Hamza Asumah, MD, MBA, MPH
The efficiency game is over. And most healthcare businesses don’t realize it yet.
For two decades, the winning formula was simple: optimize operations, increase patient throughput, consolidate back-office functions, squeeze margins. Private equity bet $58 billion on this playbook in 2024 alone. The problem? We’ve hit the ceiling.
The Efficiency Paradox
You can’t cut your way to prosperity anymore. Labor costs aren’t declining—healthcare workers know their worth in a shortage market. Real estate isn’t getting cheaper. Compliance requirements keep expanding. And patients? They’re demanding longer appointments, more personalized attention, and better communication—the opposite of efficiency optimization.
This is what economists call margin compression: revenue growth flattens while costs continue their upward march. According to Deloitte’s 2025 healthcare outlook, traditional fee-for-service models will see 2-3% annual margin erosion over the next decade unless they fundamentally transform their revenue architecture.
That’s not a recession. That’s structural obsolescence.
Three Revenue Models That Actually Work in 2035
So if squeezing pennies won’t save us, what will? Here are the emerging business models already generating sustainable profits:
1. The Subscription Health Model
Forward Health doesn’t bill insurance companies for every visit. They charge patients $149/month for unlimited access to care, digital health tools, and proactive wellness coaching. No copays. No surprise bills. Just continuous, preventive care.
The genius? When you’re not incentivized by procedure volume, you can actually keep people healthy. Fewer emergency visits. Fewer hospitalizations. Lower total cost of care. And according to Accenture, one in three Gen Z patients will willingly pay for this model by 2030.
Tia Health has built a women’s health ecosystem around this same principle. Annual memberships include primary care, gynecology, mental health support, and a dedicated care team. They’re profitable, rapidly expanding, and solving a problem the traditional system ignored.
2. Direct Employer Partnerships
Employers are hemorrhaging money on healthcare benefits. So they’re bypassing insurance entirely and contracting directly with providers for comprehensive care delivery.
This isn’t a wellness program. We’re talking full primary care, chronic disease management, behavioral health, and even surgical coordination—delivered on-site, virtually, or through dedicated clinics, funded directly by the employer.
Carbon Health and Vera Whole Health have built entire businesses around this model. For employers, it’s 20-30% cheaper than traditional insurance. For employees, it’s more convenient and accessible. For providers, it’s predictable revenue with built-in patient volume and no claims hassles.
3. Predictive Health Memberships
This is where genomics meets wearables meets AI-driven risk modeling.
Instead of treating disease, you predict it. Using continuous biometric monitoring, genetic risk profiles, and machine learning algorithms, providers identify who’s going to get sick before symptoms appear. Then they intervene early—medication adjustments, lifestyle coaching, specialist referrals—while prevention is still possible.
Deloitte projects preventive care spending will grow at 8% CAGR through 2030, outpacing nearly every other healthcare segment. The revenue shift is clear: the money’s moving from sick care to well care.
Technology: The Invisible Profit Center
None of these models work without technology as the foundation.
Genomics enables personalized interventions at scale. Wearables provide continuous health data streams. AI transforms that data into predictive insights and actionable recommendations. Digital platforms deliver care without the crushing overhead of brick-and-mortar operations.
By 2035, the most profitable healthcare organizations won’t just use technology—they’ll BE technology companies that also deliver clinical services. They’ll license their predictive models to other providers. They’ll sell their care coordination software. They’ll integrate seamlessly with insurers, employers, and health plans in ways we’re only beginning to imagine.
The Uncomfortable Truth
If you’re running a healthcare business today and betting entirely on fee-for-service volume and operational efficiency, you’re building on a crumbling foundation.
The future belongs to organizations that can:
- Build predictive, proactive care models generating recurring revenue
- Leverage technology not just for efficiency, but as an independent profit center
- Focus on keeping patients healthy, not just treating them when they’re sick
Because in 2035, the most profitable healthcare businesses won’t be the ones that see the most patients. They’ll be the ones that know their patients best—and keep them well.
Dr. Hamza Asumah 
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