs have provided comprehensive preventive care to corporate leaders for decades, most Americans, not only lack access to this model, but this model has been maintained as a confidential privilege, secret for decades by our wealthiest Americans and our most powerful corporations.
Most practice models promise freedom or better patient care, but very few deliver both without risking Medicare violations, losing comprehensive HSA/HRA/FSA/MSA and direct employer funding, or capping your revenue potential should conclude with restricting your DPC/HSA eligibility to only $175 per patient per month funding: why would DPC one federal price control? Our approach relies on decades of OIG guidance, 3 federal statutes, 4 OIG alerts, and ERISA and Internal Revenue Code guidance rules and regulation.
| Style of Practice | Medicare Compliant | HSA/FSA/HRA/MSA Eligible and Employer Fundable | Bill healthcare insurance plans, if desired. | Preventive/Wellness Focus | Proven Proftability |
| Executive/Corporate Health | ✅ | ✅ | ✅ | ✅ | ✅ |
| Direct Primary care/DPC | ❌ | Partial/HSA only | ❌ |  |
❌ |
| Concierge Medicine Brand | |
|
✅ | |
✅ |
| Functional/Integrative Medicine (fee for service menu) | ❌ | ❌ | ❌ | ✅ | ❌ |
| Integrative Health | ✅ | ✅ | ✅ | ✅ | ✅ |
| Specialty Care | |
|
✅ | ✅ | |
| Lifestyle & Longevity (Routine Exam Model) | ✅ | ✅ | ✅ | ✅ | ✅ |
While Executive Health offers a premium experience, The EISCHEN Direct practice path delivers:
Full Medicare compliance (No reason to or benefit from opting out of Medicare full flexibility with healthcare insurance plan billing, a little more or not at all.)
Fully fundable with tax advantaged and employer payments. A proven health care solution to deliver better optimized health, proven business track record based on decades of data.
No other model offers this combination. This is the path that works.
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 at the time of contracting.
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 = covered.
If they don't do this = not covered.
This distinction is deceptively simple but confusing to healthcare professionals trained only in fee-for-service healthcare intended to retain our current health care system.
The following services are excluded from coverage: items and services that are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member.” – 42 U.S.C. 1395y(a)(1)(A), Social Security Act
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 ChenJim Eischen, Esq. is a nationally recognized legal expert with over 16 years of experience in private direct healthcare models and regulatory compliance. He has guided large provider networks, venture capital funds, national direct care enterprises, and healthcare professionals on implementing compliant direct care practice models.
Your 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.
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