Authored by Charlie Lonardo VP, Digital Client Engagement
A subtle but meaningful shift hits American healthcare in January 2026: patients will be able to use their HSAs to pay for Direct Primary Care memberships and services. This simple regulatory change lowers the barrier to cash-pay care and accelerates a broader movement already underway—from primary care to pharma—toward going direct to patients. Across the system, the momentum is the same: transparency, simplicity, and choice.
Konovo’s Cash-to-Care Intelligence Tracker shows clinicians already preparing for that tilt. Patients are asking more about DPC and cash-pay models, and 78% of clinicians expect access to improve as these models expand. Yet clinicians also anticipate new fault lines: reduced access for lower-income patients, growing inequality, and confusion where direct care meets insurance-bound care.
For life sciences companies, this is not a peripheral trend—it is a structural one. As more primary care moves outside traditional insurance frameworks, prescribing behavior becomes less tethered to formularies, step edits, and prior authorizations. Autonomy widens. Variation increases. The points of influence shift from payer-driven pathways to clinician judgment and patient preference.
Direct care also compresses the distance between diagnosis and decision. In a world where prices are clearer and administrative drag is lighter, medication access programs, affordability tools, and engagement models must adapt to a more consumer-governed environment.
2026 marks the beginning of this realignment. Konovo will follow it closely. Reporting monthly on how direct care adoption evolves, how access changes, and how these movements ultimately reshape the terrain in which pharma operates.
Download Konovo’s Cash-to-Care Intelligence Tracker here.
